Study on peak expiratory flow rate in school children from Madurai district, Tamil Nadu, India


  • Thangavel A. Department of Pediatrics, KAPV Government Medical College, Trichy, Tamil Nadu, India
  • Vairamuthu G. S. Department of Pediatrics, KAPV Government Medical College, Trichy, Tamil Nadu, India



Body surface area, Height, Peak expiratory flow rate, Weight


Background: Data on peak expiratory flow rate (PEFR) for Madurai district, Tamil Nadu, India, school children is not available. Hence, this study aims to construct predicted equations for PEFR in both sexes in the age group of 5 - 12 years according to the height as a reference.

Methods: About 961 healthy children (493 boys and 468 girls) were randomly selected from six schools of Madurai district. PEFR readings were repeated thrice and the  highest value of these 3 readings was taken as the observed PEFR. Linear regression analysis was performed using age, weight, height and body surface area (BSA) as independent variables and PEFR as the dependent variable.

Results: Statistical correlation is found between height, age, BSA, weight and PEFR in both sexes. The variables which show significant positive relationship with PEFR are height (r=0.78), age (r=0.74), BSA (r=0.73), weight(r=0.67) of which height shows the most significant correlation. The regression equation for PEFR with height is: boys: PEFR =3.12 x (height)-211.85, girls: PEFR = 3.07 x (height)- 212.3.

Conclusions: BSA needs further formula-based calculation and age may be falsely given in the school records or may be forgotten by uneducated parents. Weight is having less correlation coefficient compared to other parameters. So, this study recommends deriving predicted equation for PEFR based on height for both genders. The prediction equations for PEFR obtained in this study can be used as local reference for the follow up of children with respiratory disorders in and around Madurai district, Tamil Nadu, India.


Al-Dawood K. Peak expiratory flow rate in Saudi schoolboys at Al-Khobar City, Saudi Arabia. Saudi Med J. 2000;21(6):561-4.

Swaminathan S, Venkatesan P, Mukunth R. Peak expiratory flow rate in South Indian children. Ind Paediatr. 1993;30(2):207-11.

Andrew H Liu. Childhood asthma. Behrman RE, Kleigman RM, eds. In: Nelson’s textbook of paediatrics. 19th ed. Elsevier: Saunders company. USA. 2012;780-801.

Seaton A, Seaton D, Leiteh GA, eds. Epidemiology and respiratory diseases. In: Crofon and Douglas respirtory diseases, 4th ed. UK: Blackwell Science Oxford.1989:90.

Gardnner RM, Hankinson JL, Clausen JL, Crapo RO, Johnson RL, Epler GR. Standardization of spirometry 1987 update: statement of the American Thoracic Society. Am Rev Respir Dis. 1987;136:1285-98.

Ullah MI, Cuddhy V, Savoners KB, Addis GJ. How many blows really make an FEV1, FVC or PEFR. Thorax. 1983;38:113-8.

Kodgule RR, Singh V, Dhar R, Saicharan BG, Madas SJ, Gogtay JA, et al. Reference values for peak expiratory flow in Indian adult population using a European Union scale peak flow meter. J Postgraduate Med. 2014;60(2):123.

Jain SK, Kumar R, Sharma DA. Factors influencing peak expiratory flow rate (PEFR) in normal subjects-II. Lung Ind. 1983;1(3):92.

Sagher FA, Roushdy MA, Hweta AM. Peak, expiratory flow rate nomogram in Libyan school children. East Med Health J. 1999:5(3):560-3.

Seo WH, Ahn SH, Park SH, Kim J, Ahn KM, Ko BJ, Lee SI. The standard range of peak expiratory flow rates of Korean children. Asian Pac J Allerg Immunol. 2011;29(2):143-9.

Mahajan KK, Mahajan SK, Maini BK, Srivastava SC. Peak expiratory flow rate and its prediction formulae in Haryanavis. Indian J Physiol Pharmacol. 1984;28:319-25.

Parmar VR, Kumar L, Malik SK. Normal values of peak expiratory f low rate in healthy North Indian school children, 6-16 years of age. Indian Pediatr. 1977;14:591-4.

Singh HD, Peri S. Peak expiratory flow rate in South Indian children and adolescents. Indian Pediatr. 1978;15:473-8.

Shiyas KP, Gopi Mohan G. Factors affecting peak expiratory flow rates in children of 9-12 years of age. Int J Pediatr Res. 2017;4(11).

Paramesh H. Normal peak expirtory flow rate in urban and rural children. Indian J Pediatr. 2003;70(5):375.

Gharagozlo M, Khajooe V, Moin M, Rezvani M. Peak expiratory flow rate in healthy children from Tehran. IJMS. 2003;28(1):26-8.

Carson JWK, Hoey H, Taylor MRH. Growth and other factors affecting peak expiratory flow rate. Arch Dis Childhood. 1989;64:96-102.

Taksande A, Jain M, Vihekar K, Chadurvedi P. Peak expiratory flow rate of rural school children from Warda district, Maharashtra in India. World J Pediatr. 2008;4(3):211-4.

Malik SK, Jindal SK, Sharda PK, Banga N. Peak expiratory flow rate of healthy schoolboys from Punjab. Indian Peditr. 1981;18:517-21.

Pulickal AS, Fernandez GV. Peak expiratory flow rate in healthy rural south Indian school children preclicted from body height. Indian J Public Health. 2007:51(2):117-9.






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