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Pulmonary function is tested using a hand-held spirometer which measures forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) [MicroPlus Spirometer MS03, MicroMedical LTC. Kent, UK]. Two trials of each measure are collected and averaged for every participant. Raw scores from the three averaged component measures are then converted to z scores using the means and standard deviations computed from the entire cohort. A composite pulmonary function score is created by averaging the z scores for FVC, FEV1, and PEF.