Physiological Daily Inhalation Rates for Free-Living Individuals Aged 2.6 Months to 96 Years Based on Doubly Labeled Water Measurements: Comparison with Time-Activity-Ventilation and Metabolic Energy Conversion Estimates

In the first part of this article, a critical review of traditional approaches used to estimate daily inhalation rates as a function of age for health risk assessment purposes shows that such rates are not totally reliable due to various biases introduced by both quantitative and qualitative deficiencies regarding certain input parameters. In the second part, the magnitude of under- and overestimations of published inhalation rates derived from each approach is described by a comparison with new sets of physiological daily inhalation rates and distribution percentile values based on total daily energy expenditures (TDEEs) measured by the doubly labeled water (DLW) method. TDEEs are derived from the analysis of deuterium (²H) and heavy oxygen-18 (¹⁸O) in urine samples by gas-isotope-ratio mass spectrometry during an aggregate period of over 20,000 days for unrestrained free-living normal-weight individuals aged 2.6 months to 96 years (n = 1252). Regarding physiological values based on DLW measurements, opposite tendencies have been observed between two sets of estimates using time-activity patterns both biased by conservative input data assumptions during sleep and light activities: most estimates based on the time-activity-ventilation approach are overestimated, whereas most of those using metabolic equivalent approach are underestimated. Erroneous food intakes have clearly lead to underestimated rates when used in daily food-energy intake (EFD) and Parameter A approaches. With the latter approach, overestimated basal metabolic rates (BMRs) used in EFD/BMR ratios contribute to the underestimation of inhalation values. Few mean daily inhalation rates and Monte Carlo simulation percentiles based on traditional approaches (57 out of 253) are close to physiological values within a gap of ± 5% or less. Aggregate errors in all estimates (in m³/day and m³/kg-day) vary from -52 to +126%. The most accurate daily inhalation rates are those based on DLW measurements with an error of about ± 5%, as calculated in previous studies for free-living males and females aged 1 month to 96 years and pregnant and lactating adolescents and women aged 11 to 55 years during real-life situations in their normal surroundings.