Interstitial Lung Disease and Progressive Pulmonary Fibrosis: A World Trade Center Cohort 20-Year Longitudinal Study

Details

• Personal Author:
  Choi J ; Cleven KL ; Cohen HW ; Goldfarb DG ; Hall CB ; Jaber N ; Mueller AK ; Nolan A ; Prezant DJ ; Salzman SH ; Schecter DE ; Vaeth B ; Weiden MD ; Zeig-Owens R
• Description:
  Purpose: World Trade Center (WTC) exposure is associated with obstructive airway diseases and sarcoidosis. There is limited research regarding the incidence and progression of non-sarcoidosis interstitial lung diseases (ILD) after WTC-exposure. ILD encompasses parenchymal diseases which may lead to progressive pulmonary fibrosis (PPF). We used the Fire Department of the City of New York's (FDNY's) WTC Health Program cohort to estimate ILD incidence and progression. Methods: This longitudinal study included 14,525 responders without ILD prior to 9/11/2001. ILD incidence and prevalence were estimated and standardized to the US 2014 population. Poisson regression modeled risk factors, including WTC-exposure and forced vital capacity (FVC), associated with ILD. Follow-up time ended at the earliest of incident diagnosis, end of study period/case ascertainment, transplant or death. Results: ILD developed in 80/14,525 FDNY WTC responders. Age, smoking, and gastroesophageal reflux disease (GERD) prior to diagnosis were associated with incident ILD, though FVC was not. PPF developed in 40/80 ILD cases. Among the 80 cases, the average follow-up time after ILD diagnosis was 8.5 years with the majority of deaths occurring among those with PPF (PPF: n = 13; ILD without PPF: n = 6). Conclusions: The prevalence of post-9/11 ILD was more than two-fold greater than the general population. An exposure-response gradient could not be demonstrated. Half the ILD cases developed PPF, higher than previously reported. Age, smoking, and GERD were risk factors for ILD and PPF, while lung function was not. This may indicate that lung function measured after respirable exposures would not identify those at risk for ILD or PPF. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Emergency Responders Firefighters Lung Lung Diseases Occupational Health Respiratory System Respiratory Tract Diseases Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: Interstitial Lung Disease Cohort Studies Emergency Medical Service Providers Emergency Responders Fire Fighters Longitudinal Study Lung Fibrosis Progressive Pulmonary Fibrosis Pulmonary Disorders Pulmonary Fibrosis Rescue Workers World Trade Center WTC

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• ISSN:
  0341-2040
• Document Type:
  Text
• Funding:
  Contract ; Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  257-267
• Volume:
  202
• Issue:
  3
• NIOSHTIC Number:
  nn:20069694
• Citation:
  Lung 2024 Jun; 202(3):257-267
• Contact Point Address:
  David J. Prezant, Bureau of Health Services, Fire Department of the City of New York, 9 Metrotech Center, Brooklyn, NY, 11201, USA
• Email:
  David.Prezant@fdny.nyc.gov
• Federal Fiscal Year:
  2024
• Performing Organization:
  New York University School of Medicine
• Peer Reviewed:
  True
• Start Date:
  20210701
• Source Full Name:
  Lung
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:c4302d18a7bab761d9a31bffdde67c764a7944226f6cab9595179c72d408e8dce2c5e243f8905bf96a17adab2a744ef18064871aa51d2bf6b060101df0c23703
• Download URL:
  https://stacks.cdc.gov/view/cdc/208071/cdc_208071_DS1.pdf
• File Type:
  [PDF - 982.98 KB ]