Normal Lung Function and Mortality in World Trade Center Responders and National Health and Nutrition Examination Survey III Participants

Details

• Personal Author:
  Cannon MF ; Choi J ; Cohen HW ; Goldfarb DG ; Hall CB ; Prezant DJ ; Weiden MD ; Zeig-Owens RA
• Description:
  Rationale: Low FEV1 is a biomarker of increased mortality. The association of normal lung function and mortality is not well described. Objectives: To evaluate the FEV1-mortality association among participants with normal lung function. Methods: A total of 10,999 Fire Department of the City of New York (FDNY) responders and 10,901 Third National Health and Nutrition Examination Survey (NHANES III) participants, aged 18-65 years with FEV1 ≥80% predicted, were analyzed, with FEV1 percent predicted calculated using Global Lung Function Initiative Global race-neutral reference equations. Mortality data were obtained from linkages to the National Death Index. Cox proportional hazards models estimated the association between FEV1 and all-cause mortality, controlling for age, sex, race/ethnicity, smoking history, and, for FDNY, work assignment. Cohorts were followed for a maximum of 20.3 years. Measurements and Main Results: We observed 504 deaths (4.6%) of 10,999 for FDNY and 1,237 deaths (9.4% [weighted]) of 10,901 for NHANES III. Relative to FEV1 ≥120% predicted, mortality was significantly higher for FEV1 100-109%, 90-99%, and 80-89% predicted in the FDNY cohort. In the NHANES III cohort, mortality was significantly higher for FEV1 90-99% and 80-89% predicted. Each 10% higher predicted FEV1 was associated with 15% (hazard ratio, 0.85; 95% confidence interval, 0.80-0.91) and 23% (hazard ratio, 0.77; 95% confidence interval, 0.71-0.84) lower mortality for FDNY and NHANES III, respectively. Conclusions: In both cohorts, higher FEV1 is associated with lower mortality, suggesting higher FEV1 is a biomarker of better health. These findings demonstrate that a single cross-sectional measurement of FEV1 is predictive of mortality over two decades, even when FEV1 is in the normal range. [Description provided by NIOSH]
• Subjects:
  Biomarkers Cohort Studies Emergency Responders Firefighters Lung Mortality Occupational Health Respiratory System Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: FEV1 Cohort Studies Cross Sectional Studies Emergency Responders Fire Fighters Firefighters Lung Function Mortality Rates Occupational Health Pulmonary Medicine World Trade Center WTC

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• ISSN:
  1073-449X
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Contract
• 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
• Volume:
  209
• Issue:
  10
• NIOSHTIC Number:
  nn:20069721
• Citation:
  Am J Respir Crit Care Med 2024 May; 209(10):1229-1237
• Contact Point Address:
  Michael D. Weiden, M.D., M.S., Bureau of Health Services, 9 Metrotech Center, Brooklyn, NY 11201
• Email:
  michael.weiden@nyulangone.org
• Federal Fiscal Year:
  2024
• Performing Organization:
  New York University School of Medicine
• Peer Reviewed:
  True
• Start Date:
  20190701
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• End Date:
  20210630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a679c2bdd1e6d4bc8ce0cf4d5ab8fa8d60786a0a37e6d6db412b45ac65bd37290dfe00d852929fbefbbcc64f270eb0b1c1635887aaee974d2e3d5e20dd5ad8e9
• Download URL:
  https://stacks.cdc.gov/view/cdc/208089/cdc_208089_DS1.pdf
• File Type:
  [PDF - 939.25 KB ]