Increased Airway Wall Thickness Is Associated with Adverse Longitudinal First-Second Forced Expiratory Volume Trajectories of Former World Trade Center Workers

Details

• Personal Author:
  Bienenfeld LA ; Celedón JC ; de la Hoz RE ; Doucette JT ; Liu X ; Lynch DA ; Reeves AP ; San José Estépar R ; Wisnivesky JP
• Description:
  RATIONALE: Occupational exposures at the WTC site after September 11, 2001 have been associated with several presumably inflammatory lower airway diseases. In this study, we describe the trajectories of expiratory air flow decline, identify subgroups with adverse progression, and investigate the association of a quantitative computed tomography (QCT) imaging measurement of airway wall thickness, and other risk factors for adverse progression. METHODS: We examined the trajectories of expiratory air flow decline in a group of 799 former WTC workers and volunteers with QCT-measured (with two independent systems) wall area percent (WAP) and at least 3 periodic spirometries. We calculated individual regression lines for first-second forced expiratory volume (FEV1), identified subjects with rapidly declining and increasing ("gainers"), and compared them to subjects with normal and "stable" FEV1 decline. We used multivariate logistic regression to model decliner vs. stable trajectories. RESULTS: The mean longitudinal FEV1slopes for the entire study population, and its stable, decliner, and gainer subgroups were, respectively, - 35.8, - 8, - 157.6, and + 173.62 ml/year. WAP was associated with "decliner" status (ORadj 1.08, 95% CI 1.02, 1.14, per 5% increment) compared to stable. Age, weight gain, baseline FEV1 percent predicted, bronchodilator response, and pre-WTC occupational exposures were also significantly associated with accelerated FEV1 decline. Analyses of gainers vs. stable subgroup showed WAP as a significant predictor in unadjusted but not consistently in adjusted analyses. CONCLUSIONS: The apparent normal age-related rate of FEV1 decline results from averaging widely divergent trajectories. WAP is significantly associated with accelerated air flow decline in WTC workers. [Description provided by NIOSH]
• Subjects:
  Emergency Responders Occupational Health Respiratory Function Tests Respiratory System Respiratory Tract Diseases Safety September 11 Terrorist Attacks
• Keywords:
  Airflow Airway Obstruction Author Keywords: 2001 Chronic Bronchitis Emergency Responders Multidetector Computed Tomography Occupational Disease Rescue Workers Respiratory Function Respiratory System Disorders Smoke Inhalation Injury Spirometry Weight Factors World Trade Center World Trade Center Attack WTC

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• ISSN:
  0341-2040
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Colorado ; Massachusetts ; New York ; OSHA Region 1 ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 8 ; Pennsylvania
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  481-489
• Volume:
  196
• Issue:
  4
• NIOSHTIC Number:
  nn:20051637
• Citation:
  Lung 2018 Aug; 196(4):481-489
• Contact Point Address:
  Rafael E. de la Hoz, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, USA
• Email:
  Rafael.delaHoz@mssm.edu
• Federal Fiscal Year:
  2018
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  True
• Start Date:
  20120901
• Source Full Name:
  Lung
• End Date:
  20260831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:c1f87f16adc4a04eb23e753e9df382453ec3ac1d036112d58ff93fa5bc753921f8bea3580636a007b6a5552e4150157afc7e776b8cb5182f966f62034383855e
• Download URL:
  https://stacks.cdc.gov/view/cdc/211494/cdc_211494_DS1.pdf
• File Type:
  [PDF - 689.80 KB ]