Bronchodilator Response Predicts Longitudinal Improvement in Small Airway Function in World Trade Center Dust Exposed Community Members

Details

• Personal Author:
  Berger KI ; Goldring RM ; Liu M ; Pradhan D ; Reibman J ; Shao Y ; Xu N
• Description:
  The evolution of lung function, including assessment of small airways, was assessed in individuals enrolled in the World Trade Center Environmental Health Center (WTC-EHC). We hypothesized that a bronchodilator response at initial evaluation shown by spirometry or in small airways, as measured by forced oscillation technique (FOT), would be associated with improvement in large and small airway function over time. Standardized longitudinal assessment included pre and post bronchodilator (BD) spirometry (forced vital capacity, FVC; forced expiratory volume in 1 second, FEV1) and FOT (resistance at 5 Hz, R5; resistance at 5 minus 20 Hz, R5-20). Longitudinal changes were assessed using linear mixed-effects modelling with adjustment for potential confounders (median follow-up 2.86 years; 95% measurements within 4.9 years). Data demonstrated: (1) parallel improvement in airflow and volume measured by spirometry and small airway function (R5 and R5-20) measured by FOT; (2) the magnitude of longitudinal improvement was tightly linked to the initial BD response; and (3) longitudinal values for small airway function on FOT were similar to residual abnormality observed post BD at initial visit. These findings suggest presence of reversible and irreversible components of small airway injury that are identifiable at initial presentation. These results have implications for treatment of isolated small airway abnormalities that can be identified by non-invasive effort independent FOT particularly in symptomatic individuals with normal spirometry indices. This study underscores the need to study small airway function to understand physiologic changes over time following environmental and occupational lung injury. [Description provided by NIOSH]
• Subjects:
  Aging Demography Dust Environmental Exposure Lung Lung Diseases Men Mental Health Nervous System Occupational Health Respiratory Function Tests Respiratory System Respiratory Tract Diseases Risk Assessment Risk Factors Safety September 11 Terrorist Attacks Women

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• Keywords:
  Age Groups Author Keywords: Airway Physiology Demographic Characteristics Disaster Sites Dust Dust Exposure Dusts Environmental Health Exposure Levels Forced Oscillation Humans Injuries Lung Function Mental Health Monitoring Systems Pulmonary Function Pulmonary System Disorders Respiratory Function Respiratory System Disorders Risk Factors Small Airway Disease Spirometry World Trade Center WTC

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• ISSN:
  1660-4601
• Document Type:
  Text
• Funding:
  Grant ; 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:
  16
• Issue:
  8
• NIOSHTIC Number:
  nn:20055556
• Citation:
  Int J Environ Res Public Health 2019 Apr; 16(8):1421
• Contact Point Address:
  Kenneth I. Berger, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, NY 10016
• Email:
  kenneth.berger@nyumc.org
• Federal Fiscal Year:
  2019
• Performing Organization:
  New York City Health and Hospitals Corporation
• Peer Reviewed:
  True
• Start Date:
  20080929
• Source Full Name:
  International Journal of Environmental Research and Public Health
• End Date:
  20110928
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:825af4cfd6aac731eda055d874dd0b2faebcf16d1cd26fb543e28e414862cd469cf17e7c934e918a3d2225d7a33f6eaf4d66010833f43009ef9c8e1250630599
• Download URL:
  https://stacks.cdc.gov/view/cdc/213381/cdc_213381_DS1.pdf
• File Type:
  [PDF - 671.59 KB ]