Increased Pulmonary Artery Diameter Is Associated with Reduced FEV1 in Former World Trade Center Workers

Details

• Personal Author:
  Celedón JC ; de la Hoz RE ; Doucette JT ; Jeon Y ; Liu X ; Nolan A ; Reeves AP ; San José Estépar R
• Description:
  Rationale: Occupational exposures at the WTC site after September 11, 2001 have been associated with several presumably inflammatory lower airway diseases. Pulmonary arterial enlargement, as suggested by an increased ratio of the diameter of the pulmonary artery to the diameter of the aorta (PAAr) has been reported as a computed tomographic (CT) scan marker of adverse respiratory health outcomes, including WTC-related disease. In this study, we sought to utilize a novel quantitative CT (QCT) measurement of PAAr to test the hypothesis that an increased ratio is associated with FEV1 below each subject's statistically determined lower limit of normal (FEV1 < LLN). Methods: In a group of 1,180 WTC workers and volunteers, we examined whether FEV1 < LLN was associated with an increased QCT-measured PAAr, adjusting for previously identified important covariates. Results: Unadjusted analyses showed a statistically significant association of FEV1 < LLN with PAAr (35.3% vs 24.7%, P = 0.0001), as well as with height, body mass index, early arrival at the WTC disaster site, shorter WTC exposure duration, post-traumatic stress disorder checklist (PCL) score, wall area percent and evidence of bronchodilator response. The multivariate logistic regression model confirmed the association of FEV1 < LLN with PAAr (OR 1.63, 95% CI 1.21, 2.20, P = 0.0015) and all the unadjusted associations, except for PCL score. Conclusions: In WTC workers, FEV1 < LLN is associated with elevated PAAr which, although likely multifactorial, may be related to distal vasculopathy, as has been hypothesized for chronic obstructive pulmonary disease. [Description provided by NIOSH]
• Subjects:
  Emergency Responders Lung Occupational Health Respiratory Function Tests Respiratory System Respiratory Tract Diseases Safety September 11 Terrorist Attacks
• Keywords:
  Airway Obstruction Author Keywords: 2001 BMI Body Mass Index Chronic Obstructive Pulmonary Disease Computer-assisted Image Processing COPD Emergency Responders Imaging Techniques Lung Function Multidetector Computed Tomography Occupational Medicine Pulmonary Artery Rescue Workers Respiratory Function Tests Respiratory System Disorders Smoke Inhalation Smoke Inhalation Injury Spirometry World Trade Center World Trade Center Attack WTC

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• ISSN:
  1752-699X
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Contract
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; New York ; OSHA Region 1 ; OSHA Region 2 ; OSHA Region 3 ; Pennsylvania
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  13
• Issue:
  10
• NIOSHTIC Number:
  nn:20056684
• Citation:
  Clin Respir J 2019 Oct; 13(10):614-623
• Contact Point Address:
  Rafael E. de la Hoz, Division of Occupational Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, WTC HP CCE Box 1059, New York, NY 10029
• Email:
  Rafael.delaHoz@mssm.edu
• Federal Fiscal Year:
  2020
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  True
• Start Date:
  20120901
• Source Full Name:
  The Clinical Respiratory Journal
• End Date:
  20260831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:30cdc4301a208eaaf85db4b90582260dfdafadcea1406cbc03983d134cb15cd0babfc6dd6b09da4e72c518eaffe8c1d42536a483ad67a5ac14298820c5966ce3
• Download URL:
  https://stacks.cdc.gov/view/cdc/214238/cdc_214238_DS1.pdf
• File Type:
  [PDF - 156.70 KB ]