Factors Predicting Treatment of World Trade Center-Related Lung Injury: A Longitudinal Cohort Study

Details

• Personal Author:
  Cohen HW ; Goldfarb DG ; Hall CB ; Lahousse L ; Lancet EA ; Prezant DJ ; Putman B ; Schwartz T ; Singh A ; Vaeth B ; Webber MP ; Weiden MD ; Zeig-Owen R
• Description:
  The factors that predict treatment of lung injury in occupational cohorts are poorly defined. We aimed to identify patient characteristics associated with initiation of treatment with inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) >2 years among World Trade Center (WTC)-exposed firefighters. The study population included 8530 WTC-exposed firefighters. Multivariable logistic regression assessed the association of patient characteristics with ICS/LABA treatment for >2 years over two-year intervals from 11 September 2001-10 September 2017. Cox proportional hazards models measured the association of high probability of ICS/LABA initiation with actual ICS/LABA initiation in subsequent intervals. Between 11 September 2001-1 July 2018, 1629/8530 (19.1%) firefighters initiated ICS/LABA treatment for >2 years. Forced Expiratory Volume in 1 s (FEV1), wheeze, and dyspnea were consistently and independently associated with ICS/LABA treatment. High-intensity WTC exposure was associated with ICS/LABA between 11 September 2001-10 September 2003. The 10th percentile of risk for ICS/LABAbetween 11 September 2005-10 Septmeber 2007 was associated with a 3.32-fold increased hazard of actual ICS/LABA initiation in the subsequent 4 years. In firefighters with WTC exposure, FEV1, wheeze, and dyspnea were independently associated with prolonged ICS/LABA treatment. A high risk for treatment was identifiable from routine monitoring exam results years before treatment initiation. [Description provided by NIOSH]
• Subjects:
  Blood Cohort Studies Dust Epidemiology Firefighters Lung Occupational Health Respiratory System Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: Inhalation Therapy Blood Serum Cohort Studies Corticosteroids Dust Exposure Epidemiological Studies Fire Fighters Longitudinal Study Lung Function Lung Injury Occupational Exposure; Pulmonary Function Tests World Trade Center WTC

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• ISSN:
  1660-4601
• 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:
  17
• Issue:
  23
• NIOSHTIC Number:
  nn:20061607
• Citation:
  Int J Environ Res Public Health 2020 Dec; 17(23):9056
• Contact Point Address:
  Michael D. Weiden, Pulmonary, Critical Care and Sleep Medicine Division, Department of Medicine and Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016
• Email:
  Michael.Weiden@nyumc.org
• Federal Fiscal Year:
  2021
• Performing Organization:
  New York University School of Medicine
• Peer Reviewed:
  True
• Start Date:
  20160901
• Source Full Name:
  International Journal of Environmental Research and Public Health
• End Date:
  20190831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:0fc5bd4f2ff47acc04f3eb70ff32cef7de05e2538d67e3bb6cea268b70976aac4b49c8c4227e7ebb674f6c553fb39b2b424f4ff1f0b733b469d65746401277f3
• Download URL:
  https://stacks.cdc.gov/view/cdc/225093/cdc_225093_DS1.pdf
• File Type:
  [PDF - 750.02 KB ]