Quantitative CT Metrics of Injury Patterns Among WTC Workers on Different Longitudinal FEV1 Trajectory Groups

Details

• Journal Article:
  Respiratory Medicine
• Personal Author:
  Zhang, Zitong ; San José Estépar, Raul ; Doucette, John T. ; Weber, Jonathan ; Ross, James C. ; Celedón, Juan C. ; de la Hoz, Rafael E.
• Description:
  Introduction: We have demonstrated diverging FEV1 trajectories in WTC workers on longitudinal health surveillance. We performed a cohort study to investigate the association of those FEV1 trajectories with novel QCT markers of subtle lung parenchymal injury. Methods: We included WTC responders with CT scans with quantitative measurements (all as percentage of the CT-measured lung volume) of five different metrics: normal parenchyma (Norm%), high attenuation normal parenchyma (NormHA%), interstitial lung abnormality features (ILAV%), honeycombing pattern (HcV%), and emphysema. We used linear regression to calculate each subject's FEV1 slope and classified them into three distinct trajectories: 1) accelerated decline (ACCEL): < -62.5 mL/year; 2) normal decline (NORM): 0 to -30 ml/year, baseline FEV1%predicted>70% and no significant dyspnea; 3) improved: >0 mL/year. Results: Among 446 participants, 211 had ACCEL, 142 NORM, and 93 improved FEV1 trajectory. On chest CTs at an average of 7.5 years after 11-September-2001 and compared to the NORM subgroup, ACCEL and improved trajectory subgroups both had less normal lung tissue (Norm%), with ACCEL having more emphysema, and improved participants higher ILAV% and NormHA%. The values of HcV% were very low and not significantly different across groups. ACCEL had a significantly higher all-cause mortality. Conclusion: In this occupational cohort on longitudinal surveillance, accelerated lung function decline appears primarily associated with emphysema and airway disease, while lung function improvement is associated with subtle quantitative CT findings suggestive of interstitial inflammatory processes. The latter appeared largely nonprogressive at the time, as honeycombing was very infrequent and not different across trajectory subgroups.
• Subjects:
  Lung Occupational Health Pulmonary Disease, Chronic Obstructive Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: Occupational Medicine; Occupational Health; Inhalation Injury; Chronic Obstructive Pulmonary Disease; Spirometry; Cohort Study; Interstitial Lung Disease; World Trade Center Attack; 2001 World Trade Center; WTC; Longitudinal Study; Lung Function; Spirometry; Cohort Studies; Surveillance; Chronic Obstructive Pulmonary Disease; COPD; Medical Screening;
• Source:
  Respir Med 2026 May; 256:108810
• ISSN:
  0954-6111
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Contract
• Genre:
  Journal Article
• Place as Subject:
  New York ; Massachusetts ; Pennsylvania ; New York City Region [OSHA] ; Boston Region [OSHA] ; Philadelphia Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  6 pdf pages
• Volume:
  256
• NIOSHTIC Number:
  nn:20071488
• Contact Point Address:
  Rafael E. de la Hoz, Division of Occupational and Environmental Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, WTC HP CCE Box 1059, New York, NY, 10029, USA
• Email:
  Rafael.delaHoz@mssm.edu
• Federal Fiscal Year:
  2026
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  True
• Start Date:
  20120901
• End Date:
  20260831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:62495911f58ff94a87c2f0d9de9d5113864458692c7a29c8e2822485c80df3b0b1764d6fd728e4371798c317bbf7aa6640f2d8a11b37d787bf1cee5676b33c95
• Download URL:
  https://stacks.cdc.gov/view/cdc/259086/cdc_259086_DS1.pdf
• File Type:
  [PDF - 1.03 MB ]