Smokers with COPD Had Higher Risk of Having an Accelerated Lung Function Decline Compared to Non-Smokers with COPD in a WTC Cohort on Surveillance

Details

• Journal Article:
  Occupational and Environmental Medicine. 30th Epidemiology in Occupational Health Conference (EPICOH 2025), October 6-9, 2025, Utrecht, the Netherlands
• Personal Author:
  Zhang, Zitong ; Shapiro, Moshe Z. ; Weber, Jonathan ; Doucette, John T. ; Celedón, Juan C. ; de la Hoz, Rafael E.
• Description:
  Objective: In the Mount Sinai WTC General Responders' Cohort on longitudinal health surveillance, about a third of participants who met the spirometric definition of chronic obstructive pulmonary disease (COPDspiro) have never smoked tobacco products, and we have observed less radiological emphysema. We examined the hypothesis that smoking-related COPDspiro is associated with accelerated longitudinal FEV1 decline. Methods: All study subjects participated were diagnosed with COPDspiro based on post-bronchodilator FEV1/FVC<0.7. We examined differences between participants with ever vs. never smoking on longitudinal lung function trajectory based on our previous publication[PMC7605357] and defined those with an average decrease in FEV1 larger than 62.5ml/year as an accelerated decliner. We additionally compared the effect of bronchodilator response using and a five-category bronchodilator response grading strategy[PMC6956832]. We used multivariable logistic regressions to examine the odds of an accelerated FEV1 decline trajectory between ever- vs never smoking COPDspiro groups. Results: Among the 504 subjects with COPDspiro, 181 (35.9%) never smoked. Compared with the ever smokers, nonsmokers were younger and more often of Latino/any race ethnicity. While the smokers had higher prevalence of high blood neutrophil count (>6000/mcl), the non-smokers had higher prevalence of self-reported asthma and evidence of bronchodilator responsiveness (BDR), and a higher proportion of subjects with marked BDR category (DeltaFEV1>0.26 L or 26%). Smokers had 1.56 times higher odds (95%CI 1.01-2.42) of having dyspnea, and 1.74 times higher odds (95%CI 1.05-2.89) of having an accelerated FEV1 decline compared to non-smokers. Conclusion: Among WTC responders, COPDspiro in smokers was associated with an accelerated FEV1 decline and shortness of breath compared to never smokers, while never smokers with COPD tended to have higher percentage of asthma diagnosis and a positive BDR.
• Subjects:
  Lung Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  World Trade Center; WTC; Emergency responders; Cohort studies; Longitudinal study; Lung function; Spirometry; Smoking
• Source:
  Occup Environ Med 2025 Oct; 82(Suppl 2):A130-A131
• ISSN:
  1351-0711
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Contract
• Genre:
  Abstract
• Place as Subject:
  New York ; Pennsylvania ; New York City Region [OSHA] ; Philadelphia Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  3 pdf pages
• Volume:
  82
• NIOSHTIC Number:
  nn:20071528
• Federal Fiscal Year:
  2026
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  False
• Start Date:
  20180701
• End Date:
  20210630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:71cc0f21b5df982bff49eae731c76831f194260064c1da12d6624792bfe112a5ea3456b03c7332776412cb881eed2bee76328b5f303407a1dc62e8dc6936d630
• Download URL:
  https://stacks.cdc.gov/view/cdc/259124/cdc_259124_DS1.pdf
• File Type:
  [PDF - 123.29 KB ]