Worsened Longitudinal Visit-to-Visit-FEV1-Variation and Mortality in WTC Exposed FDNY Workers: A 23-Year Landmark Analysis

Details

• Journal Article:
  Lung
• Personal Author:
  Walraedt, Marie-Helene ; Vanhauwaert, Amber ; Goldfarb, David G. ; Cohen, Hillel W. ; Prezant, David J. ; Lahousse, Lies ; Weiden, Michael D.
• Description:
  Introduction: The World Trade Center (WTC) collapse produced an inhalation disaster. Body Mass index (BMI) is a risk-factor for WTC-related lung injury. Visit-to-visit-forced-expiratory-volume-at-one-second-variation (FEV1-variation) is a mortality risk-factor in WTC-exposed Fire Department of New York (FDNY) workers. We hypothesized: worsened-FEV1-variation with greater time post-9/11/2001 will be a mortality risk-factor associated with cross sectional BMI and longitudinal weight-variation. Methods: Annual WTC-monitoring measured lung function and weight. FEV1-variation was quantified as individual-specific coefficient of variation (CV) and FEV1-slope-SEM, among 9410 WTC-exposed workers who were alive at the 1/1/2019 Landmark and had ≥ 3 FEV1-measurments early (9/12/2001 through 12/31/2009) and later (1/1/2010 through 12/31/2018). Weight-variation quantified as individual-specific weight-CV 9/12/2001 through 12/31/2018. Worsened-FEV1-variation was defined as later/early FEV1-variation ratio > 1. The outcome was all-cause mortality 1/1/2019 through 12/31/23. Cox regression assessed the 5-year mortality risk of Worsened-FEV1-variation. Logistic regression assessed covariates associated with worsened-FEV1-variation. Results: Forty-seven percent (4459/9410) of WTC-exposed FDNY-workers experienced worsened-FEV1-variation. an exposure that was associated with 40% greater 5-year mortality risk (HR = 1.40; 95% CI 1.07, 1.89) in a Cox model adjusted for landmark, age, FEV1, BMI, weight-variation, and smoking. Similarly, Worsened-FEV1-variation defined by FEV1-slope-SEM was a mortality risk factor (HR = 1.39; 95% CI 1.05, 1.83). Each 5 kg/m2 increase in BMI and each 5%CV increased weight-variation was associated with 18% and 17% greater odds of worsened-FEV1-variation (OR = 1.18; 95% CI 1.06, 1.27 and OR = 1.17; 95% CI 1.07, 1.27 respectively). Interpretation: Worsened-FEV1-variation with greater time post-9/11/2001 is a mortality risk-factor associated with obesity and weight-variation. The association of Worsened-FEV1-variation and weight-variation may reflect concurrent metabolic and pulmonary instability that increase vulnerability to death. Description provided by NIOSH
• Subjects:
  • Firefighters
  • Mortality
  • Occupational Health
  • Respiratory System
  • Safety
  • September 11 Terrorist Attacks
• Keywords:
  • World Trade Center
  • WTC
  • Emergency responders
  • Fire fighters
  • Rescue workers
  • Longitudinal study
  • Cohort studies
  • Lung function
  • Spirometry
  • Body weight
  More +
• ISSN:
  0341-2040
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  New York ; New York City Region OSHA
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  10 pdf pages
• Volume:
  204
• Issue:
  1
• NIOSHTIC Number:
  nn:20071766
• Citation:
  Lung 2026 Jun; 204(1):36
• Contact Point Address:
  Michael D. Weiden, The FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY, 11201, USA
• Email:
  Michael.Weiden@nyulangone.org
• Federal Fiscal Year:
  2026
• Performing Organization:
  New York University School of Medicine
• Peer Reviewed:
  True
• Start Date:
  2025/07/01
• End Date:
  2027/06/30
• Download URL:
  https://stacks.cdc.gov/view/cdc/259991/cdc_259991_DS1.pdf
• File Type:
  [PDF - 1.40 MB]
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:758468d15d6b989281aa87f6b71f4937d7dce12b61e147c6074869c006b41a58cc799a366af1fe6b4b0358cea883be90eed9ad8434f4dc7360c9c0977c2a8125