Pulmonary Function Predicting Confirmed Recovery from Lower-respiratory Symptoms in World Trade Center-exposed Firefighters, 2001 to 2010

Overview

Journal Chest

Publisher Elsevier

Specialty Pulmonary Medicine

Date 2012 May 12

PMID 22576633

Citations 9

Authors

Jackie Soo

Mayris P Webber

Charles B Hall

Hillel W Cohen

Theresa M Schwartz

Kerry J Kelly

David J Prezant

Affiliations

Soon will be listed here.

Abstract

Background: We examined the relationship between pulmonary function (FEV 1 ) and confirmed recovery from three lower-respiratory symptoms (LRSs) (cough, dyspnea, and wheeze) up to 9 years after symptom onset.

Methods: The study included white and black male World Trade Center (WTC)-exposed firefighters who reported at least one LRS on a medical monitoring examination during the fi rst year after September 11, 2001. Confirmed recovery was defined as reporting no LRSs on two consecutive and all subsequent examinations. FEV 1 was assessed at the fi rst post-September 11, 2001, examination and at each examination where symptom information was ascertained. We used stratified Cox regression models to analyze FEV 1 , WTC exposure, and other variables in relation to confirmed symptom recovery.

Results: A total of 4,368 fi refighters met inclusion criteria and were symptomatic at year 1, of whom1,592 (36.4%) experienced confirmed recovery. In univariable models, fi rst post-September 11,2001, concurrent, and difference between fi rst post-September 11, 2001, and concurrent FEV 1 values were all significantly associated with confirmed recovery. In adjusted analyses, both fi rst post-September 11, 2001, FEV 1 (hazard ratio [HR], 1.07 per 355-mL difference; 95% CI, 1.04-1.10) and FEV 1 % predicted (HR, 1.08 per 10% predicted difference; 95% CI, 1.04-1.12) predicted confirmed recovery. WTC exposure had an inverse association with confirmed recovery in the model with FEV 1 , with the earliest arrival group less likely to recover than the latest arrival group (HR, 0.73;95% CI, 0.58-0.92).

Conclusions: Higher FEV 1 and improvement in FEV 1 after September 11, 2001, predicted confirmed LRS recovery, supporting a physiologic basis for recovery and highlighting consideration of spirometry as part of any postexposure respiratory health assessment.

Citing Articles

The Effect of Fire Smoke Exposure on Firefighters' Lung Function: A Meta-Analysis.

Barbosa J, Farraia M, Branco P, Alvim-Ferraz M, Martins F, Annesi-Maesano I Int J Environ Res Public Health. 2022; 19(24).

PMID: 36554677 PMC: 9779288. DOI: 10.3390/ijerph192416799.

Lung function decline before and after treatment of World Trade Center associated obstructive airways disease with inhaled corticosteroids and long-acting beta agonists.

Goldfarb D, Putman B, Lahousse L, Zeig-Owens R, Vaeth B, Schwartz T Am J Ind Med. 2021; 64(10):853-860.

PMID: 34254700 PMC: 9292780. DOI: 10.1002/ajim.23272.

Airway Disease in Rescue/Recovery Workers: Recent Findings from the World Trade Center Collapse.

Cleven K, Webber M, Zeig-Owens R, Hena K, Prezant D Curr Allergy Asthma Rep. 2017; 17(1):5.

PMID: 28181152 DOI: 10.1007/s11882-017-0670-9.

Incomplete lung recovery following sub-acute inhalation of combustion-derived ultrafine particles in mice.

Noel A, Xiao R, Perveen Z, Zaman H, Rouse R, Paulsen D Part Fibre Toxicol. 2016; 13:10.

PMID: 26911867 PMC: 4766714. DOI: 10.1186/s12989-016-0122-z.

Destruction of the World Trade Center Towers. Lessons Learned from an Environmental Health Disaster.

Reibman J, Levy-Carrick N, Miles T, Flynn K, Hughes C, Crane M Ann Am Thorac Soc. 2016; 13(5):577-83.

PMID: 26872108 PMC: 5018893. DOI: 10.1513/AnnalsATS.201509-572PS.

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