Longitudinal assessment of spirometry in the world trade center medical monitoring program

Gwen S. Skloot, Clyde B. Schechter, Robin Herbert, Jacqueline M. Moline, Stephen M. Levin, Laura E. Crowley, Benjamin J. Luft, Iris G. Udasin, Paul L. Enright

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Background: Multiple studies have demonstrated an initial high prevalence of spirometric abnormalities following World Trade Center (WTC) disaster exposure. We assessed prevalence of spirometric abnormalities and changes in spirometry between baseline and first follow-up evaluation in participants in the WTC Worker and Volunteer Medical Monitoring Program. We also determined the predictors of spirometric change between the two examinations. Methods: Prebronchodilator and postbronchodilator spirometry, demographics, occupational history, smoking status, and respiratory symptoms and exposure onset were obtained at both examinations (about 3 years apart). Results: At the second examination, 24.1% of individuals had abnormal spirometry findings. The predominant defect was a low FVC without obstruction (16.1%). Between examinations, the majority of individuals did not have a greater-than-expected decline in lung function. The mean declines in prebronchodilator FEV 1 and FVC were 13 mL/yr and 2 mL/yr, respectively (postbronchodilator results were similar and not reported). Significant predictors of greater average decline between examinations were bronchodilator responsiveness at examination 1 and weight gain. Conclusions: Elevated rates of spirometric abnormalities were present at both examinations, with reduced FVC most common. Although the majority had a normal decline in lung function, initial bronchodilator response and weight gain were significantly associated with greater-than-normal lung function declines. Due to the presence of spirometric abnormalities > 5 years after the disaster in many exposed individuals, longer-term monitoring of WTC responders is essential.

Original languageEnglish (US)
Pages (from-to)492-498
Number of pages7
JournalChest
Volume135
Issue number2
DOIs
StatePublished - Feb 2009

Fingerprint

Spirometry
Bronchodilator Agents
Disasters
Lung
Weight Gain
Volunteers
Smoking
Demography

Keywords

  • Bronchodilator response
  • Occupational lung disease
  • Spirometry
  • Weight gain
  • World trade center

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Skloot, G. S., Schechter, C. B., Herbert, R., Moline, J. M., Levin, S. M., Crowley, L. E., ... Enright, P. L. (2009). Longitudinal assessment of spirometry in the world trade center medical monitoring program. Chest, 135(2), 492-498. https://doi.org/10.1378/chest.08-1391

Longitudinal assessment of spirometry in the world trade center medical monitoring program. / Skloot, Gwen S.; Schechter, Clyde B.; Herbert, Robin; Moline, Jacqueline M.; Levin, Stephen M.; Crowley, Laura E.; Luft, Benjamin J.; Udasin, Iris G.; Enright, Paul L.

In: Chest, Vol. 135, No. 2, 02.2009, p. 492-498.

Research output: Contribution to journalArticle

Skloot, GS, Schechter, CB, Herbert, R, Moline, JM, Levin, SM, Crowley, LE, Luft, BJ, Udasin, IG & Enright, PL 2009, 'Longitudinal assessment of spirometry in the world trade center medical monitoring program', Chest, vol. 135, no. 2, pp. 492-498. https://doi.org/10.1378/chest.08-1391
Skloot, Gwen S. ; Schechter, Clyde B. ; Herbert, Robin ; Moline, Jacqueline M. ; Levin, Stephen M. ; Crowley, Laura E. ; Luft, Benjamin J. ; Udasin, Iris G. ; Enright, Paul L. / Longitudinal assessment of spirometry in the world trade center medical monitoring program. In: Chest. 2009 ; Vol. 135, No. 2. pp. 492-498.
@article{506cf3448cfb44939f6af94181c3bf7f,
title = "Longitudinal assessment of spirometry in the world trade center medical monitoring program",
abstract = "Background: Multiple studies have demonstrated an initial high prevalence of spirometric abnormalities following World Trade Center (WTC) disaster exposure. We assessed prevalence of spirometric abnormalities and changes in spirometry between baseline and first follow-up evaluation in participants in the WTC Worker and Volunteer Medical Monitoring Program. We also determined the predictors of spirometric change between the two examinations. Methods: Prebronchodilator and postbronchodilator spirometry, demographics, occupational history, smoking status, and respiratory symptoms and exposure onset were obtained at both examinations (about 3 years apart). Results: At the second examination, 24.1{\%} of individuals had abnormal spirometry findings. The predominant defect was a low FVC without obstruction (16.1{\%}). Between examinations, the majority of individuals did not have a greater-than-expected decline in lung function. The mean declines in prebronchodilator FEV 1 and FVC were 13 mL/yr and 2 mL/yr, respectively (postbronchodilator results were similar and not reported). Significant predictors of greater average decline between examinations were bronchodilator responsiveness at examination 1 and weight gain. Conclusions: Elevated rates of spirometric abnormalities were present at both examinations, with reduced FVC most common. Although the majority had a normal decline in lung function, initial bronchodilator response and weight gain were significantly associated with greater-than-normal lung function declines. Due to the presence of spirometric abnormalities > 5 years after the disaster in many exposed individuals, longer-term monitoring of WTC responders is essential.",
keywords = "Bronchodilator response, Occupational lung disease, Spirometry, Weight gain, World trade center",
author = "Skloot, {Gwen S.} and Schechter, {Clyde B.} and Robin Herbert and Moline, {Jacqueline M.} and Levin, {Stephen M.} and Crowley, {Laura E.} and Luft, {Benjamin J.} and Udasin, {Iris G.} and Enright, {Paul L.}",
year = "2009",
month = "2",
doi = "10.1378/chest.08-1391",
language = "English (US)",
volume = "135",
pages = "492--498",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "2",

}

TY - JOUR

T1 - Longitudinal assessment of spirometry in the world trade center medical monitoring program

AU - Skloot, Gwen S.

AU - Schechter, Clyde B.

AU - Herbert, Robin

AU - Moline, Jacqueline M.

AU - Levin, Stephen M.

AU - Crowley, Laura E.

AU - Luft, Benjamin J.

AU - Udasin, Iris G.

AU - Enright, Paul L.

PY - 2009/2

Y1 - 2009/2

N2 - Background: Multiple studies have demonstrated an initial high prevalence of spirometric abnormalities following World Trade Center (WTC) disaster exposure. We assessed prevalence of spirometric abnormalities and changes in spirometry between baseline and first follow-up evaluation in participants in the WTC Worker and Volunteer Medical Monitoring Program. We also determined the predictors of spirometric change between the two examinations. Methods: Prebronchodilator and postbronchodilator spirometry, demographics, occupational history, smoking status, and respiratory symptoms and exposure onset were obtained at both examinations (about 3 years apart). Results: At the second examination, 24.1% of individuals had abnormal spirometry findings. The predominant defect was a low FVC without obstruction (16.1%). Between examinations, the majority of individuals did not have a greater-than-expected decline in lung function. The mean declines in prebronchodilator FEV 1 and FVC were 13 mL/yr and 2 mL/yr, respectively (postbronchodilator results were similar and not reported). Significant predictors of greater average decline between examinations were bronchodilator responsiveness at examination 1 and weight gain. Conclusions: Elevated rates of spirometric abnormalities were present at both examinations, with reduced FVC most common. Although the majority had a normal decline in lung function, initial bronchodilator response and weight gain were significantly associated with greater-than-normal lung function declines. Due to the presence of spirometric abnormalities > 5 years after the disaster in many exposed individuals, longer-term monitoring of WTC responders is essential.

AB - Background: Multiple studies have demonstrated an initial high prevalence of spirometric abnormalities following World Trade Center (WTC) disaster exposure. We assessed prevalence of spirometric abnormalities and changes in spirometry between baseline and first follow-up evaluation in participants in the WTC Worker and Volunteer Medical Monitoring Program. We also determined the predictors of spirometric change between the two examinations. Methods: Prebronchodilator and postbronchodilator spirometry, demographics, occupational history, smoking status, and respiratory symptoms and exposure onset were obtained at both examinations (about 3 years apart). Results: At the second examination, 24.1% of individuals had abnormal spirometry findings. The predominant defect was a low FVC without obstruction (16.1%). Between examinations, the majority of individuals did not have a greater-than-expected decline in lung function. The mean declines in prebronchodilator FEV 1 and FVC were 13 mL/yr and 2 mL/yr, respectively (postbronchodilator results were similar and not reported). Significant predictors of greater average decline between examinations were bronchodilator responsiveness at examination 1 and weight gain. Conclusions: Elevated rates of spirometric abnormalities were present at both examinations, with reduced FVC most common. Although the majority had a normal decline in lung function, initial bronchodilator response and weight gain were significantly associated with greater-than-normal lung function declines. Due to the presence of spirometric abnormalities > 5 years after the disaster in many exposed individuals, longer-term monitoring of WTC responders is essential.

KW - Bronchodilator response

KW - Occupational lung disease

KW - Spirometry

KW - Weight gain

KW - World trade center

UR - http://www.scopus.com/inward/record.url?scp=60249090233&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=60249090233&partnerID=8YFLogxK

U2 - 10.1378/chest.08-1391

DO - 10.1378/chest.08-1391

M3 - Article

C2 - 19141527

AN - SCOPUS:60249090233

VL - 135

SP - 492

EP - 498

JO - Chest

JF - Chest

SN - 0012-3692

IS - 2

ER -