Longitudinal pulmonary function in newly hired, non-world trade center-exposed fire department city of New York firefighters

The first 5 years

Thomas K. Aldrich, Fen Ye, Charles B. Hall, Mayris P. Webber, Hillel W. Cohen, Michael Dinkels, Kaitlyn Cosenza, Michael D. Weiden, Anna Nolan, Vasilios Christodoulou, Kerry J. Kelly, David J. Prezant

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Few longitudinal studies characterize firefighters' pulmonary function. We sought to determine whether firefighters have excessive FEV 1 decline rates compared with control subjects. Methods: We examined serial measurements of FEV 1 from about 6 months prehire to about 5 years posthire in newly hired male, never smoking, non-Hispanic black and white firefighters, hired between 2003 and 2006, without prior respiratory disease or World Trade Center exposure. Similarly defined Emergency Medical Service (EMS) workers served as control subjects. Results: Through June 30, 2011, 940 firefighters (82%) and 97 EMS workers (72%) who met study criteria had four or more acceptable posthire spirometries. Prehire FEV 1 % averaged higher for firefighters than EMS workers (99% vs 95%), reflecting more stringent job entry criteria. FEV 1 (adjusted for baseline age and height) declined by an average of 45 mL/y both for firefighters and EMS workers, with Fire 2 EMS decline rate differences averaging 0.2 mL/y (CI, 2 9.2 to 9.6). Four percent of each group had FEV 1 less than the lower limit of normal before hire, increasing to 7% for firefighters and 17.5% for EMS workers, but similar percentages of both groups had adjusted FEV 1 decline rates ≥10%. Mixed effects modeling showed a significant influence of weight gain but not baseline weight: FEV1 declined by about 8 mL/kg gained for both groups. Adjusting for weight change, FEV1 decline averaged 38 mL/y for firefighters and 34 mL/y for EMS workers. Conclusions: During the first 5 years of duty, firefighters do not show greater longitudinal FEV1 decline than EMS control subjects, and fewer of them develop abnormal lung function. Weight gain is associated with a small loss of lung function, of questionable clinical relevance in this fit and active population.

Original languageEnglish (US)
Pages (from-to)791-797
Number of pages7
JournalChest
Volume143
Issue number3
DOIs
StatePublished - Mar 2013

Fingerprint

Firefighters
Emergency Medical Services
Lung
Weight Gain
Weights and Measures
Spirometry
Longitudinal Studies
Smoking

ASJC Scopus subject areas

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

Cite this

Longitudinal pulmonary function in newly hired, non-world trade center-exposed fire department city of New York firefighters : The first 5 years. / Aldrich, Thomas K.; Ye, Fen; Hall, Charles B.; Webber, Mayris P.; Cohen, Hillel W.; Dinkels, Michael; Cosenza, Kaitlyn; Weiden, Michael D.; Nolan, Anna; Christodoulou, Vasilios; Kelly, Kerry J.; Prezant, David J.

In: Chest, Vol. 143, No. 3, 03.2013, p. 791-797.

Research output: Contribution to journalArticle

Aldrich, Thomas K. ; Ye, Fen ; Hall, Charles B. ; Webber, Mayris P. ; Cohen, Hillel W. ; Dinkels, Michael ; Cosenza, Kaitlyn ; Weiden, Michael D. ; Nolan, Anna ; Christodoulou, Vasilios ; Kelly, Kerry J. ; Prezant, David J. / Longitudinal pulmonary function in newly hired, non-world trade center-exposed fire department city of New York firefighters : The first 5 years. In: Chest. 2013 ; Vol. 143, No. 3. pp. 791-797.
@article{3575ad1d2dde449786104c64f9b4d6d4,
title = "Longitudinal pulmonary function in newly hired, non-world trade center-exposed fire department city of New York firefighters: The first 5 years",
abstract = "Background: Few longitudinal studies characterize firefighters' pulmonary function. We sought to determine whether firefighters have excessive FEV 1 decline rates compared with control subjects. Methods: We examined serial measurements of FEV 1 from about 6 months prehire to about 5 years posthire in newly hired male, never smoking, non-Hispanic black and white firefighters, hired between 2003 and 2006, without prior respiratory disease or World Trade Center exposure. Similarly defined Emergency Medical Service (EMS) workers served as control subjects. Results: Through June 30, 2011, 940 firefighters (82{\%}) and 97 EMS workers (72{\%}) who met study criteria had four or more acceptable posthire spirometries. Prehire FEV 1 {\%} averaged higher for firefighters than EMS workers (99{\%} vs 95{\%}), reflecting more stringent job entry criteria. FEV 1 (adjusted for baseline age and height) declined by an average of 45 mL/y both for firefighters and EMS workers, with Fire 2 EMS decline rate differences averaging 0.2 mL/y (CI, 2 9.2 to 9.6). Four percent of each group had FEV 1 less than the lower limit of normal before hire, increasing to 7{\%} for firefighters and 17.5{\%} for EMS workers, but similar percentages of both groups had adjusted FEV 1 decline rates ≥10{\%}. Mixed effects modeling showed a significant influence of weight gain but not baseline weight: FEV1 declined by about 8 mL/kg gained for both groups. Adjusting for weight change, FEV1 decline averaged 38 mL/y for firefighters and 34 mL/y for EMS workers. Conclusions: During the first 5 years of duty, firefighters do not show greater longitudinal FEV1 decline than EMS control subjects, and fewer of them develop abnormal lung function. Weight gain is associated with a small loss of lung function, of questionable clinical relevance in this fit and active population.",
author = "Aldrich, {Thomas K.} and Fen Ye and Hall, {Charles B.} and Webber, {Mayris P.} and Cohen, {Hillel W.} and Michael Dinkels and Kaitlyn Cosenza and Weiden, {Michael D.} and Anna Nolan and Vasilios Christodoulou and Kelly, {Kerry J.} and Prezant, {David J.}",
year = "2013",
month = "3",
doi = "10.1378/chest.12-0675",
language = "English (US)",
volume = "143",
pages = "791--797",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "3",

}

TY - JOUR

T1 - Longitudinal pulmonary function in newly hired, non-world trade center-exposed fire department city of New York firefighters

T2 - The first 5 years

AU - Aldrich, Thomas K.

AU - Ye, Fen

AU - Hall, Charles B.

AU - Webber, Mayris P.

AU - Cohen, Hillel W.

AU - Dinkels, Michael

AU - Cosenza, Kaitlyn

AU - Weiden, Michael D.

AU - Nolan, Anna

AU - Christodoulou, Vasilios

AU - Kelly, Kerry J.

AU - Prezant, David J.

PY - 2013/3

Y1 - 2013/3

N2 - Background: Few longitudinal studies characterize firefighters' pulmonary function. We sought to determine whether firefighters have excessive FEV 1 decline rates compared with control subjects. Methods: We examined serial measurements of FEV 1 from about 6 months prehire to about 5 years posthire in newly hired male, never smoking, non-Hispanic black and white firefighters, hired between 2003 and 2006, without prior respiratory disease or World Trade Center exposure. Similarly defined Emergency Medical Service (EMS) workers served as control subjects. Results: Through June 30, 2011, 940 firefighters (82%) and 97 EMS workers (72%) who met study criteria had four or more acceptable posthire spirometries. Prehire FEV 1 % averaged higher for firefighters than EMS workers (99% vs 95%), reflecting more stringent job entry criteria. FEV 1 (adjusted for baseline age and height) declined by an average of 45 mL/y both for firefighters and EMS workers, with Fire 2 EMS decline rate differences averaging 0.2 mL/y (CI, 2 9.2 to 9.6). Four percent of each group had FEV 1 less than the lower limit of normal before hire, increasing to 7% for firefighters and 17.5% for EMS workers, but similar percentages of both groups had adjusted FEV 1 decline rates ≥10%. Mixed effects modeling showed a significant influence of weight gain but not baseline weight: FEV1 declined by about 8 mL/kg gained for both groups. Adjusting for weight change, FEV1 decline averaged 38 mL/y for firefighters and 34 mL/y for EMS workers. Conclusions: During the first 5 years of duty, firefighters do not show greater longitudinal FEV1 decline than EMS control subjects, and fewer of them develop abnormal lung function. Weight gain is associated with a small loss of lung function, of questionable clinical relevance in this fit and active population.

AB - Background: Few longitudinal studies characterize firefighters' pulmonary function. We sought to determine whether firefighters have excessive FEV 1 decline rates compared with control subjects. Methods: We examined serial measurements of FEV 1 from about 6 months prehire to about 5 years posthire in newly hired male, never smoking, non-Hispanic black and white firefighters, hired between 2003 and 2006, without prior respiratory disease or World Trade Center exposure. Similarly defined Emergency Medical Service (EMS) workers served as control subjects. Results: Through June 30, 2011, 940 firefighters (82%) and 97 EMS workers (72%) who met study criteria had four or more acceptable posthire spirometries. Prehire FEV 1 % averaged higher for firefighters than EMS workers (99% vs 95%), reflecting more stringent job entry criteria. FEV 1 (adjusted for baseline age and height) declined by an average of 45 mL/y both for firefighters and EMS workers, with Fire 2 EMS decline rate differences averaging 0.2 mL/y (CI, 2 9.2 to 9.6). Four percent of each group had FEV 1 less than the lower limit of normal before hire, increasing to 7% for firefighters and 17.5% for EMS workers, but similar percentages of both groups had adjusted FEV 1 decline rates ≥10%. Mixed effects modeling showed a significant influence of weight gain but not baseline weight: FEV1 declined by about 8 mL/kg gained for both groups. Adjusting for weight change, FEV1 decline averaged 38 mL/y for firefighters and 34 mL/y for EMS workers. Conclusions: During the first 5 years of duty, firefighters do not show greater longitudinal FEV1 decline than EMS control subjects, and fewer of them develop abnormal lung function. Weight gain is associated with a small loss of lung function, of questionable clinical relevance in this fit and active population.

UR - http://www.scopus.com/inward/record.url?scp=84874961214&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84874961214&partnerID=8YFLogxK

U2 - 10.1378/chest.12-0675

DO - 10.1378/chest.12-0675

M3 - Article

VL - 143

SP - 791

EP - 797

JO - Chest

JF - Chest

SN - 0012-3692

IS - 3

ER -