TY - JOUR
T1 - Lung Function Trajectories in World Trade Center-Exposed New York City Firefighters over 13 Years the Roles of Smoking and Smoking Cessation
AU - Aldrich, Thomas K.
AU - Vossbrinck, Madeline
AU - Zeig-Owens, Rachel
AU - Hall, Charles B.
AU - Schwartz, Theresa M.
AU - Moir, William
AU - Webber, Mayris P.
AU - Cohen, Hillel W.
AU - Nolan, Anna
AU - Weiden, Michael D.
AU - Christodoulou, Vasilios
AU - Kelly, Kerry J.
AU - Prezant, David J.
N1 - Funding Information:
This project was supported by World Trade Center Health Program contracts (200-2011-39378 and 200-2011-39383) from the National Institute of Occupational Safety and Health.
Publisher Copyright:
© 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Background World Trade Center (WTC)-exposed Fire Department of the City of New York firefighters lost, on average, 10% of lung function after September 11, 2011, and >10% developed new obstructive airways disease. There was little recovery (on average) over the first 6 years. Follow-up into the next decade allowed us to determine the longer-term exposure effects and the roles of cigarette smoking and cessation on lung function trajectories. Methods We examined serial measurements of FEV1 from March 11, 2000, to September 10, 2014, among 10,641 WTC-exposed Fire Department of the City of New York firefighters with known smoking and body weight histories. Results The median number of FEV1 measurements during follow-up was 9; 15% of firefighters arrived at the WTC during the morning of September 11, 2001; and 65% never smoked. Firefighters arriving the morning of September 11, 2001 averaged lower lung function than did lesser exposed firefighters; this difference remained significant during most of follow-up (P <.05). Never smokers had significantly better lung function than current smokers; former smokers fell in between, depending upon their cessation date. Those arriving the morning of September 11, 2001 were more likely to have an FEV1 < lower limits of normal compared with those arriving between September 13, 2001, and September 24, 2001 (OR = 1.70, P <.01). Current smokers were more likely to have an FEV1 < lower limits of normal compared with never smokers (OR = 2.06, P <.01), former smokers who quit before September 11, 2001 (OR = 1.96, P <.01), or those who quit between September 11, 2001 and March 10, 2008 (OR = 1.49, P <.01). Conclusions Thirteen years after September 11, 2001, most firefighters continued to show a lack of lung function recovery, with the trajectory of decline differing by WTC exposure and smoking status. Unlike the immutable effect of WTC exposure, we demonstrated the benefit on lung function of smoking cessation in this unique occupational/environmental cohort.
AB - Background World Trade Center (WTC)-exposed Fire Department of the City of New York firefighters lost, on average, 10% of lung function after September 11, 2011, and >10% developed new obstructive airways disease. There was little recovery (on average) over the first 6 years. Follow-up into the next decade allowed us to determine the longer-term exposure effects and the roles of cigarette smoking and cessation on lung function trajectories. Methods We examined serial measurements of FEV1 from March 11, 2000, to September 10, 2014, among 10,641 WTC-exposed Fire Department of the City of New York firefighters with known smoking and body weight histories. Results The median number of FEV1 measurements during follow-up was 9; 15% of firefighters arrived at the WTC during the morning of September 11, 2001; and 65% never smoked. Firefighters arriving the morning of September 11, 2001 averaged lower lung function than did lesser exposed firefighters; this difference remained significant during most of follow-up (P <.05). Never smokers had significantly better lung function than current smokers; former smokers fell in between, depending upon their cessation date. Those arriving the morning of September 11, 2001 were more likely to have an FEV1 < lower limits of normal compared with those arriving between September 13, 2001, and September 24, 2001 (OR = 1.70, P <.01). Current smokers were more likely to have an FEV1 < lower limits of normal compared with never smokers (OR = 2.06, P <.01), former smokers who quit before September 11, 2001 (OR = 1.96, P <.01), or those who quit between September 11, 2001 and March 10, 2008 (OR = 1.49, P <.01). Conclusions Thirteen years after September 11, 2001, most firefighters continued to show a lack of lung function recovery, with the trajectory of decline differing by WTC exposure and smoking status. Unlike the immutable effect of WTC exposure, we demonstrated the benefit on lung function of smoking cessation in this unique occupational/environmental cohort.
KW - World Trade Center
KW - firefighting
KW - occupational lung disease
KW - pulmonary function test
KW - smoking
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U2 - 10.1016/j.chest.2015.10.067
DO - 10.1016/j.chest.2015.10.067
M3 - Article
C2 - 26836912
AN - SCOPUS:84973574835
SN - 0012-3692
VL - 149
SP - 1419
EP - 1427
JO - Diseases of the chest
JF - Diseases of the chest
IS - 6
ER -