Factors Predicting Treatment of World Trade Center-Related Lung Injury: A Longitudinal Cohort Study.

Factors Predicting Treatment of World Trade Center-Related Lung Injury: A Longitudinal Cohort Study.
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DOI:
10.3390/ijerph17239056
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发表时间:
2020-12-04
影响因子:
--
通讯作者:
Weiden MD
Weiden MD
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Putman B;Lahousse L;Goldfarb DG;Zeig-Owens R;Schwartz T;Singh A;Vaeth B;Hall CB;Lancet EA;Webber MP;Cohen HW;Prezant DJ;Weiden MD

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在职业队列中预测肺损伤治疗的因素并不明确。我们的目标是确定在世贸中心(WTC)暴露的消防员中开始使用吸入皮质类固醇/长效β-激动剂(ICS/LABA)和GT;2年的患者特征。研究人群包括8530名接触WTC的消防员。多变量Logistic回归评估了患者特征与ICS/LABA治疗的相关性,时间间隔为两年,从2001年9月11日至2017年9月10日。COX比例风险模型测量了ICS/LABA启动的高概率与随后间隔的实际ICS/LABA启动之间的关联。在2001年9月11日至2018年7月1日期间,1629/8530名(19.1%)消防员开始接受ICS/LABA治疗,为期2年。1 S用力呼气量(FEV1)、喘息和呼吸困难与ICS/LABA治疗一致且独立相关。2001年9月11日至2003年9月10日期间,高强度WTC暴露与ICS/LABA有关。2005年9月11日至2007年9月10日期间ICS/LABA的第10个百分位数的风险与随后4年实际启动ICS/LABA的风险增加了3.32倍。在接触WTC的消防员中,FEV1、喘息和呼吸困难独立地与ICS/LABA治疗时间延长有关。从治疗开始前几年的常规监测检查结果中可以看出治疗的高风险。
The factors that predict treatment of lung injury in occupational cohorts are poorly defined. We aimed to identify patient characteristics associated with initiation of treatment with inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) >2 years among World Trade Center (WTC)-exposed firefighters. The study population included 8530 WTC-exposed firefighters. Multivariable logistic regression assessed the association of patient characteristics with ICS/LABA treatment for >2 years over two-year intervals from 11 September 2001–10 September 2017. Cox proportional hazards models measured the association of high probability of ICS/LABA initiation with actual ICS/LABA initiation in subsequent intervals. Between 11 September 2001–1 July 2018, 1629/8530 (19.1%) firefighters initiated ICS/LABA treatment for >2 years. Forced Expiratory Volume in 1 s (FEV1), wheeze, and dyspnea were consistently and independently associated with ICS/LABA treatment. High-intensity WTC exposure was associated with ICS/LABA between 11 September 2001–10 September 2003. The 10th percentile of risk for ICS/LABA between 11 September 2005–10 Septmeber 2007 was associated with a 3.32-fold increased hazard of actual ICS/LABA initiation in the subsequent 4 years. In firefighters with WTC exposure, FEV1, wheeze, and dyspnea were independently associated with prolonged ICS/LABA treatment. A high risk for treatment was identifiable from routine monitoring exam results years before treatment initiation.
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