Post-9/11/2001 lung function trajectories by sex and race in World Trade Center-exposed New York City emergency medical service workers
Post-9/11/2001 lung function trajectories by sex and race in World Trade Center-exposed New York City emergency medical service workers
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DOI：
10.1136/oemed-2016-103619
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发表时间：
2017-03-01
影响因子：
4.9
通讯作者：
Prezant, David J.
中科院分区：
文献类型：
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作者：
Vossbrinck, Madeline;Zeig-Owens, Rachel;Prezant, David J.
目的 确定纽约市世贸中心消防局紧急医疗服务 (EMS) 工作人员在 2001 年 9 月 11 日 (9/11) 后的肺功能轨迹是否因性别或种族/民族而异。方法对 2015 年 9 月 11 日至 9/10 之间进行的肺功能测试 (PFT) 进行连续横断面研究。我们使用的数据来自常规 PFT（1 秒用力呼气量 (FEV1) 和 FEV1% 预测值），每 12-18 个月进行一次。 FEV1 和 FEV1% 预测值随着时间的推移进行评估，按性别和种族/民族分层。我们还评估了当前、以前和从不吸烟者的 FEV1 和 FEV1% 预测值。 结果 在 1817 名 EMS 工作人员中，334 名 (18.4%) 是女性，979 名 (53.9%) 自认为是白人，939 名 (51.6%) 是从不吸烟者。中位随访时间为 13.1 年 (IQR 10.5-13.6)，每人中位 PFT 次数为 11 (IQR 7-13)。 9/11 事件导致肺功能大幅下降后，肺功能没有明显恢复。在仅限于从不吸烟者的分析中，调整后的 FEV1 和 FEV1% 预测的下降轨迹对于 3 个种族/族裔群体中的男性和女性而言相对平行。同样，各组之间 FEV1 年度下降的微小差异没有临床意义。包括曾经吸烟者在内的分析基本上是相同的。结论 9/11 14 年后，大多数 EMS 工作人员仍然表现出肺功能恢复不足。然而，肺功能下降的轨迹在性别和种族/民族方面是相似的。这些发现支持对急救人员随时间推移使用常规、连续的肺功能测量，并证明与暴露相关的肺功能下降不存在性别或种族敏感性。
Objective To determine whether lung function trajectories after 9/11/2001 (9/11) differed by sex or race/ethnicity in World Trade Center-exposed Fire Department of the City of New York emergency medical service (EMS) workers.Method Serial cross-sectional study of pulmonary function tests (PFTs) taken between 9/11 and 9/10/2015. We used data from routine PFTs (forced expiratory volume in 1 s (FEV1) and FEV1% predicted), conducted at 12-18 month intervals. FEV1 and FEV1% predicted were assessed over time, stratified by sex, and race/ethnicity. We also assessed FEV1 and FEV1% predicted in current, former and never-smokers.Results Among 1817 EMS workers, 334 (18.4%) were women, 979 (53.9%) self-identified as white and 939 (51.6%) were never-smokers. The median follow-up was 13.1 years (IQR 10.5-13.6), and the median number of PFTs per person was 11 (IQR 7-13). After large declines associated with 9/11, there was no discernible recovery in lung function. In analyses limited to never-smokers, the trajectory of decline in adjusted FEV1 and FEV1% predicted was relatively parallel for men and women in the 3 racial/ethnic groups. Similarly, small differences in FEV1 annual decline between groups were not clinically meaningful. Analyses including ever-smokers were essentially the same.Conclusions 14 years after 9/11, most EMS workers continued to demonstrate a lack of lung function recovery. The trajectories of lung function decline, however, were parallel by sex and by race/ethnicity. These findings support the use of routine, serial measures of lung function over time in first responders and demonstrate no sex or racial sensitivity to exposure-related lung function decline.