Pulmonary Function Predicting Confirmed Recovery From Lower-Respiratory Symptoms in World Trade Center-Exposed Firefighters, 2001 to 2010
Pulmonary Function Predicting Confirmed Recovery From Lower-Respiratory Symptoms in World Trade Center-Exposed Firefighters, 2001 to 2010
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DOI：
10.1378/chest.11-2210
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发表时间：
2012-11-01
期刊：
影响因子：
9.6
通讯作者：
Prezant, David J.
中科院分区：
文献类型：
--
作者：
Soo, Jackie;Webber, Mayris P.;Prezant, David J.
背景资料：我们研究了肺功能（FEV 1）和确认恢复三个下呼吸道症状（LRS）（咳嗽，呼吸困难，喘息）长达9年后症状onset.Methods：该研究包括白色和黑人男性世界贸易中心（WTC）暴露消防员谁报告至少有一个LRS在2001年9月11日之后的第一年的医疗监测检查之间的关系。确认恢复定义为连续两次检查和所有后续检查均未报告LRS。在2001年9月11日之后的第一次检查和确定症状信息的每次检查时评估FEV 1。我们使用分层考克斯回归模型来分析FEV 1，WTC暴露，和其他变量确认symptom recovery.Results：共4,368消防员符合纳入标准，并在第1年有症状，其中1,592（36.4%）经历了确认的恢复。在单变量模型中，2001年9月11日之后的第一次、同期以及2001年9月11日之后的第一次与同期之间的FEV 1值的差异均与确认的恢复显著相关。在校正分析中，2001年9月11日之后的第一次，FEV 1（风险比[HR]，1.07/355 mL差异; 95% CI，1.04-1.10）和FEV1%预测值（HE，1.08/10%预测值差异; 95% CI，1.04-1.12）预测证实恢复。在FEV 1模型中，WTC暴露与确认的恢复呈负相关，最早到达组比最晚到达组恢复的可能性更小（HR，0.73; 95% CI，0.58-0.92）。2001年9月11日之后，FEV 1升高和改善，预测确认LRS恢复，支持恢复的生理学基础，并强调将肺活量测定法作为任何运动后呼吸健康评估的一部分。胸部2012; 142（5）：1244-1250
Background: We examined the relationship between pulmonary function (FEV1) and confirmed recovery from three lower-respiratory symptoms (LRSs) (cough, dyspnea, and wheeze) up to 9 years after symptom onset.Methods: The study included white and black male World Trade Center (WTC)-exposed firefighters who reported at least one LRS on a medical monitoring examination during the first year after September 11, 2001. Confirmed recovery was defined as reporting no LRSs on two consecutive and all subsequent examinations. FEV1 was assessed at the first post-September 11, 2001, examination and at each examination where symptom information was ascertained. We used stratified Cox regression models to analyze FEV1, WTC exposure, and other variables in relation to confirmed symptom recovery.Results: A total of 4,368 firefighters met inclusion criteria and were symptomatic at year 1, of whom 1,592 (36.4%) experienced confirmed recovery. In univariable models, first post-September 11, 2001, concurrent, and difference between first post-September 11, 2001, and concurrent FEV1, values were all significantly associated with confirmed recovery. In adjusted analyses, both first post-September 11, 2001, FEV1 (hazard ratio [HR], 1.07 per 355-mL difference; 95% CI, 1.04-1.10) and FEV1 % predicted (HE, 1.08 per 10% predicted difference; 95% CI, 1.04-1.12) predicted confirmed recovery. WTC exposure had an inverse association with confirmed recovery in the model with FEV1 with the earliest arrival group less likely to recover than the latest arrival group (HR, 0.73; 95% CI, 0.58-0.92).Conclusions: Higher FEV1 and improvement in FEV1 after September 11, 2001, predicted confirmed LRS recovery, supporting a physiologic basis for recovery and highlighting consideration of spirometry as part of any postexposure respiratory health assessment. CHEST 2012; 142(5):1244-1250