Association of low FVC spirometric pattern with WTC occupational exposures.
Association of low FVC spirometric pattern with WTC occupational exposures.
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DOI：
10.1016/j.rmed.2020.106058
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发表时间：
2020-08
影响因子：
4.3
通讯作者：
Lucchini RG
中科院分区：
文献类型：
--
作者：
de la Hoz RE;Shapiro M;Nolan A;Celedón JC;Szeinuk J;Lucchini RG
2001-2002年，在世界贸易中心（WTC）灾难现场，暴露于粉尘、气体和烟雾的工人和志愿者报告的主要肺功能异常是无阻塞的用力肺活量降低（低FVC）。虽然低FVC与肥胖和代谢综合征相关，但其与WTC职业暴露的相关性尚未得到证实。我们估计了这种异常的患病率，并研究了其与WTC暴露水平的关系。在2002年至2018年期间，对10，284名至少进行了两次肺量测定的工人进行了一项纵向研究，旨在研究48小时内到达WTC现场与任何时间FVC低于正常下限（FVC<LLN，FEV 1/FVC比值正常）之间的关系。多因素分析采用Logistic回归和线性混合模型。低FVC的患病率从2003年6月的17.0%（95% CI 15.4%，18.5%）增加至2018年6月的26.4%（95% CI 24.8%，28.1%），两次均超过梗阻。研究期间FVC下降率为-43.7 ml/年。在调整肥胖、代谢综合征指标和其他因素的多变量分析中，早期到达世贸中心灾难现场与低FVC显著相关，但仅在男性中（ORadj =1.29，95%CI 1.17，1.43）。纵向FVC下降率在WTC研究中心到达时间之间没有差异。在WTC工作者中，低FVC的患病率在16年内增加。早期到达世贸中心灾难现场与男性FVC低显著相关。
A reduced forced vital capacity without obstruction (low FVC) is the predominant spirometric abnormality reported in workers and volunteers exposed to dust, gases, and fumes at the World Trade Center (WTC) disaster site in 2001–2002. While low FVC has been associated with obesity and metabolic syndrome, its association with WTC occupational exposures has not been demonstrated. We estimated the prevalence of this abnormality and examined its association with WTC exposure level. Longitudinal study of the relation between arrival at the WTC site within 48 hours and FVC below the lower limit of normal (FVC<LLN, with normal FEV1/FVC ratio) at any time in 10,284 workers with at least two spirometries between 2002 and 2018. Logistic regression and linear mixed models were used for the multivariable analyses. The prevalence of low FVC increased from 17.0% (95% CI 15.4%, 18.5%) in June 2003, to 26.4% (95% CI 24.8%, 28.1%) in June 2018, and exceeded at both times that of obstruction. The rate of FVC decline was −43.7 ml/year during the study period. In a multivariable analysis adjusting for obesity, metabolic syndrome indicators, and other factors, early arrival at the WTC disaster site was significantly associated with low FVC, but only among men (ORadj =1.29, 95% CI 1.17, 1.43). Longitudinal FVC rate of decline did not differ by WTC site arrival time. Among WTC workers, the prevalence of low FVC increased over a 16-year period. Early arrival to the WTC disaster site was significantly associated with low FVC in males.
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