Lung Function Trajectories in World Trade Center-Exposed New York City Firefighters Over 13 Years The Roles of Smoking and Smoking Cessation
Lung Function Trajectories in World Trade Center-Exposed New York City Firefighters Over 13 Years The Roles of Smoking and Smoking Cessation
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DOI：
10.1016/j.chest.2015.10.067
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发表时间：
2016-06-01
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：
Aldrich, Thomas K.;Vossbrinck, Madeline;Prezant, David J.
背景技术背景：在2011年9月11日之后，纽约市消防局暴露于世界贸易中心（WTC）的消防员平均丧失了10%的肺功能，并且>10%发展为新的阻塞性气道疾病。前6年几乎没有恢复（平均）。接下来十年的随访使我们能够确定长期暴露的影响以及吸烟和戒烟对肺功能轨迹的作用。方法：我们检查了从2000年3月11日至2014年9月10日的FEV 1系列测量值，其中有10，641名纽约市消防局WTC暴露的消防员，已知吸烟和体重史。结果：随访期间FEV 1测量值的中位数为9; 15%的消防员在2001年9月11日上午到达世贸中心; 65%的人从不吸烟。2001年9月11日早晨到达的消防员的平均肺功能低于暴露较少的消防员;这种差异在大多数随访期间仍然显着（P <0.05）。从不吸烟者的肺功能明显好于目前吸烟者;前吸烟者介于两者之间，这取决于他们的戒烟日期。与2001年9月13日至2001年9月24日之间到达的人相比，2001年9月11日上午到达的人更可能具有FEV 1 <正常下限（OR = 1.70，P < .01）。与从不吸烟者相比，目前吸烟者更可能有FEV 1 <正常下限2001年9月11日以前戒烟者的OR = 2.06，P <0.01 2001年9月11日至2008年3月10日期间戒烟者OR = 1.96，P <0.01（OR = 1.49，P <0.01）。2001年9月11日13年后，大多数消防员继续表现出肺功能恢复不足，随着WTC暴露和吸烟状况的不同，下降的轨迹也不同。与WTC暴露的不可改变的影响不同，我们在这个独特的职业/环境队列中证明了戒烟对肺功能的益处。
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.