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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.

Authors :
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
Source :
International journal of environmental research and public health [Int J Environ Res Public Health] 2020 Dec 04; Vol. 17 (23). Date of Electronic Publication: 2020 Dec 04.
Publication Year :
2020

Abstract

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 (FEV <subscript>1</subscript> ), 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, FEV <subscript>1</subscript> , 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.

Details

Language :
English
ISSN :
1660-4601
Volume :
17
Issue :
23
Database :
MEDLINE
Journal :
International journal of environmental research and public health
Publication Type :
Academic Journal
Accession number :
33291671
Full Text :
https://doi.org/10.3390/ijerph17239056