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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.
- 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.
- Subjects :
- Administration, Inhalation
Adult
Cohort Studies
Drug Therapy, Combination
Forced Expiratory Volume
Humans
Longitudinal Studies
Middle Aged
Adrenal Cortex Hormones therapeutic use
Firefighters
Lung Injury drug therapy
Pulmonary Disease, Chronic Obstructive drug therapy
September 11 Terrorist Attacks
Subjects
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