Factors Predicting Treatment of World Trade Center-Related Lung Injury: A Longitudinal Cohort Study.
Int J Environ Res Public Health
; 17(23)2020 12 04.
Article
em En
| MEDLINE
| ID: mdl-33291671
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 (FEV1), 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, FEV1, 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.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Corticosteroides
/
Bombeiros
/
Doença Pulmonar Obstrutiva Crônica
/
Ataques Terroristas de 11 de Setembro
/
Lesão Pulmonar
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article