Predictors of Asthma/COPD Overlap in FDNY Firefighters With World Trade Center Dust Exposure: A Longitudinal Study

Chest
Ankura SinghMichael D Weiden

Abstract

Previously healthy firefighters with World Trade Center (WTC) dust exposure developed airway disease. Risk factors for irritant-associated asthma/COPD overlap are poorly defined. This study included 2,137 WTC-exposed firefighters who underwent a clinically indicated bronchodilator pulmonary function test (BD-PFT) between 9/11/2001 and 9/10/2017. A post-BD FEV1 increase of > 12% and 200 mL from baseline defined asthma, and a post-BD FEV1/FVC ratio < 0.7 identified COPD cases. Participants who met both criteria had asthma/COPD overlap. Eosinophil levels were measured on screening blood tests performed shortly after 9/11/2001 and prior to BD-PFT; a subgroup of participants also had serum IgE and 21 cytokines measured (n = 215). Marginal Cox regression models for multiple events assessed the associations of eosinophil levels or serum biomarkers with subsequent diagnosis, with age, race, smoking, WTC exposure, first post-9/11 FEV1/FVC ratio, and BMI included as covariates. BD-PFT diagnosed asthma/COPD overlap in 99 subjects (4.6%), isolated-asthma in 202 (9.5%), and isolated-COPD in 215 (10.1%). Eosinophil concentration ≥ 300 cells/μL was associated with increased risk of asthma/COPD overlap (hazard ratio [HR], 1.85; 95% CI, 1.16-2....Continue Reading

Citations

Nov 13, 2019·Current Opinion in Pulmonary Medicine·Anand N Venkata
May 16, 2019·International Journal of Environmental Research and Public Health·Charles LiuMichael D Weiden
Sep 3, 2020·International Journal of Environmental Research and Public Health·Hilary L ColbethDavid J Prezant
Feb 19, 2020·Annals of the American Thoracic Society·Barbara PutmanMichael D Weiden
Sep 16, 2020·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Asieh HaghighiRafael E de la Hoz
Jul 1, 2020·International Journal of Environmental Research and Public Health·Angelica I TiotiuDenislava Nedeva
Dec 10, 2020·International Journal of Environmental Research and Public Health·Barbara PutmanMichael D Weiden
Feb 3, 2021·ERJ Open Research·Michael D WeidenDavid J Prezant
Jul 3, 2021·Diagnostics·Peter M A Calverley, Paul Phillip Walker
Jul 22, 2021·American Journal of Industrial Medicine·Michael D WeidenDavid J Prezant
Oct 10, 2021·Chest·Clarus Leung, Don D Sin
Oct 21, 2021·American Journal of Physiology. Lung Cellular and Molecular Physiology·Surajit DeySukhwinder Singh Sohal
Jun 27, 2021·The European Respiratory Journal·Victoria S BensonNamhee Kwon

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