Background

A reduced forced vital capacity without obstruction (low FVC) is the predominant spirometric abnormality reported in workers and volunteers exposed to dust, gases, and fumes at the World Trade Center (WTC) disaster site in 2001–2002. While low FVC has been associated with obesity and metabolic syndrome, its association with WTC occupational exposures has not been demonstrated. We estimated the prevalence of this abnormality and examined its association with WTC exposure level.

Methods

Longitudinal study of the relation between arrival at the WTC site within 48 h and FVC below the lower limit of normal (FVC < LLN, with normal FEV₁/FVC ratio) at any time in 10,284 workers with at least two spirometries between 2002 and 2018. Logistic regression and linear mixed models were used for the multivariable analyses.

Results

The prevalence of low FVC increased from 17.0% (95% CI 15.4%, 18.5%) in June 2003, to 26.4% (95% CI 24.8%, 28.1%) in June 2018, and exceeded at both times that of obstruction. The rate of FVC decline was −43.7 ml/year during the study period. In a multivariable analysis adjusting for obesity, metabolic syndrome indicators, and other factors, early arrival at the WTC disaster site was significantly associated with low FVC, but only among men (OR_adj = 1.29, 95% CI 1.17, 1.43). Longitudinal FVC rate of decline did not differ by WTC site arrival time.

Conclusions

Among WTC workers, the prevalence of low FVC increased over a 16-year period. Early arrival to the WTC disaster site was significantly associated with low FVC in males.

中文翻译：

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低 FVC 肺活量模式与 WTC 职业暴露的关联。

背景

无阻塞用力肺活量降低（低 FVC）是 2001-2002 年世界贸易中心 (WTC) 灾难现场暴露于灰尘、气体和烟雾的工人和志愿者报告的主要肺活量异常。虽然低 FVC 与肥胖和代谢综合征有关，但其与世贸中心职业暴露的关系尚未得到证实。我们估计了这种异常的流行程度，并检查了它与 WTC 暴露水平的关联。

方法

对2002 年至 2018 年至少进行两次肺活量测定的 10,284 名工人在 48 小时内到达世贸中心站点与 FVC 低于正常下限（FVC < LLN，正常 FEV ₁ / FVC 比率）之间关系的纵向研究. Logistic 回归和线性混合模型用于多变量分析。

结果

低 FVC 的患病率从 2003 年 6 月的 17.0%（95% CI 15.4%, 18.5%）增加到 2018 年 6 月的 26.4%（95% CI 24.8%, 28.1%），并超过梗阻的两倍。在研究期间，FVC 下降率为 -43.7 毫升/年。在调整肥胖、代谢综合征指标和其他因素的多变量分析中，提前到达世贸中心灾难现场与低 FVC 显着相关，但仅限于男性（OR _adj  = 1.29, 95% CI 1.17, 1.43）。纵向 FVC 下降率不因世贸中心站点到达时间而异。

结论

在世贸中心工作人员中，低 FVC 的流行率在 16 年期间有所增加。提前到达世贸中心灾区与男性的低 FVC 显着相关。