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.

中文翻译：

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世贸中心相关肺损伤治疗的预测因素：一项纵向队列研究


预测职业人群肺损伤治疗的因素尚不明确。我们的目的是确定暴露于世贸中心 (WTC) 的消防员中与开始吸入皮质类固醇/长效 β 受体激动剂 (ICS/LABA) 治疗 >2 年相关的患者特征。研究对象包括 8530 名曾在世贸中心工作过的消防员。多变量逻辑回归评估了 2001 年 9 月 11 日至 2017 年 9 月 10 日期间两年以上患者特征与 ICS/LABA 治疗的关联。Cox 比例风险模型测量了 ICS/LABA 启动的高概率与实际 ICS 的关联/LABA 在后续间隔中启动。 2001年9月11日至2018年7月1日期间，1629/8530名（19.1%）消防员开始接受ICS/LABA治疗超过2年。 1 秒用力呼气量 (FEV ₁ )、喘息和呼吸困难与 ICS/LABA 治疗一致且独立相关。 2001年9月11日至2003年9月10日期间，高强度WTC暴露与ICS/LABA相关。2005年9月11日至2007年9月10日期间，ICS/LABA风险的第10个百分位与实际ICS/LABA风险增加3.32倍相关。随后 4 年开始进行 LABA。在接触过 WTC 的消防员中，FEV ₁ 、喘息和呼吸困难与延长 ICS/LABA 治疗独立相关。从治疗开始前几年的常规监测检查结果可以识别出治疗的高风险。