Normal Lung Function and Mortality inWorld Trade Center Responders and National Health and Nutrition Examination Survey III Participants

被引:5
作者
Cannon, Madeline F. [1 ,2 ]
Goldfarb, David G. [1 ,2 ,3 ]
Zeig-Owens, Rachel A. [1 ,2 ,3 ]
Hall, Charles B. [3 ]
Choi, Jaeun [3 ]
Cohen, Hillel W. [3 ]
Prezant, David J. [1 ,2 ,3 ]
Weiden, Michael D. [2 ,4 ]
机构
[1] Montefiore Med Ctr, Dept Med, Bronx, NY USA
[2] Fire Dept City New York, Bur Hlth Serv, Brooklyn, NY USA
[3] Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, Bronx, NY USA
[4] NYU, Grossman Sch Med, New York, NY USA
关键词
FEV1; pulmonary medicine; occupational health; firefighters; emergency responders; PULMONARY-FUNCTION; FUNCTION TRAJECTORIES; FUNCTION DECLINE; VASCULAR MORTALITY; BLOOD-PRESSURE; ALL-CAUSE; LIFE; POPULATION;
D O I
10.1164/rccm.202309-1654OC
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Rationale: Low FEV1 is a biomarker of increased mortality. The association of normal lung function and mortality is not well described. Objectives: To evaluate the FEV1-mortality association among participants with normal lung function. Methods: A total of 10,999 Fire Department of the City of New York (FDNY) responders and 10,901 Third National Health and Nutrition Examination Survey (NHANES III) participants, aged 18-65 years with FEV1 >80% predicted, were analyzed, with FEV1 percent predicted calculated using Global Lung Function Initiative Global race-neutral reference equations. Mortality data were obtained from linkages to the National Death Index. Cox proportional hazards models estimated the association between FEV1 and all-cause mortality, controlling for age, sex, race/ethnicity, smoking history, and, for FDNY, work assignment. Cohorts were followed for a maximum of 20.3 years. Measurements and Main Results: We observed 504 deaths (4.6%) of 10,999 for FDNY and 1,237 deaths (9.4% [weighted]) of 10,901 for NHANES III. Relative to FEV1 >120% predicted, mortality was significantly higher for FEV1 100-109%, 90-99%, and 80-89% predicted in the FDNY cohort. In the NHANES III cohort, mortality was significantly higher for FEV1 90-99% and 80-89% predicted. Each 10% higher predicted FEV1 was associated with 15% (hazard ratio, 0.85; 95% confidence interval, 0.80-0.91) and 23% (hazard ratio, 0.77; 95% confidence interval, 0.71-0.84) lower mortality for FDNY and NHANES III, respectively. Conclusions: In both cohorts, higher FEV1 is associated with lower mortality, suggesting higher FEV1 is a biomarker of better health. These findings demonstrate that a single cross-sectional measurement of FEV1 is predictive of mortality over two decades, even when FEV1 is in the normal range.
引用
收藏
页码:1229 / 1237
页数:9
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