Bronchodilator Response Predicts Longitudinal Improvement in Small Airway Function in World Trade Center Dust Exposed...

Area of Science:

• Pulmonary Medicine
• Environmental Health
• Occupational Health

Background:

• World Trade Center (WTC) environmental exposure has been linked to respiratory issues.
• Longitudinal lung function changes, particularly in small airways, require further investigation.

Purpose of the Study:

• To assess the evolution of lung function, including small airways, in WTC-EHC participants.
• To determine if initial bronchodilator response predicts longitudinal lung function improvement.

Main Methods:

• Longitudinal assessment using spirometry (FVC, FEV1) and forced oscillation technique (FOT; R5, R5-20) pre- and post-bronchodilator (BD).
• Linear mixed-effects modeling was used to analyze changes over time, adjusting for confounders.
• Median follow-up was 2.86 years, with measurements within 4.9 years.

Main Results:

• Spirometry and FOT-measured small airway function showed parallel improvement over time.
• The degree of improvement was strongly correlated with the initial BD response.
• Initial post-BD FOT values mirrored later longitudinal small airway function, indicating both reversible and irreversible injury.

Conclusions:

• Initial bronchodilator response is a key indicator of future lung function recovery in WTC-exposed individuals.
• Forced oscillation technique (FOT) can identify reversible and irreversible small airway injury, aiding in treatment strategies.
• Assessing small airway function is crucial for understanding lung injury evolution after environmental or occupational exposures.