Association of low FVC spirometric pattern with WTC occupational exposures.

Area of Science:

• Environmental Health
• Occupational Medicine
• Pulmonary Medicine

Background:

• Reduced forced vital capacity (FVC) without obstruction is common in World Trade Center (WTC) responders.
• The link between WTC exposures and low FVC has not been established.
• This study investigates low FVC prevalence and its association with WTC exposure levels.

Purpose of the Study:

• To estimate the prevalence of low FVC among WTC workers.
• To examine the association between WTC exposure levels and low FVC.
• To analyze the longitudinal changes in FVC in relation to WTC exposure.

Main Methods:

• A longitudinal study of 10,284 WTC workers with at least two spirometries between 2002 and 2018.
• Assessed the relationship between early WTC site arrival (within 48 hours) and FVC below the lower limit of normal.
• Used logistic regression and linear mixed models for multivariable analyses, adjusting for obesity and metabolic syndrome indicators.

Main Results:

• The prevalence of low FVC increased from 17.0% in 2003 to 26.4% in 2018, surpassing the prevalence of obstruction.
• Early arrival at the WTC disaster site was significantly associated with low FVC in men (aOR=1.29).
• The rate of FVC decline did not differ based on WTC site arrival time.

Conclusions:

• Low FVC prevalence rose significantly among WTC workers over a 16-year period.
• Early WTC disaster site arrival is a significant risk factor for developing low FVC, particularly in males.
• These findings highlight the long-term respiratory health consequences of WTC exposure.