Longitudinal pulmonary function in newly-hired, non-World Trade Center-exposed FDNY firefighters: the first 5 years.
Aldrich-TK; Ye-F; Hall-CB; Webber-MP; Cohen-HW; Dinkels-M; Cosenza-K; Weiden-MD; Nolan-A; Christodoulou-V; Kelly-KJ; Prezant-DJ
Chest 2013 Mar; 143(3):791-797
BACKGROUND: Few longitudinal studies characterize firefighters' pulmonary function. We sought to determine whether firefighters have excessive FEV1 decline rates compared with controls. METHODS: We examined serial FEV1s from ~6 months pre-hire to ~5 years post-hire in newly-hired male, never-smoking, non-Hispanic Black and White firefighters, hired between 2003-2006, without prior respiratory disease or World Trade Center exposure. Similarly-defined Emergency Medical Service (EMS) workers served as controls. RESULTS: Through 6/30/2011, 940 (82%) firefighters and 97 (72%) EMS workers who met study criteria had > / = 4 acceptable post-hire spirometries. Pre-hire FEV1% averaged higher for firefighters than EMS: 99% vs. 95%, reflecting more stringent job entry criteria. FEV1 (adjusted for baseline age & height) declined by an average of 45ml/yr both for firefighters and EMS, with Fire-EMS decline rate differences averaging 0.2 ml/yr (CI -9.2,9.6). 4% of each group had FEV1 < lower limit of normal before hire, increasing to 7% for firefighters and 17.5% for EMS, but similar percentages of both groups had adjusted FEV1 decline rates > / = 10%. Mixed effects modeling showed significant influence of weight gain but not baseline weight: FEV1 declined by ~8 ml per kg gained for both groups. Adjusting for weight change, FEV1 decline averaged 38 ml/yr for firefighters, 34 ml/yr for EMS. CONCLUSION: During the first 5 years of duty, firefighters do not show greater longitudinal FEV1 decline than EMS controls, and fewer of them develop abnormal lung function. Weight gain is associated with a small loss of lung function, of questionable clinical relevance in this fit and active population.
Emergency-response; Dust-exposure; Fire-fighters; Emergency-responders; Rescue-workers; Respiratory-system-disorders; Pulmonary-function; Pulmonary-function-tests; Pulmonary-system-disorders; Lung-function; Lung-irritants; Spirometry; Long-term-study; Men; Preemployment-examinations; Weight-factors; Epidemiology;
Author Keywords: Epidemiology; occupational lung disease; spirometry; FEV1; firefighting
Thomas Aldrich, MD, Pulmonary Medicine Division, Montefiore Medical Center, 111 East 210th St., Bronx, NY 10467
New York City Fire Department