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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
Publication Date
Document Type
Journal Article
Email Address
Funding Type
Cooperative Agreement
Fiscal Year
NTIS Accession No.
NTIS Price
Identifying No.
Cooperative-Agreement-Number-U10-OH-008243; Cooperative-Agreement-Number-U10-OH-008242
Issue of Publication
Source Name
Performing Organization
New York City Fire Department