Background
Metabolic syndrome (MetSyn) predicted future development of World Trade Center lung
injury (WTC-LI) in a subgroup of firefighters who never smoked and were male. An intracohort
validation of MetSyn as a predictor of WTC-LI is examined in the cohort exposed to
the World Trade Center (WTC) that has been followed longitudinally for 16 years.
Methods
Results of pulmonary function tests (n = 98,221) in workers exposed to the WTC (n =
9,566) were evaluated. A baseline cohort of firefighters who had normal FEV
1 before 9/11 and who had had serum drawn before site closure on July 24, 2002 (n =
7,487) was investigated. Case subjects with WTC-LI (n = 1,208) were identified if
they had at least two measured instances of FEV
1 less than the lower limit of normal (LLN). Cox proportional hazards modeled early
MetSyn biomarker ability to predict development of FEV
1 less than the LLN.
Results
Case subjects were more likely to smoke, be highly exposed, and have MetSyn. There
was a significant exposure dose response; the individuals most highly exposed had
a 30.1% increased risk of developing WTC-LI, having MetSyn increased risk of developing
WTC-LI by 55.7%, and smoking increased risk by 15.2%. There was significant interaction
between smoking and exposure.
Conclusions
We validated the usefulness of MetSyn to predict future WTC-LI in a larger population
of individuals who were exposed. MetSyn defined by dyslipidemia, insulin resistance,
and cardiovascular disease suggests that systemic inflammation can contribute to future
lung function loss.
Key Words
Abbreviations:
DBP ( diastolic BP), FDNY ( Fire Department of New York), HDL ( high-density lipoprotein), HR ( hazard ratio), LDL ( low-density lipoprotein), LLN ( lower limit of normal), MetSyn ( metabolic syndrome), PFT ( pulmonary function test), PM ( particulate matter), SBP ( systolic BP), WTC ( World Trade Center), WTC-HP ( WTC Health Program), WTC-LI ( WTC Lung Injury)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: March 02, 2019
Footnotes
FUNDING/SUPPORT: This study was funded by the National Heart, Lung, and Blood Institute [Grant R01HL119326]; the Centers for Disease Control and Prevention , National Institute for Occupational Safety and Health [Grant U01-OH11300]; the Clinical Center of Excellence [Grant 200-2017-93426]; and the Data Center [Grant 200-2017-93326].
Identification
Copyright
© 2019 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
