Excessive longitudinal FEV1 decline and risks to future health: a case-control study.
BACKGROUND
Accelerated loss of forced expiratory volume in 1 s (FEV(1)) in an individual is considered an indicator of developing lung disease.


METHODS
We investigated longitudinal FEV(1) slopes, calculated by simple linear regression, and adverse health outcomes after 10-30 years, among 1,428 chemical plant workers. Cases were defined by FEV(1) slopes below 5th percentile values for the cohort. Cases were matched with controls (107 pairs) for race, gender, smoking status, year of birth, age, height, and calendar year at first test. Matched pair statistics were used for comparisons.


RESULTS
Cases had a higher proportion, compared to controls, of diagnosis of COPD or emphysema (17.8% vs. 1.9%, P = 0.0002), medication use for respiratory diseases (24.3% vs. 4.7%, P < 0.0001), dyspnea (15% vs. 3.7%, P = 0.0042), and wheezing or rhonchi on examination (10.3% vs. 1.9%, P = 0.0225).


CONCLUSIONS
Chemical plant workers who experienced accelerated FEV(1) declines experienced four to nine times as many adverse health conditions over 10-30 years.
Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia 26505, USA.
Mei Lin
ML
Wang
Bipin H
BH
Avashia
John
J
Wood
Edward L
EL
Petsonk
D000328:Adult; D016022:Case-Control Studies; D002617:Chemical Industry; D002619:Chemical Warfare Agents / Q000633:toxicity*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004417:Dyspnea / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects*; D006540:Herbicides / Q000633:toxicity*; D006801:Humans; D017879:Isothiocyanates / Q000633:toxicity*; D008137:Longitudinal Studies; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000175:diagnosis*; D016273:Occupational Exposure / Q000009:adverse effects*; D010705:Phosgene / Q000633:toxicity*; D029424:Pulmonary Disease, Chronic Obstructive / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology; D011656:Pulmonary Emphysema / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology; D012135:Respiratory Sounds / Q000175:diagnosis; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D013147:Spirometry; D014903:West Virginia
D002619:Chemical Warfare Agents; D006540:Herbicides; D017879:Isothiocyanates; D010705:Phosgene; C005227:methyl isothiocyanate