title: Lung function predicts mortality: 10-year follow-up after lung cancer screening among asbestos-exposed workers.
abstract: OBJECTIVE
  To assess the predictive value of lung function impairment on mortality among asbestos-exposed workers.
  
  
  METHODS
  A total of 590 workers originally screened for occupational lung disease including spirometry and pulmonary diffusing capacity measurements were followed up for mortality data (ICD-10 classification). The mean follow-up time was 10.5 years. Associations of different lung function parameters with mortality from all causes and from cardiovascular (I00-I99) and non-malignant respiratory diseases (J00-J99) were analysed. Factor analysis was used to create obstructive and restrictive factors.
  
  
  RESULTS
  A total of 191 deaths were found altogether. Most measured lung function variables were associated with increased mortality when studied separately. Both decreased forced expiratory flow in one second (hazard ratio/measurement unit = 0.977, 95 % CI 0.969-0.988, p < 0.001) and impaired diffusing capacity (0.973, 0.965-0.981, p < 0.001) were independently associated with mortality from all causes, as well as from cardiovascular and non-malignant respiratory diseases. Both obstructive factor alone and the sum of obstructive and restrictive factors were associated with all studied mortality categories. The restrictive factor alone was associated with all-cause and respiratory mortality.
  
  
  CONCLUSIONS
  Deteriorated lung function predicts deaths. The reasons for impaired lung function should be medically explored to enable restoring measures aiming thus to prevent premature deaths.
authors.affiliation: Health and Work Ability, Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland. tapio.vehmas@ttl.fi
authors.forename: Tapio
authors.initials: T
authors.lastname: Vehmas
authors.forename: Paula
authors.initials: P
authors.lastname: Pallasaho
authors.forename: Päivi
authors.initials: P
authors.lastname: Piirilä
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001195:Asbestosis / Q000401:mortality*; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D015331:Cohort Studies; D060389:Construction Industry; D055088:Early Detection of Cancer / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008171:Lung Diseases / Q000401:mortality; D008175:Lung Neoplasms / Q000401:mortality* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D061213:Mortality, Premature; D011237:Predictive Value of Tests; D012129:Respiratory Function Tests; D016019:Survival Analysis