title: Longitudinal pulmonary function in newly hired, non-World Trade Center-exposed fire department City of New York firefighters: the first 5 years.
abstract: BACKGROUND
  Few longitudinal studies characterize firefighters’ pulmonary function. We sought to determine whether firefighters have excessive FEV(1) decline rates compared with control subjects.
  
  
  METHODS
  We examined serial measurements of FEV(1) from about 6 months prehire to about 5 years posthire in newly hired male, never smoking, non-Hispanic black and white firefighters, hired between 2003 and 2006, without prior respiratory disease or World Trade Center exposure. Similarly defined Emergency Medical Service (EMS) workers served as control subjects.
  
  
  RESULTS
  Through June 30, 2011, 940 firefighters (82%) and 97 EMS workers (72%) who met study criteria had four or more acceptable posthire spirometries. Prehire FEV(1) % averaged higher for firefighters than EMS workers (99% vs 95%), reflecting more stringent job entry criteria. FEV(1) (adjusted for baseline age and height) declined by an average of 45 mL/y both for firefighters and EMS workers, with Fire 2 EMS decline rate differences averaging 0.2 mL/y (CI, 2 9.2 to 9.6). Four percent of each group had FEV(1) less than the lower limit of normal before hire, increasing to 7% for firefighters and 17.5% for EMS workers, but similar percentages of both groups had adjusted FEV(1) decline rates 10%. Mixed effects modeling showed a significant influence of weight gain but not baseline weight: FEV(1) declined by about 8 mL/kg gained for both groups. Adjusting for weight change, FEV(1) decline averaged 38 mL/y for firefighters and 34 mL/y for EMS workers.
  
  
  CONCLUSIONS
  During the first 5 years of duty, firefighters do not show greater longitudinal FEV(1) decline than EMS control subjects, 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.
authors.affiliation: Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY. Electronic address: taldrich@montefiore.org.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Aldrich
authors.affiliation: Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, NY.
authors.forename: Fen
authors.initials: F
authors.lastname: Ye
authors.affiliation: Biostatistics Division, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Hall
authors.affiliation: Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, NY; Epidemiology Division, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Mayris P
authors.initials: MP
authors.lastname: Webber
authors.affiliation: Biostatistics Division, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY; Epidemiology Division, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Hillel W
authors.initials: HW
authors.lastname: Cohen
authors.affiliation: Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Michael
authors.initials: M
authors.lastname: Dinkels
authors.affiliation: Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, NY.
authors.forename: Kaitlyn
authors.initials: K
authors.lastname: Cosenza
authors.affiliation: Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, NY; Pulmonary Medicine Division, Department of Medicine, NYU School of Medicine, New York, NY.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Weiden
authors.affiliation: Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, NY; Pulmonary Medicine Division, Department of Medicine, NYU School of Medicine, New York, NY.
authors.forename: Anna
authors.initials: A
authors.lastname: Nolan
authors.affiliation: Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, NY.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Christodoulou
authors.affiliation: Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, NY.
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Kelly
authors.affiliation: Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY; Bureau of Health Services and Office of Medical Affairs, Fire Department of the City of New York, Brooklyn, NY.
authors.forename: David J
authors.initials: DJ
authors.lastname: Prezant
mesh_terms: D000328:Adult; D004634:Emergency Medical Technicians; D061388:Firefighters; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000502:physiology* / Q000503:physiopathology; D008297:Male; D009519:New York City; D016272:Occupational Health; D012129:Respiratory Function Tests; D012907:Smoking / Q000503:physiopathology; D013147:Spirometry; D015430:Weight Gain / Q000502:physiology