Post-9/11/2001 lung function trajectories by sex and race in World Trade Center-exposed New York City emergency medical service workers.
To determine whether lung function trajectories after 9/11/2001 (9/11) differed by sex or race/ethnicity in World Trade Center-exposed Fire Department of the City of New York emergency medical service (EMS) workers.



Serial cross-sectional study of pulmonary function tests (PFTs) taken between 9/11 and 9/10/2015. We used data from routine PFTs (forced expiratory volume in 1 s (FEV1) and FEV1% predicted), conducted at 12-18 month intervals. FEV1and FEV1% predicted were assessed over time, stratified by sex, and race/ethnicity. We also assessed FEV1and FEV1% predicted in current, former and never-smokers.



Among 1817 EMS workers, 334 (18.4%) were women, 979 (53.9%) self-identified as white and 939 (51.6%) were never-smokers. The median follow-up was 13.1 years (IQR 10.5-13.6), and the median number of PFTs per person was 11 (IQR 7-13). After large declines associated with 9/11, there was no discernible recovery in lung function. In analyses limited to never-smokers, the trajectory of decline in adjusted FEV1and FEV1% predicted was relatively parallel for men and women in the 3 racial/ethnic groups. Similarly, small differences in FEV1annual decline between groups were not clinically meaningful. Analyses including ever-smokers were essentially the same.



14 years after 9/11, most EMS workers continued to demonstrate a lack of lung function recovery. The trajectories of lung function decline, however, were parallel by sex and by race/ethnicity. These findings support the use of routine, serial measures of lung function over time in first responders and demonstrate no sex or racial sensitivity to exposure-related lung function decline.
Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA.|Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Brooklyn, New York, USA.
Madeline
M
Vossbrinck
Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA.|Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Brooklyn, New York, USA.
Rachel
R
Zeig-Owens
Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Brooklyn, New York, USA.
Charles B
CB
Hall
Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA.|Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Brooklyn, New York, USA.
Theresa
T
Schwartz
Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA.|Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Brooklyn, New York, USA.
William
W
Moir
Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA.|Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Brooklyn, New York, USA.
Mayris P
MP
Webber
Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Brooklyn, New York, USA.
Hillel W
HW
Cohen
Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA.|Department of Medicine, New York University School of Medicine, New York, New York, USA.
Anna
A
Nolan
Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA.|Department of Medicine, New York University School of Medicine, New York, New York, USA.
Michael D
MD
Weiden
Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA.
Vasilios
V
Christodoulou
Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA.
Kerry J
KJ
Kelly
Department of Medicine, New York University School of Medicine, New York, New York, USA.
Thomas K
TK
Aldrich
Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA.|Department of Medicine, Pulmonary Division, Montefiore Medical Center and Albert Einstein College of Medicine, Brooklyn, New York, USA.
David J
DJ
Prezant
D000328:Adult; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services; D060731:Emergency Responders; D005006:Ethnicity; D005260:Female; D061388:Firefighters; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008173:Lung Diseases, Obstructive / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology*; D016273:Occupational Exposure / Q000009:adverse effects*; D020127:Recovery of Function; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency; D047851:September 11 Terrorist Attacks; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D013147:Spirometry