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Quality of life in relation to upper and lower respiratory conditions among retired 9/11-exposed firefighters with pulmonary disability

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Abstract

Purpose

To examine health-related quality of life (HRQoL) and World Trade Center (WTC) cough syndrome conditions in male firefighters who retired due to a 9/11-related pulmonary disability.

Methods

From 3/1/2008 to 1/31/2009, we contacted 275 disability-retired firefighters and compared their HRQoL and current aerodigestive conditions to those from WTC-exposed non-disabled retired and active firefighters. Relationships between HRQoL and explanatory variable(s) were examined using multivariable linear regression models.

Results

Mean physical component summary (PCS) scores were lowest in disabled retirees compared with non-disabled retirees and actives: 36.4 (9.6), 49.4 (8.7), and 53.1 (5.1), respectively (P < 0.0001). Mean mental component summary (MCS) scores were closer: 44.5 (11.9), 48.1 (8.5), and 48.7 (7.4), respectively (P < 0.0001). In multivariable models, after adjustment for many factors, PCS scores were not associated with early WTC arrival, but were inversely associated with disability retirement and all WTC cough syndrome conditions. MCS scores were inversely associated with early WTC arrival and most WTC cough syndrome conditions, but were not associated with disability retirement.

Conclusion

WTC cough syndrome conditions predict lower HRQoL scores even 8 years after exposure, independent of retirement status. These data suggest that monitoring physical conditions of individuals with occupational exposures might help identify those at risk for impaired HRQoL.

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Abbreviations

9/11:

September 11, 2001

WTC:

World Trade Center

FDNY:

Fire Department, City of New York

EMS:

Emergency medical service

GERD:

Gastroesophageal reflux disease

FEV1 :

Forced expiratory volume in 1 second

COPD:

Chronic obstructive pulmonary disease

HRQoL:

Health-related quality of life

IRB:

Institutional Review Board

SF-12v2:

Short Form Health Survey-12, version 2

PCS:

Physical composite summary

MCS:

Mental composite summary

NHLBI:

National Heart, Lung, and Blood Institute

BMI:

Body mass index

FDNY-WTC-MMP:

FDNY World Trade Center Medical Monitoring and Treatment Program

References

  1. Landrigan, P. J., Lioy, P. J., Thurston, G., Berkowitz, G., Chen, L. C., Chillrud, S. N., et al. (2004). Health and environmental consequences of the world trade center disaster. Environmental Health Perspectives, 112(6), 731–739.

    Article  CAS  PubMed  Google Scholar 

  2. McGee, J. K., Chen, L. C., Cohen, M. D., Chee, G. R., Prophete, C. M., Haykal-Coates, N., et al. (2003). Chemical analysis of World Trade Center fine particulate matter for use in toxicologic assessment. Environmental Health Perspectives, 111(7), 972–980.

    Article  CAS  PubMed  Google Scholar 

  3. Lioy, P. J., Weisel, C. P., Millette, J. R., Eisenreich, S., Vallero, D., Offenberg, J., et al. (2002). Characterization of the dust/smoke aerosol that settled east of the World Trade Center (WTC) in lower Manhattan after the collapse of the WTC 11 September 2001. Environmental Health Perspectives, 110(7), 703–714.

    Article  CAS  PubMed  Google Scholar 

  4. Prezant, D. J., Weiden, M., Banauch, G. I., McGuinness, G., Rom, W. N., Aldrich, T. K., et al. (2002). Cough and bronchial responsiveness in firefighters at the World Trade Center site. New England Journal of Medicine, 347(11), 806–815.

    Article  PubMed  Google Scholar 

  5. Izbicki, G., Chavko, R., Banauch, G. I., Weiden, M. D., Berger, K. I., Aldrich, T. K., et al. (2007). World Trade Center “sarcoid-like” granulomatous pulmonary disease in New York City Fire Department rescue workers. Chest, 131(5), 1414–1423.

    Article  PubMed  Google Scholar 

  6. Aldrich, T. K., Gustave, J., Hall, C. B., Cohen, H. W., Webber, M. P., Zeig-Owens, R., et al. (2010). Lung Function in Rescue Workers at the World Trade Center after 7 Years. New England Journal of Medicine, 362(14), 1263–1272.

    Article  CAS  PubMed  Google Scholar 

  7. Banauch, G. I., Hall, C., Weiden, M., Cohen, H. W., Aldrich, T. K., Christodoulou, V., et al. (2006). Pulmonary function after exposure to the World Trade Center collapse in the New York City Fire Department. American Journal of Respiratory and Critical Care Medicine, 174(3), 312–319.

    Article  PubMed  Google Scholar 

  8. Skloot, G., Goldman, M., Fischler, D., Goldman, C., Schechter, C., Levin, S., et al. (2004). Respiratory symptoms and physiologic assessment of ironworkers at the World Trade Center disaster site. Chest, 125(4), 1248–1255.

    Article  PubMed  Google Scholar 

  9. de la Hoz, R. E., Shohet, M. R., Chasan, R., Bienenfeld, L. A., Afilaka, A. A., Levin, S. M., et al. (2008). Occupational toxicant inhalation injury: the World Trade Center (WTC) experience. International Archives of Occupational and Environmental Health, 81(4), 479–485.

    Article  Google Scholar 

  10. Voll-Aanerud, M., Eagan, T. M., Wentzel-Larsen, T., Gulsvik, A., & Bakke, P. S. (2008). Respiratory symptoms, COPD severity, and health related quality of life in a general population sample. Respiratory Medicine, 102(3), 399–406.

    Article  PubMed  Google Scholar 

  11. Voll-Aanerud, M., Eagan, T. M., Wentzel-Larsen, T., Gulsvik, A., & Bakke, P. S. (2007). Changes in respiratory symptoms and health-related quality of life. Chest, 131(6), 1890–1897.

    Article  PubMed  Google Scholar 

  12. Brignall, K., Jayaraman, B., & Birring, S. S. (2008). Quality of life and psychosocial aspects of cough. Lung, 186(Suppl 1), S55–S58.

    Article  PubMed  Google Scholar 

  13. Kelsall, A., Decalmer, S., Webster, D., Brown, N., McGuinness, K., Woodcock, A., et al. (2008). How to quantify coughing: Correlations with quality of life in chronic cough. European Respiratory Journal, 32(1), 175–179.

    Article  CAS  PubMed  Google Scholar 

  14. Braido, F., Baiardini, I., Tarantini, F., Fassio, O., Balestracci, S., Pasquali, M., et al. (2006). Chronic cough and QoL in allergic and respiratory diseases measured by a new specific validated tool-CCIQ. Journal of Investigational Allergology & Clinical Immunology, 16(2), 110–116.

    CAS  Google Scholar 

  15. Sarna, L., Evangelista, L., Tashkin, D., Padilla, G., Holmes, C., Brecht, M. L., et al. (2004). Impact of respiratory symptoms and pulmonary function on quality of life of long-term survivors of non-small cell lung cancer. Chest, 125(2), 439–445.

    Article  PubMed  Google Scholar 

  16. Sauni, R., Oksa, P., Vattulainen, K., Uitti, J., Palmroos, P., & Roto, P. (2001). The effects of asthma on the quality of life and employment of construction workers. Occupational Medicine (Oxford, England), 51(3), 163–167.

    CAS  Google Scholar 

  17. Vollmer, W. M., Markson, L. E., O’Connor, E., Sanocki, L. L., Fitterman, L., Berger, M., et al. (1999). Association of asthma control with health care utilization and quality of life. American Journal of Respiratory and Critical Care Medicine, 160(5 Pt 1), 1647–1652.

    CAS  PubMed  Google Scholar 

  18. Orbon, K. H., Schermer, T. R., van der Gulden, J. W., Chavannes, N. H., Akkermans, R. P., Schayck, O. P., et al. (2005). Employment status and quality of life in patients with chronic obstructive pulmonary disease. International Archives of Occupational and Environmental Health, 78(6), 467–474.

    Article  PubMed  Google Scholar 

  19. Eden, L., Ejlertsson, G., & Petersson, J. (1999). Quality of life among early retirees. Experimental Aging Research, 25(4), 471–475.

    Article  CAS  PubMed  Google Scholar 

  20. Szinovacz, M. E., & Davey, A. (2004). Retirement transitions and spouse disability: Effects on depressive symptoms. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 59(6), S333–S342.

    Google Scholar 

  21. Butterworth, P., Gill, S. C., Rodgers, B., Anstey, K. J., Villamil, E., & Melzer, D. (2006). Retirement and mental health: Analysis of the Australian national survey of mental health and well-being. Social Science and Medicine, 62(5), 1179–1191.

    Article  PubMed  Google Scholar 

  22. Ware, J., Kosinski, M., Turner-Bodker, D., & Gandek, B. (2002). User’s manual for the SF-12v2 health survey with a supplement documenting SF-12 health survey.

  23. Webber, M. P., Gustave, J., Lee, R., Niles, J. K., Kelly, K., Cohen, H. W., et al. (2009). Trends in respiratory symptoms of firefighters exposed to the world trade center disaster: 2001–2005. Environmental Health Perspectives, 117(6), 975–980.

    PubMed  Google Scholar 

  24. National Asthma Education and Prevention Programs. (2007). Guidelines for the diagnosis and managment of asthma, summary report.

  25. Esteban, C., Moraza, J., Quintana, J. M., Aburto, M., & Capelastegui, A. (2006). Use of medication and quality of life among patients with COPD. Respiratory Medicine, 100(3), 487–495.

    Article  PubMed  Google Scholar 

  26. Chen, H., Gould, M. K., Blanc, P. D., Miller, D. P., Kamath, T. V., Lee, J. H., et al. (2007). Asthma control, severity, and quality of life: Quantifying the effect of uncontrolled disease. The Journal of Allergy and Clinical Immunology, 120(2), 396–402.

    Article  PubMed  Google Scholar 

  27. French, C. L., Irwin, R. S., Curley, F. J., & Krikorian, C. J. (1998). Impact of chronic cough on quality of life. Archives of Internal Medicine, 158(15), 1657–1661.

    Article  CAS  PubMed  Google Scholar 

  28. Birring, S. S., Prudon, B., Carr, A. J., Singh, S. J., Morgan, M. D., & Pavord, I. D. (2003). Development of a symptom specific health status measure for patients with chronic cough: Leicester Cough Questionnaire (LCQ). Thorax, 58(4), 339–343.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This work was supported by the National Institute for Occupational Safety and Health (NIOSH) #R01-OH07350.

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Authors and Affiliations

  1. Department of Medicine, Montefiore Medical Center, Bronx, NY, USA

    Amy Berninger, Jessica Weakley, Rachel Zeig-Owens & Fairouz Al-Othman

  2. Fire Department of the City of New York, Bureau of Health Services, 9 Metrotech Center, Brooklyn, NY, 11201, USA

    Amy Berninger, Mayris P. Webber, Jessica Weakley, Jackson Gustave, Rachel Zeig-Owens, Roy Lee, Kerry Kelly & David J. Prezant

  3. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA

    Mayris P. Webber & Hillel W. Cohen

  4. Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA

    David J. Prezant

Authors
  1. Amy Berninger
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  2. Mayris P. Webber
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Correspondence to Mayris P. Webber.

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Berninger, A., Webber, M.P., Weakley, J. et al. Quality of life in relation to upper and lower respiratory conditions among retired 9/11-exposed firefighters with pulmonary disability. Qual Life Res 19, 1467–1476 (2010). https://doi.org/10.1007/s11136-010-9710-9

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