Lung function predicts mortality: 10-year follow-up after lung cancer screening among asbestos-exposed workers
Menée auprès de 590 travailleurs exposés à l'amiante, diagnostiqués avec un cancer du poumon et suivis pendant 10,5 années, cette étude montre que des déficiences des fonctions pulmonaires permettent de prédire la mortalité
Purpose 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.
International Archives of Occupational and Environmental Health 2012