Exploring Body Mass Index and Health Disparities on Lung Function Trajectories in WTC Survivors.

Project Abstract Over two decades after the 9/11 terrorist attacks, many exposed community members in the World Trade Center (WTC) Environmental Health Center (EHC) still struggle with ongoing airway symptoms, with functional abnormalities in large and/or small airways as indicated by spirometry measures of airflow and/or oscillometry measures of airway heterogeneity. Recent studies within WTC cohorts are drawing attention to the complex interplay between WTC exposures and Body Mass Index (BMI) on lung function trajectories. Notably, the WTC Fire Department of the City of New York (FDNY) cohort has identified BMI as the most significant metabolic syndrome characteristic in the risk of developing WTC-related lung diseases. However, there remains a significant gap in understanding this relationship within the WTC Survivor population, which could significantly benefit from weight and BMI management to improve lung function and physical health. Additionally, our unique access to oscillometry data, reflective of small airway function, provides a novel opportunity to assess changes in lung function that may not be captured in large airway spirometry measures. Moreover, the demographic diversity of the WTC Survivor population highlights an essential opportunity to determine the health disparities within the WTC EHC and the critical need to address them. In this project, we propose to tackle the important scientific questions related to BMI, lung function trajectories, and health disparities among WTC Survivors, through the following specific aims: Aim 1: Assess the complex interplay between WTC exposures and BMI on lung function trajectories in WTC Survivors, with a unique focus on small airway oscillometry data. Aim 2: Utilize advanced analytics of algorithmic fairness tools and machine learning to identify factors driving lung function trajectory disparities in WTC Survivors, particularly for BMI and related key factors. Upon its completion, the proposed project will improve our understanding of how BMI influences the health effects of severe respiratory diseases related to the 9/11 terrorist attacks and help develop more effective prevention and treatment interventions that will shape equitable health policies.