World Trade Center Collapse Produced Airway Injury and Air Trapping

Details

• Personal Author:
  Berger K ; Beringer A ; Comfort A ; Cosenza K ; Ferrier N ; Glass L ; Goldring R ; Gustave J ; Lee R ; Nolan A ; Prezant DJ ; Rom, William N. ; Webber M ; Weiden MD ; Zeig-Owens R ; Zheng S
• Description:
  Background: The collapse of the World Trade Center (WTC) on 9/11/01 produced a massive toxic exposure in a well defined cohort of 12,000 FDNY personnel. This group received intensive post-exposure medical evaluation and had pulmonary function testing pre- and post-WTC. We observed a high incidence of reactive airways disease and an accelerated decline in lung function with parallel decline in FEV1 and VC. Methods: We analyzed the results of lung function testing performed at a single physiology laboratory on 1876 patients who presented for evaluation of persistent respiratory complaints. Results: The mean duration between pre-9/11 and first post-9/11 spirometry was 1.6 years. This subset of patients who sought evaluation had greater annualized decline in FEV1 post-9/11 than the entire cohort (490cc vs. 372cc, p<0.0001). A vast majority of the symptomatic group maintained normal TLC, FRC and DLCO. However, they had an FEV1/FVC of (74 % +/-10) and an RV of 131% +/-39 predicted. Only 18% (330/1876) had abnormal spirometry. Of these 87% (287/330) had evidence of obstruction as defined by positive methacholine, BD response or FEV1/FVC<0.75. The most common physiologic abnormality was air trapping with an elevated RV which correlated well with reduction in lung function, bronchodilator response and methacholine reactivity. High resolution chest CT demonstrated a high incidence of peribronchial inflammation and air trapping. Physiologic abnormalities only correlated with peribronchial thickening. Conclusion: These data demonstrate that airway injury with air trapping was the predominate cause of the pseudorestrictive pattern seen post-9/11 exposure. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Biological Factors Environmental Monitoring Hazardous Substances Irritants Laboratories Lung Lung Diseases Occupational Health Respiratory Function Tests Respiratory Hypersensitivity Respiratory System Respiratory Tract Diseases Safety Workplace

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• Keywords:
  Biological-factors Bronchial-asthma Exposure-assessment Exposure-levels Exposure-methods Inhalation-studies Laboratory-testing Lung-disorders Lung-function Lung-irritants Mathematical-models Physiological-effects Physiological-factors Physiological-measurements Pulmonary-disorders Pulmonary-function-tests Respiratory-function-tests Respiratory-hypersensitivity Respiratory-infections Respiratory-irritants Respiratory-system-disorders Statistical-analysis Toxic-effects Toxins Work-environment Work-performance Worker-health

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• ISSN:
  1073-449X
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Abstract or Summary
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  179
• NIOSHTIC Number:
  nn:20036378
• Citation:
  Am J Respir Crit Care Med 2009 Apr; 179(Meeting Abstracts):A5852
• Email:
  michael.weiden@med.nyu.edu
• Federal Fiscal Year:
  2009
• Peer Reviewed:
  False
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Supplement:
  Meeting Abstracts
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:34722c7ee2203cbe36f2bf8c53f5efc946c4536277746c203d06b09d783f95d5ff15d4351fe76eba9afa8ae98a043658c549927e75a904436d3d5e111621dc0e
• Download URL:
  https://stacks.cdc.gov/view/cdc/187835/cdc_187835_DS1.pdf
• File Type:
  [PDF - 116.59 KB ]