Obstructive Airways Disease with Air Trapping Among Firefighters Exposed to World Trade Center Dust

Details

• Personal Author:
  Aldrich TK ; Berger KI ; Comfort A ; Cosenza K ; Ferrier N ; Goldring RM ; Gustave J ; Kelly KJ ; Lee R ; Nolan A ; Prezant DJ ; Rom, William N. ; Webber MP ; Weiden MD ; Zeig-Owens R ; Zheng S
  More +
• Description:
  BACKGROUND: The World Trade Center (WTC) collapse produced a massive exposure to respirable particulates in New York City Fire Department (FDNY) rescue workers. This group had spirometry examinations pre-September 11, 2001, and post-September 11, 2001, demonstrating declines in lung function with parallel declines in FEV(1) and FVC. To date, the underlying pathophysiologic cause for this has been open to question. METHODS: Of 13,234 participants in the FDNY-WTC Monitoring Program, 1,720 (13%) were referred for pulmonary subspecialty evaluation at a single institution. Evaluation included 919 full pulmonary function tests, 1,219 methacholine challenge tests, and 982 high-resolution chest CT scans. RESULTS: At pulmonary evaluation (median 34 months post-September 11, 2001), median values were FEV(1) 93% predicted (interquartile range IQR, 83%-101%), FVC 98% predicted (IQR, 89%-106%), and FEV(1)/FVC 0.78 (IQR, 0.72-0.82). The residual volume (RV) was 123% predicted (IQR, 106%-147%) with nearly all participants having normal total lung capacity, functional residual capacity, and diffusing capacity of carbon monoxide. Also, 1,051/1,720 (59%) had obstructive airways disease based on at least one of the following: FEV(1)/FVC, bronchodilator responsiveness, hyperreactivity, or elevated RV. After adjusting for age, gender, race, height and weight, and tobacco use, the decline in FEV(1) post-September 11, 2001, was significantly correlated with increased RV percent predicted (P < .0001), increased bronchodilator responsiveness (P < .0001), and increased hyperreactivity (P = .0056). CT scans demonstrated bronchial wall thickening that was significantly associated with the decline in FEV(1) post-September 11, 2001 (P = .024), increases in hyperreactivity (P < .0001), and increases in RV (P < .0001). Few had evidence for interstitial disease. CONCLUSIONS: Airways obstruction was the predominant physiologic finding underlying the reduction in lung function post-September 11, 2001, in FDNY WTC rescue workers presenting for pulmonary evaluation. Description provided by NIOSH
• Subjects:
  • Biological Factors
  • Dust
  • Emergency Responders
  • Environmental Monitoring
  • Firefighters
  • Hazardous Substances
  • Health Care Facilities Workforce and Services
  • Health Personnel
  • Irritants
  • Lung
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• Keywords:
  • Biological-factors
  • Breathing
  • Dust-exposure
  • Exposure-assessment
  • Exposure-levels
  • Exposure-methods
  • Fire-fighters
  • Health-care-personnel
  • Inhalation-studies
  • Lung-disorders
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• ISSN:
  0012-3692
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Grant
• Genre:
  Journal Article
• 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:
  137
• Issue:
  3
• NIOSHTIC Number:
  nn:20036711
• Citation:
  Chest 2010 Mar; 137(3):566-574
• Contact Point Address:
  David J. Prezant, MD, Office of Medical Affairs, New York City Fire Department, 9 Metrotech Center, Room 4W-1, Brooklyn, NY 11201
• Email:
  prezand@fdny.nyc.gov
• Federal Fiscal Year:
  2010
• NORA Priority Area:
  Services
• Performing Organization:
  New York City Fire Department
• Peer Reviewed:
  True
• Start Date:
  20040701
• Source Full Name:
  Chest
• End Date:
  20110630
• Download URL:
  https://stacks.cdc.gov/view/cdc/188025/cdc_188025_DS1.pdf
• File Type:
  [PDF - 323.28 KB]
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:c9e0c4a9d7642c64fbbda5a0bb0182a9fb273ded35356b406224b4ea449c1e48d8d2b55e42ad0839765c765e43fadc7664df644e81db08acd9ae7fe06d6e25d8