Similar Exposure to World Trade Center (WTC) Dust Produced Variable Lung Function Decline: Defining Most and Least Effected Subgroups in the FDNY Cohort

Details

• Personal Author:
  Comfort AL ; Ferrier N ; Nolan A ; Prezant DJ ; Rom, William N. ; Weiden MD
• Description:
  Background: The terrorist attack on 9/11/2001 produced a well-defined, intense irritant exposure in FDNY rescue workers. Airway obstruction predominates in 1720 FDNY personnel who required treatment for respiratory symptoms (Weiden et al. 2009). Moderate reduction of serum alpha-1-antitrypsin (14.9 +/- 3.2 microM/L vs. 23.9 +/- 3 microM/L for normal AAT) identifies a subgroup of FDNY personnel with 150ml/yr excess FEV1 decline. Methods: PFTs were obtained: (1) pre 9/11 (2) within nine months post 9/11 and (3) upon entry into treatment. From the 1720 treatment cohort, we identified 100 patients with the and 100 patients with the smallest FEV1 decline. A biorepository of serum drawn on the first post 9/11 exam includes samples from the most and least effected subgroups. Results: The first PFT after 9/11 occurred 3 months post 9/11 (IQR 2-4). Treatment entry PFT occurred 32 months post 9/11 (21-54) for both best and worst groups. Both groups had equal exposure intensity but marked differences in FEV1 decline. The least affected had no decline in FEV1 over the three PFTs. The most affected subgroup lost 0.875 L of FEV1 (0.58-1.10) from pre- to first post-9/11 PFT; an additional 0.410L FEV1 declined (IQR, 0.09-1.03) at treatment entry. The most affected had marked increase in airway reactivity 8-31%) vs. 3%; (2%-8%), p< 0.01) and MCT slope (0.09; (0.05-0.41) vs. 0.05; (0.03-0.10), p< 0.01). Surprisingly, the most affected had significantly higher BMI at the first post 9/11 PFT (29; (27-31) vs. 28; (26-30) p< 0.01). Conclusions: Symptomatic patients with similar WTC exposure had divergent changes in FEV1, defining subgroups with differential susceptibility to lung injury. AAT is one biomarker of individual susceptibility to accelerated FEV1 decline. Case control studies using serum drawn in 2001-2002 will define biomarkers of lung injury at a time of active disease; these results will be validated in the whole cohort. We will assay serum from this early point using Luminex for 100 analytes probing a broad array of pathways that may be activated or suppressed during lung injury. BMI differences between the most and least effected point to metabolic markers as one fruitful avenue of investigation. Defining a comprehensive set of serum biomarkers may identify those at greatest risk for lung injury following irritant exposure and focus treatment efforts on the vulnerable subgroup. [Description provided by NIOSH]
• Subjects:
  Air Pollutants, Occupational Biomarkers Demography Dust Environmental Monitoring Epidemiology Irritants Lung Lung Diseases Occupational Diseases Occupational Exposure Occupational Health Particulate Matter Respiratory Function Tests Respiratory Hypersensitivity Respiratory System Respiratory Tract Diseases Risk Assessment Risk Factors Safety Workplace

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• Keywords:
  Air-sampling Airborne-particles Airway-obstruction Biological-effects Biological-monitoring Biological-systems Breathing Demographic-characteristics Dust-exposure Dust-inhalation Dust-measurement Dust-particles Exposure-assessment Exposure-levels Exposure-methods Lung-disease Lung-disorders Lung-function Lung-irritants Occupational-diseases Occupational-exposure Occupational-hazards Occupational-health Occupational-respiratory-disease Particle-aerodynamics Particulate-dust Pulmonary-congestion Pulmonary-disorders Pulmonary-function Pulmonary-function-tests Pulmonary-system Pulmonary-system-disorders Respirable-dust Respiration Respiratory-hypersensitivity Respiratory-infections Respiratory-irritants Respiratory-system-disorders Risk-analysis Risk-factors Statistical-analysis Work-areas Work-environment Work-performance Work-practices Worker-health

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• ISSN:
  1073-449X
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; 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:
  181
• NIOSHTIC Number:
  nn:20037078
• Citation:
  Am J Respir Crit Care Med 2010 May; 181(Meeting Abstracts):A1252
• Email:
  anna.nolan@med.nyu.edu
• Federal Fiscal Year:
  2010
• NORA Priority Area:
  Services
• Performing Organization:
  New York City Fire Department
• Peer Reviewed:
  False
• Start Date:
  20040701
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Supplement:
  Meeting Abstracts
• End Date:
  20100630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:b1868ecd41f0212d4eacda5986643b020e390ba791eb2a85c92df42013eceafd18cf3c777707ebd6001ef34d5c9b9d67322a33ce40839ad7637d12da2dfe5833
• Download URL:
  https://stacks.cdc.gov/view/cdc/188235/cdc_188235_DS1.pdf
• File Type:
  [PDF - 20.52 KB ]