Symptoms and Lung Function, Including Impulse Oscillometry, in a Diverse Population with World Trade Center Dust Exposure

Details

• Personal Author:
  Berger KI ; Caplan-Shaw CE ; Cheng Q ; Goldring RM ; Kazeros A ; Liu M ; Parsia SS ; Reibman J ; Turetz ML
• Description:
  Rationale: The destruction of the World Trade Center (WTC) released a mixture of dust and fumes into the environment with the development of diverse respiratory complaints in some exposed individuals. The WTC Environmental Health Center evaluates and treats a symptomatic, exposed population of local workers, residents, and clean-up workers. We investigated the utility of impulse oscillometry (IOS), and specifically the resistance at 5Hz (R5), a measure of global airway resistance, as a tool to characterize pulmonary abnormalities. Methods: Between 8/2005-3/2009 individuals (n=2461) underwent a standardized evaluation including spirometry and IOS. Spirometry values were analyzed according to National Health and Nutrition Education Survey III (NHANES) standards. IOS measurements included R5. Individuals with current or >5 p-y tobacco use, inability to perform maneuvers, prior lung disease or respiratory symptoms were excluded from analysis. Results: There were 1366 individuals included for analysis. Mean spirometry values were normal (93 +/- 17, FVC% of predicted, 92 +/- 17, FEV 1% of predicted, 79 +/- 7, FEV1/FVC, mean +/- SD). R5 was higher than published normal values (4.6 [2.3] cmH2O/l/s; median [interquartile range]). Measurements of FEV1 and FVC were significantly lower in those with new onset persistent symptoms of wheeze and dyspnea on exertion (DOE) (p<0.004, all comparisons) although values remained in the normal range. R5 was elevated for the group, but was even higher in those with wheeze and DOE (p<0.0001). Spirometric patterns were grouped into normal or abnormal patterns (NHANES). In those with normal spirometry, median R5 was above normal values (4.4 [2.1]) and was higher in those with an obstructed pattern (5.2 [2.5]), a low FVC pattern (4.9 [2.3]), or an obstructed and low FVC pattern (7.1 [3.1). Among those with normal spirometry (FEV1 and FVC . 80% predicted), R5 was significantly elevated in individuals with persistent wheeze (4.7 [2.4], p<0.05) or DOE (4.6 [2.4], p<0.0001) and was also associated with severity of wheeze (p<0.004). Conclusions: R5, an IOS measurement of total airway resistance, was associated with new onset, persistent lower respiratory symptoms and abnormal spirometric patterns in our population. Among those with normal spirometry, R5 values were also abnormal and values were significantly higher in patients with persistent symptoms. The data suggest that IOS is a tool that can be used to characterize individuals after environmental exposures and may suggest airways dysfunction when traditional spirometry is normal. [Description provided by NIOSH]
• Subjects:
  Air Pollutants, Occupational Bacteria Cytology Dust Environmental Exposure Environmental Health Environmental Monitoring Environmental Pollution Hypersensitivity Inhalation Exposure Irritants Lung Lung Diseases Microbiology Occupational Diseases Occupational Exposure Occupational Health Particulate Matter Public Health Respiratory Function Tests Respiratory Hypersensitivity Respiratory System Respiratory Tract Diseases Risk Assessment Risk Factors Safety Workplace

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• Keywords:
  Airborne-particles Airway-obstruction Allergens Bacterial-dusts Bacteriology Biological-effects Biological-monitoring Breathing Cell-function Cellular-reactions Dust-analysis Dust-counting Dust-explosions Dust-exposure Dust-inhalation Dust-measurement Dust-particles Dust-sampling Dusts Environmental-contamination Environmental-exposure Environmental-factors Exposure-assessment Exposure-levels Exposure-methods Fumes Inhalants Inhalation-studies Lung-burden Lung-cells Lung-disease Lung-disorders Lung-fibrosis Lung-function Lung-irritants Microscopic-analysis Nanotechnology Occupational-diseases Occupational-exposure Occupational-hazards Occupational-health Occupational-respiratory-disease Particle-aerodynamics Particle-counters Particulate-dust Particulates Public-health Pulmonary-clearance Pulmonary-congestion Pulmonary-disorders Pulmonary-function Pulmonary-function-tests Pulmonary-system Pulmonary-system-disorders Quantitative-analysis Respirable-dust Respiratory-hypersensitivity Respiratory-infections Respiratory-irritants Respiratory-system-disorders Risk-analysis Risk-factors Standards Statistical-analysis Work-areas Work-environment Work-operations Work-performance Work-practices Worker-health Workplace-studies

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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:
  181
• NIOSHTIC Number:
  nn:20037079
• Citation:
  Am J Respir Crit Care Med 2010 May; 181(Meeting Abstracts):A1255
• Email:
  meredith.turetz@nyumc.org
• Federal Fiscal Year:
  2010
• Performing Organization:
  New York City Health and Hospitals Corporation
• Peer Reviewed:
  False
• Start Date:
  20080929
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Supplement:
  Meeting Abstracts
• End Date:
  20110928
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:2d349a33f94114feb9608e3288db8e9f8515782d3609b638ad942cbeee4a50d0543483e4b56b5910c86941ed5756476d3992937f9077c4759e0c93a79fe3c064
• Download URL:
  https://stacks.cdc.gov/view/cdc/188236/cdc_188236_DS1.pdf
• File Type:
  [PDF - 18.62 KB ]