Persistent Hyperreactivity and Reactive Airway Dysfunction in Firefighters at the World Trade Center

Details

• Personal Author:
  Alleyne D ; Banauch GI ; Cohen HW ; Kelly KJ ; Olender K ; Prezant DJ ; Sanchez R ; Weiden M
• Description:
  New York City Fire Department rescue workers experienced massive exposure to airborne particulates at the World Trade Center site. Aims of this longitudinal study were to (1) determine if bronchial hyperreactivity was present, persistent, and independently associated with exposure intensity, (2) identify objective measures shortly after the collapse that would predict persistent hyperreactivity and a diagnosis of reactive airways dysfunction 6 months post-collapse. A representative sample of 179 rescue workers stratified by exposure intensity (high, moderate, and control) without current smoking or prior respiratory disease was enrolled. Highly exposed workers arrived within 2 hours of collapse, moderately exposed workers arrived later on Days 1-2; control subjects were not exposed. Hyperreactivity at 1, 3, and 6 months post-collapse was associated with exposure intensity, independent of ex-smoking and airflow obstruction. Six months post-collapse, highly exposed workers were 6.8 times more likely than moderately exposed workers and control subjects to be hyperreactive (95% confidence interval, 1.8-25.2; p = 0.004), and hyperreactivity persisted in 55% of those hyperreactive at 1 and/or 3 months. In highly exposed subjects, hyperreactivity 1 or 3 months post-collapse was the sole predictor for reactive airways dysfunction (p = 0.021). In conclusion, development and persistence of hyperreactivity and reactive airways dysfunction were strongly and independently associated with exposure intensity. Hyperreactivity shortly post-collapse predicted reactive airways dysfunction at 6 months in highly exposed workers; this has important implications for disaster management. [Description provided by NIOSH]
• Subjects:
  Air Pollutants, Occupational Dust Emergency Responders Environmental Monitoring Firefighters Inorganic Chemicals Occupational Exposure Occupational Health Particulate Matter Respiratory System Safety

  More +
• Keywords:
  Airborne-dusts Airborne-particles Airway-obstruction Airway-resistance Exposure-assessment Exposure-levels Fire-fighters Fire-fighting Inorganic-compounds Occupational-exposure Particulate-dust Particulates Rescue-workers Sampling Sampling-methods

  More +
• ISSN:
  1073-449X
• Document Type:
  Text
• Funding:
  Grant ; Cooperative Agreement
• 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
• Pages in Document:
  54-62
• Volume:
  168
• Issue:
  1
• NIOSHTIC Number:
  nn:20029136
• Citation:
  Am J Respir Crit Care Med 2003 Jul; 168(1):54-62
• Contact Point Address:
  Dr. David Prezant, M.D., Professor of Medicine, Montefiore Medical Center, Pulmonary Division, Centennial 423, Bronx, NY 10467
• Email:
  Prezd@dnamail.com
• Federal Fiscal Year:
  2003
• Peer Reviewed:
  True
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a3ae0c4ef887acaa3031d9a293215106db2e9a59086e651ba082b7a0fb8bb4e0af483e1da989d645066e2fd76409b896fd27b9182baa0dbbec01a75f36be38a3
• Download URL:
  https://stacks.cdc.gov/view/cdc/190188/cdc_190188_DS1.pdf
• File Type:
  [PDF - 137.51 KB ]