Accelerated spirometric decline in New York City firefighters with alpha 1-antitrypsin deficiency

Details

• Personal Author:
  Banauch GI ; Brantly M ; Chavko R ; Christodoulou V ; Hall C ; Izbicki G ; Prezant DJ ; Santhyadka G ; Shanske A ; Weiden MD
• Description:
  BACKGROUND: On September 11, 2001, the World Trade Center (WTC) collapse caused massive air pollution, producing variable amounts of lung function reduction in the New York City Fire Department (FDNY) rescue workforce. alpha1-Antitrypsin (AAT) deficiency is a risk factor for obstructive airway disease. METHODS: This prospective, longitudinal cohort study of the first 4 years post-September 11, 2001, investigated the influence of AAT deficiency on adjusted longitudinal spirometric change (FEV1) in 90 FDNY rescue workers with WTC exposure. Workers with protease inhibitor (Pi) Z heterozygosity were considered moderately AAT deficient. PiS homozygosity or PiS heterozygosity without concomitant PiZ heterozygosity was considered mild deficiency, and PiM homozygosity was considered normal. Alternately, workers had low AAT levels if serum AAT was = 20 µmol/L. RESULTS: In addition to normal aging-related decline (37 mL/y), significant FEV(1) decline accelerations developed with increasing AAT deficiency severity (110 mL/y for moderate and 32 mL/y for mild) or with low AAT serum levels (49 mL/y). Spirometric rates pre-September 11, 2001, did not show accelerations with AAT deficiency. Among workers with low AAT levels, cough persisted in a significant number of participants at 4 years post-September 11, 2001. CONCLUSIONS: FDNY rescue workers with AAT deficiency had significant spirometric decline accelerations and persistent airway symptoms during the first 4 years after WTC exposure, representing a novel gene-by-environment interaction. Clinically meaningful decline acceleration occurred even with the mild serum AAT level reductions associated with PiS heterozygosity (without concomitant PiZ heterozygosity). [Description provided by NIOSH]
• Subjects:
  Air Pollutants, Occupational Diagnosis Emergency Responders Environmental Monitoring Epidemiology Firefighters Hazardous Substances Irritants Lung Lung Diseases Occupational Health Particulate Matter Respiratory System Respiratory Tract Diseases Risk Assessment Safety Surveys And Questionnaires Workplace

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• Keywords:
  Airborne-particles Clinical-diagnosis Emergency-responders Exposure-assessment Fire-fighters Health-hazards Health-surveys Lung-disorders Pollutants Pulmonary-disorders Pulmonary-system Pulmonary-system-disorders Rescue-workers Respiratory-irritants Respiratory-system-disorders Risk-analysis Statistical-analysis Work-analysis Work-environment Work-operations Work-performance Worker-health

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• ISSN:
  0012-3692
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; New York ; OSHA Region 1 ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  138
• Issue:
  5
• NIOSHTIC Number:
  nn:20038127
• Citation:
  Chest 2010 Nov; 138(5):1116-1124
• Contact Point Address:
  Gisela I. Banauch, MD, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Room S6-842, University of Massachusetts Memorial Hospital Center, 55 Lake Ave N, Worcester, MA 01655
• Email:
  banauchg@ummhc.org
• Federal Fiscal Year:
  2011
• NORA Priority Area:
  Services
• Performing Organization:
  New York City Fire Department
• Peer Reviewed:
  True
• Start Date:
  20040701
• Source Full Name:
  Chest
• End Date:
  20110630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:be263626c100151cc1e704170b433c8cef7fc8012d24f9f36cac23d7cf9fd204194d2a9413daec0e6211c73b84c2f69572d75c350a5e81dc2d0698a28672efbb
• Download URL:
  https://stacks.cdc.gov/view/cdc/191933/cdc_191933_DS1.pdf
• File Type:
  [PDF - 267.18 KB ]