Elevated peripheral eosinophils are associated with new-onset and persistent wheeze and airflow obstruction in World Trade Center-exposed individuals

Details

• Personal Author:
  Berger KI ; Caplan-Shaw C ; Goldring R ; Kazeros A ; Liu M ; Maa M-T ; Parsia S ; Patrawalla P ; Qian M ; Reibman J ; Rogers L ; Shao Y ; Turetz M
• Description:
  Background. Exposure to World Trade Center (WTC) dust and fumes is associated with the onset of asthma-like respiratory symptoms in rescue and recovery workers and exposed community members. Eosinophilic inflammation with increased lung and peripheral eosinophils has been described in subpopulations with asthma. We hypothesized that persistent asthma-like symptoms in WTC-exposed individuals would be associated with systemic inflammation characterized by peripheral eosinophils. Methods. The WTC Environmental Health Center (WTC EHC) is a treatment program for local residents, local workers, and cleanup workers with presumed WTC-related symptoms. Patients undergo a standardized evaluation including questionnaires and complete blood count. Between September 2005 and March 2009, 2462 individuals enrolled in the program and were available for analysis. Individuals with preexisting respiratory symptoms or lung disease diagnoses prior to September 2001 and current or significant tobacco use were excluded, Results. One thousand five hundred and seventeen individuals met the inclusion criteria. Patients had a mean age of 47 years, were mostly female (51%), and had a diverse race/ethnicity. Respiratory symptoms that developed after WTC dust/fume exposure and remained persistent included dyspnea on exertion (68%), cough (57%), chest tightness (47%), and wheeze (33%). A larger percentage of patients with wheeze had elevated peripheral eosinophils compared with those without wheeze (21% vs. 13%, p < .0001). Individuals with elevated peripheral eosinophils were more likely to have airflow obstruction on spirometry (16% vs. 7%, p = .0003). Conclusion. Peripheral eosinophils were associated with wheeze and airflow obstruction in a diverse WTC-exposed population. These data suggest that eosinophils may participate in lung inflammation in this population with symptoms consistent with WTC-related asthma. [Description provided by NIOSH]
• Subjects:
  Air Pollutants, Occupational Asthma Asthma, Occupational Dust Emergencies Emergency Responders Hazardous Substances Immune System Lung Lung Diseases Occupational Health Respiratory Function Tests Respiratory System Respiratory Tract Diseases Safety September 11 Terrorist Attacks

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• Keywords:
  Airway-obstruction Author Keywords: Asthma Bronchial-asthma Dust-exposure Emergency-responders Emergency-response Eosinophil Fumes Hazardous-waste-cleanup Immune-reaction Leukocytes Lung-disorders Lung-function Lung-irritants Medical-treatment Pulmonary-system-disorders Rescue-workers Respiratory-system-disorders Spirometry World Trade Center

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• ISSN:
  0277-0903
• Document Type:
  Text
• Funding:
  Grant ; Contract
• 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:
  25-32
• Volume:
  50
• Issue:
  1
• NIOSHTIC Number:
  nn:20042104
• Citation:
  J Asthma 2013 Feb; 50(1):25-32
• Contact Point Address:
  Joan Reibman, M.D., Department of Medicine, New York University School of Medicine, 550 1st Avenue, Room NBV-7N24, New York, NY 10016, USA
• Email:
  Joan.Reibman@nyumc.org
• Federal Fiscal Year:
  2013
• Performing Organization:
  New York City Health and Hospitals Corporation
• Peer Reviewed:
  True
• Start Date:
  20080929
• Source Full Name:
  Journal of Asthma
• End Date:
  20110928
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:055748c7ce07e51e0648b1f0b78602552b0e2c99be3631c894ccae6446bda431fa02cc9fa6de7419d5628ae7d67e10dd2aa7d3c622e9f55916387682e4ca96c4
• Download URL:
  https://stacks.cdc.gov/view/cdc/194435/cdc_194435_DS1.pdf
• File Type:
  [PDF - 311.06 KB ]