The upper respiratory pyramid: early factors and later treatment utilization in World Trade Center exposed firefighters

Details

• Personal Author:
  Aldrich TK ; Cohen HW ; Glaser MS ; Glass L ; Hall CB ; Kelly KJ ; Liu X ; Niles JK ; Nolan A ; Prezant DJ ; Schwartz TM ; Weakley J ; Webber MP ; Weiden MD ; Zeig-Owens R
• Description:
  Background: We investigated early post 9/11 factors that could predict rhinosinusitis healthcare utilization costs up to 11 years later in 8,079 World Trade Center-exposed rescue/recovery workers. Methods: We used bivariate and multivariate analytic techniques to investigate utilization outcomes; we also used a pyramid framework to describe rhinosinusitis healthcare groups at early (by 9/11/2005) and late (by 9/11/2012) time points. Results: Multivariate models showed that pre-9/11/2005 chronic rhinosinusitis diagnoses and nasal symptoms predicted final year healthcare utilization outcomes more than a decade after WTC exposure. The relative proportion of workers on each pyramid level changed significantly during the study period. Conclusions: Diagnoses of chronic rhinosinusitis within 4 years of a major inhalation event only partially explain future healthcare utilization. Exposure intensity, early symptoms and other factors must also be considered when anticipating future healthcare needs [Description provided by NIOSH]
• Subjects:
  Emergency Responders Firefighters Men Nose Occupational Health Respiratory System Respiratory Tract Diseases Risk Assessment Risk Factors Safety Sense Organs Smoke Women

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• Keywords:
  Author Keywords: World Trade Center Chronic Rhinosinusitis Exposure-levels Fire-fighters Firefighters Health-care Humans Models Nasal-disorders Rescue-workers Respiration Respiratory-rate Respiratory-system-disorders Risk-factors Sinus Symptoms Smoke-inhalation Stress Treatment Outcomes

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• ISSN:
  0271-3586
• Document Type:
  Text
• Funding:
  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
• Volume:
  57
• Issue:
  8
• NIOSHTIC Number:
  nn:20044476
• Citation:
  Am J Ind Med 2014 Aug; 57(8):857-865
• Contact Point Address:
  Mayris P.Webber, Dr PH, MPH, Department of Epidemiology and Population Health, Montefiore Medical Center/Albert Einstein College of Medicine & Director of WTC Epidemiology Bureau of Health Services, Fire Department of the City of New York, Bronx, NY
• Email:
  webberm@fdny.nyc.gov
• Federal Fiscal Year:
  2014
• Performing Organization:
  New York City Fire Department
• Peer Reviewed:
  True
• Start Date:
  20140701
• Source Full Name:
  American Journal of Industrial Medicine
• End Date:
  20170630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:ddb7d1decfad514da4bfdb6a9b93fbb017e592aa31016c2ca6fd98a510545f4ca24baf760d92e9cb9bf940aa3c396d28b17355945c94a828234bdf4123468ca0
• Download URL:
  https://stacks.cdc.gov/view/cdc/200166/cdc_200166_DS1.pdf
• File Type:
  [PDF - 267.94 KB ]