Vocal cord dysfunction in former World Trade Center (WTC) rescue and recovery workers and volunteers

Details

• Personal Author:
  Afilaka AA ; Bienenfeld LA ; de Ia Hoz RE ; Herbert R ; Levin SM ; Shohet M
• Description:
  BACKGROUND: Vocal cord dysfunction (VCD) is a condition characterized by paradoxical partial adduction of the vocal cords on inspiration. It has been associated with exposures to irritants, as well as with psychological illnesses and conditions. Workers who participated in the recovery of the WTC disaster site were exposed to a large amount of irritants as well as considerable psychological stressors. We describe the clinical characteristics of 10 symptomatic former WTC workers diagnosed with this condition, as well as the frequency of spirometric findings suggestive of variable extrathoracic obstruction. METHODS: Workers who became symptomatic after their WTC work experience have been evaluated clinically by a multidisciplinary team at an academic medical center. The evaluation included history, physical examination, chest radiograph, blood tests, and pre- and post-bronchodilator spirometry in all patients. Additional evaluations and diagnostic tests included otolaryngological evaluation with flexible rhinolaryngoscopy and stroboscopy, gastroenterological and psychiatric evaluations. A randomly selected sample of 172 spirometry results were reviewed for evidence of inspiratory flow limitation. RESULTS: Variable extrathoracic obstruction was found in 18.6% of the spirometries. Ten patients were diagnosed with VCD. In addition to symptoms suggestive of co-morbid conditions (particularly rhinitis and acid reflux disease), most of the 10 patients had (1) hoarseness, (2) dyspnea that was not associated with bronchial hyperreactivity, or (3) dyspnea associated with asthma, with either mild bronchial hyperreactivity and/or poor response to asthma treatment. CONCLUSIONS: VCD appears to be part of the spectrum of airway disorders caused by occupational exposures at the WTC disaster site. Further study of this association is warranted. [Description provided by NIOSH]
• Subjects:
  Aging Asthma Asthma, Occupational Emergency Responders Epidemiology Irritants Lung Men Mental Health Occupational Health Respiratory System Respiratory Tract Diseases Safety Women

  More +
• Keywords:
  Age-groups Airway-obstruction Asthma Author Keywords: Occupational Medicine Bronchial-asthma Etiology Humans Inhalation Injury Irritant Exposures Otolaryngologic-disorders Psychological-effects Psychological-reactions Psychological-responses Psychology Pulmonary-function Pulmonary-system Pulmonary-system-disorders Rescue-workers Respiration Respiratory-irritants Respiratory-system-disorders Respiratory Diseases Thorax Throat-disorders Vocal Cord Dysfunction

  More +
• ISSN:
  0271-3586
• Document Type:
  Text
• Funding:
  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:
  161-165
• Volume:
  51
• Issue:
  3
• NIOSHTIC Number:
  nn:20045860
• Citation:
  Am J Ind Med 2008 Mar; 51(3):161-165
• Contact Point Address:
  L. A. Bienenfeld, Department of Community and Preventive Medicine, and Medicine, The Mount Sinai School of Medicine, WTC Health EVects Treatment Program, One Gustave L. Levy Place, Box 1059, New York, NY 10029
• Email:
  Rafael.delaHoz@mssm.edu
• Federal Fiscal Year:
  2008
• Performing Organization:
  Mount Sinai School of Medicine of New York
• Peer Reviewed:
  True
• Start Date:
  20040601
• Source Full Name:
  American Journal of Industrial Medicine
• End Date:
  20100531
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:2c01c7e3cf827d87a86c3cc757e0d1fc42161b0d9bea6326a0e1d18f652c394957573c6ee96a42bac158fd714be0fda1f7685f3d90a36cbeee1fbbe1e7f9e5eb
• Download URL:
  https://stacks.cdc.gov/view/cdc/201116/cdc_201116_DS1.pdf
• File Type:
  [PDF - 94.82 KB ]