Reflux symptoms and disorders and pulmonary disease in former World Trade Center rescue and recovery workers and volunteers

Details

• Personal Author:
  Afilaka AA ; Bienenfeld LA ; Christie J ; Crane M ; de Ia Hoz RE ; Herbert R ; Levin SM ; Teamer JA
• Description:
  BACKGROUND: Gastroesophageal reflux disease is one of the most prevalent conditions among former World Trade Center (WTC) rescue and recovery workers. The reason for this proposed association with an inhalation injury is unclear. In this study, we clinically characterized the reflux disorders in former WTC workers, and we investigated their association with pulmonary function abnormalities and with clinical diagnoses of other WTC-related diseases. METHODS: Forty-two former WTC workers underwent the following testing: symptom inventories, physical examination, spirometry, esophagogastroduodenoscopy, and 24-hour pH monitoring studies for the evaluation of chronic reflux-like symptoms. Patients were classified into two groups based on clinical evaluation: group 1 (reflux patients) including definitive reflux disorders (gastroesophageal reflux, nonerosive reflux, nonacid reflux, and laryngopharyngeal reflux diseases) and group 2 (no-reflux patients) patients without clinically significant reflux disease, including functional heartburn, and hypersensitive esophagus disorder. RESULTS: The reflux and no-reflux patients had significantly different Johnson-DeMeester scores and esophageal acid exposure times. Patients with reflux disorders were more likely to have reduced forced vital capacity (chi2 = 5.49, P = 0.031) and also more likely to have been diagnosed with a lower airway disease (chi2 = 7.14, P = 0.008). We found no significant association between reflux and psychiatric disorders (chi2 = 0.02, P = 0.89), levels of exposure at the WTC site, or incidence of dry cough, or other upper airway disorders. CONCLUSIONS: A spectrum of reflux symptoms and disorders are present in WTC responders. Our data suggest that the presence of reflux disease is related to that of pulmonary function abnormality suggestive of air trapping and a diagnosis of a lower respiratory disease. Erratum in J Occup Environ Med. 2009 Apr;51(4):509. There was an error in Table 1. The diagnosis of hypersensitive esophagus syndrome (HSE), is grouped as "(Definite) reflux" The correct designation is "No reflux." [Description provided by NIOSH]
• Subjects:
  Digestive System Digestive System Diseases Emergency Responders Inhalation Exposure Lung Lung Diseases Men Mental Disorders Mental Health Occupational Health Respiratory Function Tests Respiratory System Respiratory Tract Diseases Safety Women

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• Keywords:
  Diseases Gastrointestinal-system Gastrointestinal-system-disorders Humans Inhalants Injuries Lung-disorders Lung-function Mental-disorders Physical-examination Physiological-function Physiology Pulmonary-function Pulmonary-system Pulmonary-system-disorders Rescue-workers Spirometry

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• ISSN:
  1076-2752
• 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
• Volume:
  50
• Issue:
  12
• NIOSHTIC Number:
  nn:20045861
• Citation:
  J Occup Environ Med 2008 Dec; 50(12):1351-1354
• Contact Point Address:
  Rafael E. de la Hoz, MD, MPH, Department of Community and Preventive Medicine, and Medicine, The Mount Sinai School of Medicine, One Gustave Levy Place, Box 1059, New York, NY 10029
• Email:
  Rafael.delaHoz@mssm.edu
• Federal Fiscal Year:
  2009
• Performing Organization:
  Mount Sinai School of Medicine of New York
• Peer Reviewed:
  True
• Start Date:
  20040601
• Source Full Name:
  Journal of Occupational and Environmental Medicine
• End Date:
  20100531
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:1ae13486f242a8f8a3f2d0e106cb84b4be26c46e6070ba05d70f2461324007d715d65d1e3f2d8f8afac197ce1ee4bf5290698b35ec7e780988d917bcdef59ddc
• Download URL:
  https://stacks.cdc.gov/view/cdc/201117/cdc_201117_DS1.pdf
• File Type:
  [PDF - 126.80 KB ]