Case-control study of lung function in World Trade Center health registry area residents and workers

Details

• Personal Author:
  Berger KI ; Farfel MR ; Friedman SM ; Goldring RM ; Maslow CB ; Pillai PS ; Reibman J ; Stellman SD
• Description:
  Rationale: Residents and area workers who inhaled dust and fumes from the World Trade Center disaster reported lower respiratory symptoms in two World Trade Center Health Registry surveys (2003-2004 and 2006-2007), but lung function data were lacking. Objectives: To examine the relationship between persistent respiratory symptoms and pulmonary function in a nested case-control study of exposed adult residents and area workers 7-8 years after September 11, 2001. Methods: Registrants reporting post September 11th onset of a lower respiratory symptom in the first survey and the same symptom in the second survey were solicited as potential cases. Registrants without lower respiratory symptoms in either Registry survey were solicited as potential control subjects. Final case-control status was determined by lower respiratory symptoms at a third interview (the study), when spirometry and impulse oscillometry were also performed. Measurements and Main Results: We identified 180 cases and 473 control subjects. Cases were more likely than control subjects to have abnormal spirometry (19% vs. 11%; P < 0.05), and impulse oscillometry measurements of elevated airway resistance (R5; 68% vs. 27%; P < 0.0001) and frequency dependence of resistance (R5-20; 36% vs. 7%; P < 0.0001). When spirometry was normal, cases were more likely than control subjects to have elevated R5 and R5-20 (62% vs. 25% and 27% vs. 6%, respectively; both P < 0.0001). Associations between symptoms and oscillometry held when factors significant in bivariate comparisons (body mass index, spirometry, and exposures) were analyzed using logistic regression. Conclusions: This study links persistent respiratory symptoms and oscillometric abnormalities in World Trade Center-exposed residents and area workers. Elevated R5 and R5-20 in cases despite normal spirometry suggested distal airway dysfunction as a mechanism for symptoms. [Description provided by NIOSH]
• Subjects:
  Air Pollutants, Occupational Dust Lung Lung Diseases Men Occupational Health Respiratory Function Tests Respiratory System Respiratory Tract Diseases Safety Women

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• Keywords:
  Author Keywords: Distal Airways Disaster Dust-exposure Dust-particles Dusts Exposure-levels Fumes Gases Humans Lung-disorders Lung-function Oscillography Oscillometry Physiological-effects Physiology Pulmonary-function Pulmonary-system Pulmonary-system-disorders Respiratory-system-disorders Spirometry

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• ISSN:
  1073-449X
• Document Type:
  Text
• Funding:
  Grant ; 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:
  184
• Issue:
  5
• NIOSHTIC Number:
  nn:20046140
• Citation:
  Am J Respir Crit Care Med 2011 Sep; 184(5):582-589
• Contact Point Address:
  Stephen Friedman, M.D., M.P.H., Division of Epidemiology, CN6, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Queens, NY 11101
• Email:
  sfriedm2@health.nyc.gov
• Federal Fiscal Year:
  2011
• Performing Organization:
  New York City Health and Hospitals Corporation
• Peer Reviewed:
  True
• Start Date:
  20080928
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• End Date:
  20110928
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:dec48076d22c0eb87120c74d0ddcdef1334d9dae5f168edf470f492b55ab03f05c6de1db664bc58b7af7949e95b76cde3ed2cbe766306af561b345022a36bf3b
• Download URL:
  https://stacks.cdc.gov/view/cdc/201275/cdc_201275_DS1.pdf
• File Type:
  [PDF - 779.74 KB ]