Bronchial hyperreactivity and other inhalation lung injuries in rescue/recovery workers after the World Trade Center collapse

Details

• Personal Author:
  Alleyne D ; Alva R ; Banauch GI ; Dhala A ; Kelly KJ ; Krasko A ; Prezant DJ ; Santhyadka G ; Weiden M
• Description:
  Background: The collapse of the World Trade Center (WTC) on September 11, 2001 created a large-scale disaster site in a dense urban environment. In the days and months thereafter, thousands of rescue/recovery workers, volunteers, and residents were exposed to a complex mixture of airborne pollutants. Methods: We review current knowledge of aerodigestive inhalation lung injuries resulting from this complex exposure and present new data on the persistence of nonspecific bronchial hyperreactivity (methacholine PC20 <=8 mg/mL) in a representative sample of 179 Fire Department of the City of New York (FDNY) rescue workers stratified by exposure intensity (according to arrival time) who underwent challenge testing at 1, 3, 6, and 12 months post-collapse. Results: Aerodigestive tract inflammatory injuries, such as declines in pulmonary function, reactive airways dysfunction syndrome (RADS), asthma, reactive upper airways dysfunction syndrome (RUDS), gastroesophageal reflux disease (GERD), and rare cases of inflammatory pulmonary parenchymal diseases, have been documented in WTC rescue/recovery workers and volunteers. In FDNY rescue workers, we found persistent hyperreactivity associated with exposure intensity, independent of airflow obstruction. One year post-collapse, 23% of highly exposed subjects were hyperreactive as compared with only 11% of moderately exposed and 4% of controls. At 1 yr, 16% met the criteria for RADS. Conclusions: While it is too early to ascertain all of the long-term effects of WTC exposures, continued medical monitoring and treatment is needed to help those exposed and to improve our prevention, diagnosis, and treatment protocols for future disasters. [Description provided by NIOSH]
• Subjects:
  Air Pollutants, Occupational Air Pollution, Indoor Asthma Asthma, Occupational Delivery Of Health Care Emergency Responders Environmental Exposure Health Care Facilities Workforce And Services Irritants Lung Lung Diseases Occupational Health Particulate Matter Respiratory System Respiratory Tract Diseases Risk Assessment Risk Factors Safety September 11 Terrorist Attacks Women

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• Keywords:
  Air-contamination Airborne-particles Airborne Particulates Author Keywords: World Trade Center Bronchial-asthma Emergency-responders Environmental-exposure Exposure-levels Firefighters Humans Inhalation Lung Injury Injuries Lung-irritants Medical-care Medical-monitoring Medical-treatment Nonspecific Bronchial Hyperreactivity Pollutants Pollution Pulmonary-disorders Pulmonary-function Pulmonary-system Pulmonary-system-disorders Rescue-workers Rescue Workers Respiration Respiratory-irritants Respiratory-system-disorders Risk-factors

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• ISSN:
  0090-3493
• 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:
  33
• NIOSHTIC Number:
  nn:20046186
• Citation:
  Crit Care Med 2005 Jan; 33(Suppl 1):S102-S106
• Federal Fiscal Year:
  2005
• Performing Organization:
  New York City Fire Department
• Peer Reviewed:
  True
• Start Date:
  20040701
• Source Full Name:
  Critical Care Medicine
• Supplement:
  1
• End Date:
  20110630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:20980c48d87bfd46dc9ac86e753f64a4b03516a976ec52121db19094a38f258a0a0aef6cffce488a3ffcd0c37a0ef6ef80459560ac41a54413a893faf653bf24
• Download URL:
  https://stacks.cdc.gov/view/cdc/201313/cdc_201313_DS1.pdf
• File Type:
  [PDF - 475.54 KB ]