Isolated small airway reactivity during bronchoprovocation as a mechanism for respiratory symptoms in WTC dust-exposed community members

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• Personal Author:
  Berger KI ; Chan Y ; Goldring RM ; Kalish S ; Kazeros A ; Marmor M ; Oppenheimer BW ; Reibman J ; Shao Y
• Description:
  Introduction: Small airway dysfunction occurs following WTC dust exposure, but its role in producing symptoms is unclear. Methods: Methacholine challenge (MCT) was used to assess the relationship between onset of respiratory symptoms and small airway abnormalities in 166 symptomatic WTC dust-exposed patients. Forced oscillation testing (FOT) and respiratory symptoms were assessed during MCT. FOT parameters included resistance at 5 and 20 Hz (R5 and R20) and the R5 minus R20 (R5-20). Results: Baseline spirometry was normal in all (mean FEV1 100+13% predicted, mean FEV1/FVC 80+4%). MCT revealed bronchial hyperreactivity by spirometry in 67 patients. An additional 24 patients became symptomatic despite minimal FEV1 change (<5%); symptom onset coincided with increased R5 and R5-20 (P>0.001 vs. baseline). The dose-response of FOT (reactivity) was greater compared with subjects that remained asymptomatic (P<0.05). Conclusions: FOT during MCT uncovered reactivity in small airways as a mechanism for respiratory symptoms in subjects with inhalational lung injury [Description provided by NIOSH]
• Subjects:
  Dust Environmental Exposure Lung Lung Diseases Methacholine Compounds Occupational Health Respiratory Function Tests Respiratory System Respiratory Tract Diseases Risk Assessment Risk Factors Safety September 11 Terrorist Attacks

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• Keywords:
  Author Keywords: Airway Physiology Bronchial Hyper-reactivity Dust Exposure Dusts Exposure Levels Forced Oscillation Methacholine Challenge Test Methacholines Pulmonary Effects Pulmonary Function Pulmonary System Pulmonary System Disorders Respiratory Function Respiratory System Disorders Risk Factors Spirometry World Trade Center WTC

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• ISSN:
  0271-3586
• Document Type:
  Text
• Funding:
  Contract ; 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:
  59
• Issue:
  9
• NIOSHTIC Number:
  nn:20048588
• Citation:
  Am J Ind Med 2016 Sep; 59(9):767-776
• Contact Point Address:
  Kenneth I. Berger, MD, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, NYU School of Medicine, 240 East 38th Street, Room M-15, New York, NY 10016
• Email:
  Kenneth.berger@nyumc.org
• Federal Fiscal Year:
  2016
• Performing Organization:
  New York City Health and Hospitals Corporation
• Peer Reviewed:
  True
• Start Date:
  20080929
• Source Full Name:
  American Journal of Industrial Medicine
• End Date:
  20110928
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:fb127b78c7125c1674721ad9303b89c4c8d0739e75db9fa5b916d03823709e6c98018dd09316f1afd235a97d9d4914afb1785498794951ef68425016914267d9
• Download URL:
  https://stacks.cdc.gov/view/cdc/203309/cdc_203309_DS1.pdf
• File Type:
  [PDF - 682.85 KB ]