The Association Between World Trade Center-Exposure and Obstructive Sleep Apnea in Firefighters

Details

• Personal Author:
  Appel D ; Prezant DJ ; Singh A ; Webber MP ; Zeig-Owens R
• Description:
  Background: Obstructive sleep apnea (OSA) is a common, potentially life-threatening condition. Prevalence increased in the last 2 decades, and was recently estimated to be 26% in adults, although estimates vary considerably. Previously, we reported that 44% of Fire Department of the City of New York (FDNY) World Trade Center (WTC)-exposed workers were at high risk of OSA based on a screening survey. Objective: To estimate the association between WTC exposure and self-reported OSA diagnoses in WTC-exposed FDNY and non-WTC-exposed non-FDNY firefighters. Methods: 10,020 WTC-exposed FDNY firefighters and 3,513 non-WTC-exposed firefighters from the Chicago, Philadelphia and San Francisco fire departments who were employed on 9/11/01 were included in the analyses. Each completed a health survey that included questions about OSA diagnoses by a health professional and recency of a doctor visit. Multivariable logistic regression models estimated the OR of OSA in WTC-exposed vs. non-WTC-exposed firefighters, controlling for known risk factors. Results: Overall, 33% of the WTC-exposed cohort reported an OSA diagnosis compared with 21% of the non-WTC-exposed. WTC-exposed firefighters had elevated OSA odds (OR=1.31; 95%CI=1.17-1.46) after controlling for age, sex, race, smoking, alcohol use, BMI, and self-reported hypertension and diabetes. Other statistically significant risk factors were male sex (OR=2.14; 95%CI=1.35-3.40), BMI (OR=1.14; 95%CI=1.14-1.16), hypertension (OR=1.51; 95%CI=1.39-1.65), and diabetes (OR=1.64; 95%CI=1.46-1.85). All FDNY firefighters and >90% of non-FDNY firefighters reported a doctor visit ≤2 years prior to survey completion. Conclusion: WTC exposure conferred an increased risk of OSA diagnoses, although we cannot rule out the possibility of detection bias because FDNY physicians have heightened awareness of OSA based on its association with other WTC-related respiratory conditions. All of these conditions may be manifestations of chronic systemic inflammation. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Firefighters Occupational Health Respiratory System Safety September 11 Terrorist Attacks
• Keywords:
  Airway Obstruction Cohort Studies Fire Fighters Respiratory Function Sleep Apnea World Trade Center WTC
• Publisher:
  Society for Epidemiologic Research
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Abstract or Summary
• Place as Subject:
  California ; Illinois ; New York ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 5 ; OSHA Region 9 ; Pennsylvania
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• NIOSHTIC Number:
  nn:20069625
• Citation:
  52nd Annual Society for Epidemiologic Research (SER) Meeting, June 14-17, 2022, Chicago, Illinois. Clearfield, UT: Society for Epidemiologic Research, 2022 Jun; :719
• Federal Fiscal Year:
  2022
• Performing Organization:
  Albert Einstein College of Medicine, Bronx, New York
• Peer Reviewed:
  False
• Start Date:
  20190101
• Source Full Name:
  52nd Annual Society for Epidemiologic Research (SER) Meeting, June 14-17, 2022, Chicago, Illinois
• End Date:
  20230831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:87d7f29665238df5b5f8c710a2929d178a3e20e05d90dc1de77cf4c5be8ad9cb8950bffded827ff6cbb07bcab8384d0fa4189df50e6d1ca0cea66a72679bb20f
• Download URL:
  https://stacks.cdc.gov/view/cdc/208015/cdc_208015_DS1.pdf
• File Type:
  [PDF - 210.00 KB ]