Distal Airway Function in Symptomatic Subjects with Normal Spirometry Following World Trade Center Dust Exposure

Details

• Personal Author:
  Berger KI ; Goldring RM ; Herberg ME ; Hofer IS ; Liautaud S ; Oppenheimer BW ; Reibman J ; Reyfman PA ; Rom, William N.
• Description:
  Rationale: Following collapse of the World Trade Center (WTC), individuals reported new-onset respiratory symptoms. Despite symptoms, spirometry often revealed normal airway function. However, bronchial wall thickening and air trapping were seen radiographically in some subjects. We hypothesized that symptomatic individuals following exposure to WTC dust may have functional abnormalities in distal airways not detectable with routine spirometry. Methods: One hundred seventy-four subjects with respiratory symptoms and normal spirometry results were evaluated. Impedance oscillometry (IOS) was performed to determine resistance at 5 Hz, 5 to 20 Hz, and reactance area. Forty-three subjects were also tested for frequency dependence of compliance (FDC). Testing was repeated after bronchodilation. Results: Predominant symptoms included cough (67%) and dyspnea (65%). Despite normal spirometry results, mean resistance at 5 Hz, 5 to 20 Hz, and reactance area were elevated (4.36 + 0.12 cm H2O/L/s, 0.86 + 0.05 cm H2O/L/s, and 6.12 + 0.50 cm H2O/L, respectively) [mean + SE]. Resistance and reactance normalized after bronchodilation. FDC was present in 37 of 43 individuals with improvement after bronchodilation. Conclusions: Symptomatic individuals with presumed WTC dust/fume exposure and normal spirometry results displayed airway dysfunction based on the following: (1) elevated airway resistance and frequency dependence of resistance determined by IOS; (2) heterogeneity of distal airway function demonstrated by elevated reactance area on oscillometry and FDC; and (3) reversibility of these functional abnormalities to or toward normal following administration of a bronchodilator. Since spirometry results were normal in all subjects, these abnormalities likely reflect dysfunction in airways more distal to those evaluated by spirometry. Examination of distal airway function when spirometry results are normal may be important in the evaluation of subjects exposed to occupational and environmental hazards. [Description provided by NIOSH]
• Subjects:
  Air Pollutants, Occupational Dust Environmental Exposure Lung Lung Diseases Men Occupational Health Radiation Respiratory Function Tests Respiratory System Respiratory Tract Diseases Risk Assessment Risk Factors Safety September 11 Terrorist Attacks Women

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• Keywords:
  Author Keywords: Distal Airways Dust Exposure Dusts Environmental Exposure Exposure Levels Fumes Humans Oscillography Oscillometry Pulmonary System Pulmonary System Disorders Radiography Respiratory Function Tests Respiratory System Disorders Risk Factors Spirometry World Trade Center World Trade Center Disaster WTC

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• ISSN:
  0012-3692
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Grant
• 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:
  132
• Issue:
  4
• NIOSHTIC Number:
  nn:20050789
• Citation:
  Chest 2007 Oct; 132(4):1275-1282
• Contact Point Address:
  Kenneth I. Berger, MD, FCCP, New York University School of Medicine, 550 First Ave, Room RR 108, New York, NY 10016
• Email:
  Kenneth.berger@med.nyu.edu
• Federal Fiscal Year:
  2008
• Performing Organization:
  New York State Department of Health
• Peer Reviewed:
  True
• Start Date:
  20041001
• Source Full Name:
  Chest
• End Date:
  20080928
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:3571714f019512cb008b95ff679d5fae19edecb06dab3bb3d149bd2c373f5c86347987da7ba95d45ce2246c92a3d64986086aa2beb535a865c99f6c0dd4a9aa3
• Download URL:
  https://stacks.cdc.gov/view/cdc/211003/cdc_211003_DS1.pdf
• File Type:
  [PDF - 224.13 KB ]