Chronic Rhinosinusitis Is an Independent Risk Factor for OSA in World Trade Center Responders

Details

• Personal Author:
  Alimokhtari S ; Ayappa I ; Black K ; Chitkara N ; de la Hoz RE ; Harrison D ; Lu S-E ; Rapoport DM ; Sanders H ; Sunderram J ; Twumasi A ; Udasin I ; Weintraub M
• Description:
  Background: Many respiratory conditions have been attributed to toxic dust and fume exposure in World Trade Center (WTC) rescue and recovery workers, who frequently report symptoms of OSA. We examined the prevalence of new-onset OSA and tested if the prevalence and severity of OSA are related to the presence of chronic rhinosinusitis (CRS). Methods: A total of 601 subjects (83% men; age, 33-87 years; BMI, 29.9 +/- 5.5 kg/m2) enrolled in the WTC Health Program, excluding those with significant pre-September 11, 2001, snoring or prior CRS, underwent two nights of home sleep testing. OSA was defined as Apnea Hypopnea Index 4% = 5 events/h or respiratory disturbance index of = 15 events/h. CRS was assessed using nasal symptom questionnaires. Results: The prevalence of OSA was 75% (25% no OSA, 46% mild OSA, 19% moderate OSA, and 10% severe OSA), and the prevalence of CRS was 43.5%. Compared with no CRS, new and worsening CRS was a significant risk factor for OSA with an OR of 1.80 (95% CI, 1.18-2.73; P = .006) unadjusted and 1.76 (95% CI, 1.08-2.88; P = .02) after adjustment for age, BMI, sex, gastroesophageal reflux disorder, and alcohol use. Conclusions: The high prevalence of OSA in WTC responders was not explained fully by obesity and sex. Possible mechanisms for the elevated risk of OSA in subjects with CRS include increased upper airway inflammation and/or elevated nasal/upper airway resistance, but these need confirmation. [Description provided by NIOSH]
• Subjects:
  Air Pollutants, Occupational Dust Emergency Responders Occupational Health Respiratory System Respiratory Tract Diseases Risk Assessment Risk Factors Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: Chronic Rhinosinusitis Breathing Dust Exposure Fumes Nasal Disorders Nasal Symptoms OSA Rescue Workers Respiratory Diseases Risk Factors World Trade Center WTC WTC Exposure

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• ISSN:
  0012-3692
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Contract
• Genre:
  Journal Article
• Place as Subject:
  New Jersey ; New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  375-383
• Volume:
  155
• Issue:
  2
• NIOSHTIC Number:
  nn:20055160
• Citation:
  Chest 2019 Feb; 155(2):375-383
• Contact Point Address:
  Jag Sunderram, MD, Division of Pulmonary and Critical Care Medicine, Department of Medicine, 1 Robert Wood Johnson Place, MEB 572, New Brunswick, NJ 08901
• Email:
  sunderja@rwjms.rutgers.edu
• Federal Fiscal Year:
  2019
• Performing Organization:
  RBHS-Robert Wood Johnson Medical School, Piscataway, New Jersey
• Peer Reviewed:
  True
• Start Date:
  20120901
• Source Full Name:
  Chest
• End Date:
  20170831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:9806f2a58dc6371b39dc6529f2b94c8c86805c78708a1c10ec6c6271ef60146475b20da8bb62369d3b28c321ef9bee9578bf97465362820eadb81ea6c73680fb
• Download URL:
  https://stacks.cdc.gov/view/cdc/217521/cdc_217521_DS1.pdf
• File Type:
  [PDF - 296.34 KB ]