Chronic Obstructive Pulmonary Disease in WTC Workers – Diagnoses and Transitions

Details

• Personal Author:
  de la Hoz RE ; Doucette JT
• Description:
  Background: The goal of this proposal is to characterize the transitions into chronic obstructive pulmonary disease (COPD) among former workers and volunteers at the WTC disaster site. We propose to use the Global Initiative for Chronic Obstructive Lung Disease (GOLD) physiological definition and severity classification of COPD, and investigate functional and imaging features, and the role of WTC occupational exposures in disease status and severity. Methods: We proposed to (SA1) assess the association between physiologically defined chronic obstructive pulmonary disease and quantitative chest CT indicators of its main components using a spirometric definition; (SA2) establish the diagnostic categories of COPD in the WTC population, study their progression and transitions, and assess the relationship between the most frequent ventilatory impairment in WTC workers (low FVC or GOLD-unclassified, GOLD-U) and chest CT evidence of end-expiratory air trapping; and (SA3) test whether WTC exposure level interacts with tobacco smoking on increasing the risk of chronic obstructive pulmonary disease on the Mount Sinai WTC GRC and the NYC DOH WTC Registry. Results: We established that spirometrically defined COPD is very infrequent in the WTC GRC and is usually (>90%) mild to moderate, is (expectedly) heavily determined by past smoking history, but has a modest statistically significant association with WTC related exposure indicators. COPD is associated with the expected quantitative computed tomography (QCT) markers of emphysema, proximal airway inflammation, and end-expiratory air trapping. The low FVC pattern, on the other hand, was associated with proximal but not distal airway QCT inflammation markers. We have found no interaction between tobacco smoking and WTC exposures in association with COPD either in the WTC Chest CT Imaging cohort, or the WTC Health Registry. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Emergency Responders Lung Occupational Health Respiratory Function Tests Respiratory System Safety September 11 Terrorist Attacks
• Keywords:
  Chronic Obstructive Pulmonary Disease Cohort Studies COPD Emergency Responders Longitudinal Study Lung Function Rescue Workers Spirometry Surveillance World Trade Center WTC

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• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Final Cooperative Agreement Report
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-14
• NIOSHTIC Number:
  nn:20066947
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, U01-OH-011697, 2022 Oct; :1-14
• Contact Point Address:
  Rafael E. de la Hoz, MD, MPH, MSc, Icahn School of Medicine at Mount Sinai, Division of Occupational and Environmental Medicine, One Gustave L. Levy Place, Box 1059, New York, NY 10029
• Email:
  Rafael.delaHoz@mssm.edu
• Federal Fiscal Year:
  2023
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  False
• Start Date:
  20180701
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20210630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:e2ce3ed1b4b84a72f9764cde2375ddd6141140bf1a86576a80ef764ac1fe066484b921284aea50b1996ab236189af43d141eabccb05544782e188832a17db72e
• Download URL:
  https://stacks.cdc.gov/view/cdc/219175/cdc_219175_DS1.pdf
• File Type:
  [PDF - 329.46 KB ]