Association of World Trade Center (WTC) Occupational Exposure Intensity with Chronic Obstructive Pulmonary Disease (COPD) and Asthma COPD Overlap (ACO)

Details

• Personal Author:
  Celedón JC ; Cone, James E. ; de la Hoz RE ; Lucchini RG ; Nolan A ; Shapiro M ; Sood A
• Description:
  Introduction: Reported associations between World Trade Center (WTC) occupational exposure and chronic obstructive pulmonary disease (COPD) or asthma COPD overlap (ACO) have been inconsistent. Using spirometric case definitions, we examined that association in the largest WTC occupational surveillance cohort. Methods: We examined the relation between early arrival at the 2001 WTC disaster site (when dust and fumes exposures were most intense) and COPD and ACO in workers with at least one good quality spirometry with bronchodilator response testing between 2002 and 2019, and no physician-diagnosed COPD before 9/11/2001. COPD was defined spirometrically as fixed airflow obstruction and ACO as airflow obstruction plus an increase of ≥ 400 ml in FEV1 after bronchodilator administration. We used a nested 1:4 case-control design matching on age, sex and height using incidence density sampling. Results: Of the 17,928 study participants, most were male (85.3%) and overweight or obese (84.9%). Further, 504 (2.8%) and 244 (1.4%) study participants met the COPD and ACO spirometric case definitions, respectively. In multivariable analyses adjusted for smoking, occupation, cohort entry period, high peripheral blood eosinophil count and other covariates, early arrival at the WTC site was associated with both COPD (adjusted odds ratio [ORadj] = 1.34, 95% confidence interval [CI] 1.01-1.78) and ACO (ORadj = 1.55, 95%CI 1.04-2.32). Conclusion: In this cohort of WTC workers, WTC exposure intensity was associated with spirometrically defined COPD and ACO. Our findings suggest that early arrival to the WTC site is a risk factor for the development of COPD or of fixed airway obstruction in workers with pre-existing asthma. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Cohort Studies Emergency Responders Lung Occupational Health Respiratory Function Tests Respiratory System Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease Cohort Studies COPD Emergency Responders Longitudinal Changes In Lung Function Lung Function Obesity Occupational Lung Disease Rescue Workers Smoke Inhalation Injury Spirometry Surveillance World Trade Center World Trade Center Attack 2001 WTC

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• ISSN:
  0341-2040
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Contract
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2 ; OSHA Region 3 ; Pennsylvania
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  325-341
• Volume:
  201
• Issue:
  4
• NIOSHTIC Number:
  nn:20068044
• Citation:
  Lung 2023 Aug; 201(4):325-341
• 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:
  True
• Start Date:
  20180701
• Source Full Name:
  Lung
• End Date:
  20210630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:cbc26e6c6cda84a65306c028560750027d85da4297153f304664dd60c9f050ea426ec4e415fecd8f9eef47907c6571542a9248e4b7baa161ff9bec325a6ba884
• Download URL:
  https://stacks.cdc.gov/view/cdc/230265/cdc_230265_DS1.pdf
• File Type:
  [PDF - 501.06 KB ]