Cluster Analysis of World Trade Center (WTC) Related Lower Airway Diseases

Details

• Personal Author:
  Celedón J ; de la Hoz RE ; Doucette J ; Jeon Y ; Reeves A ; San José Estépar R ; Weber J
• Description:
  Introduction: Cluster analysis can help classify the heterogeneous chronic lower airway diseases found in former workers at the World Trade Center (WTC) disaster site without a priori assumptions. Methods: We selected the first available chest CT scan with quantitative CT measurements of lung density, air trapping (ATEXP856 and MLDEI), and wall area percent on 311 former WTC workers who also had complete clinical, and spirometric data from the closest surveillance visit. We performed agglomerative hierarchical cluster analysis, using Gower distance measure. Results: A 4-cluster solution was most satisfactory. Ever smokers predominated in clusters 2 and 4. In cluster 4 (n=32), obstruction, bronchodilator response (BDR), and emphysema predominated, FEV1%predicted was the lowest, and there was less dyspnea. This group included more Caucasians, former smokers, subjects with more pack-years of smoking, and those least likely to have arrived early at the WTC disaster site. In contrast, subjects in cluster 2 (n=141), also predominantly Caucasian, were more likely to be gaining weight and to currently smoke, and had less BDR and air trapping QCT metrics. Cluster 2 subjects were the most likely to have arrived within 48 hours at the WTC disaster site. A low FVC pattern was observed in clusters 1 and 3. Cluster 3 subjects (n=79) had higher baseline BMI and were less likely to lose weight. Cluster 1 subjects (n=59) had more BDR and dyspnea, and higher FEV1% of predicted. Discussion: Cluster analysis confirms low FVC and COPD/emphysema as distinctive chronic lower airway disease phenotypes on long term surveillance of the WTC workers, and suggests characteristics of subgroups with diverging outcomes. [Description provided by NIOSH]
• Subjects:
  Lung Occupational Health Respiratory Function Tests Respiratory System Safety September 11 Terrorist Attacks
• Keywords:
  Chronic Obstructive Pulmonary Disease COPD Lung Function Spirometry Surveillance World Trade Center WTC
• ISSN:
  0903-1936
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Abstract or Summary
• Place as Subject:
  Massachusetts ; New York ; OSHA Region 1 ; OSHA Region 2 ; OSHA Region 3 ; Pennsylvania
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  58
• NIOSHTIC Number:
  nn:20068342
• Citation:
  Eur Respir J 2021 Sep; 58(Suppl 65):PA3350
• Email:
  rafael.delahoz@mssm.edu
• Federal Fiscal Year:
  2021
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  False
• Start Date:
  20120901
• Source Full Name:
  European Respiratory Journal
• Supplement:
  65
• End Date:
  20260831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:8fd950f29593ae2e3e9f71d9c77942df35d52d45fbc6ea4d8598a95cc946ea1bbc5649db38f7097711b0dedf989de800e06341272ddde5daa162c27d53bc304c
• Download URL:
  https://stacks.cdc.gov/view/cdc/230508/cdc_230508_DS1.pdf
• File Type:
  [PDF - 188.18 KB ]