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Elevated peripheral eosinophils are associated with new onset and persistent wheeze and airflow obstruction in World Trade Center exposed individuals
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Dec 11 2012
Source: J Asthma. 50(1):25-32. -
Alternative Title:J Asthma
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Personal Author:
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Description:Background
Exposure to World Trade Center (WTC) dust and fumes is associated with onset of asthma-like respiratory symptoms in rescue and recovery workers and exposed community members. Eosinophilic inflammation with increased lung and peripheral eosinophils has been described in subpopulations with asthma. We hypothesized that persistent asthma-like symptoms in WTC-exposed individuals would be associated with systemic inflammation characterized by peripheral eosinophils.
Methods
The WTC Environmental Health Center (EHC) is a treatment program for local residents, local workers, and clean-up workers with presumed WTC-related symptoms. Patients undergo a standardized evaluation including questionnaires and complete blood count. Between 9/2005–3/2009, 2461 individuals enrolled in the program and were available for analysis. Individuals with pre-existing respiratory symptoms or lung disease diagnoses prior to 9/11/2001 and current or significant tobacco use were excluded.
Results
1508 individuals met inclusion criteria. These patients had a mean age of 47 years, were mostly female (51%) and had a diverse race/ethnicity. Respiratory symptoms that developed after WTC dust/fume exposure and remained persistent included dyspnea on exertion (68%), cough (57%), chest tightness (46%), and wheeze (33%). A larger percentage of those with wheeze had elevated peripheral eosinophils compared to those without wheeze (21% vs. 13%, p<0.0001). Individuals with elevated peripheral eosinophils were more likely to have airflow obstruction on spirometry (16% vs. 7%, p = 0.0003).
Conclusions
Peripheral eosinophils were associated with wheeze and reduced lung function in a diverse WTC-exposed population. These data suggest that eosinophils may participate in lung inflammation in this population with symptoms consistent with WTC-related asthma.
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Pubmed ID:23227974
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Pubmed Central ID:PMC4001795
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