Granulomatous Pneumonitis Following Exposure to the World Trade Center Collapse

Safirstein, Benjamin H.; Klukowicz, Alan; Miller, Richard I.; Teirstein, Alvin S.

doi:10.1378/chest.123.1.301

Cited by 45 publications

(23 citation statements)

References 7 publications

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“…In these non-smoking firefighters, the increase in MMP-9 levels provides biochemical evidence for exposure-related immune activation in the lung, complementing the evidence from IS differential cell counts. Persistent inflammation, 10 months after the WTC collapse, is consistent with the clinical findings of new and persistent cough, airway hyperreactivity, and asthma previously reported in FDNY-FFs (Banauch et al 2003; Feldman et al 2004; Prezant et al 2002) and other rescue workers (Safirstein et al 2003; Saltzman et al 2004; Skloot et al 2004) after exposures to WTC dust.…”

Section: Discussionsupporting

confidence: 88%

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Induced Sputum Assessment in New York City Firefighters Exposed to World Trade Center Dust

Fireman

Lerman

Ganor

et al. 2004

Environ Health Perspect

113

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New York City Firefighters (FDNY-FFs) were exposed to particulate matter and combustion/pyrolysis products during and after the World Trade Center (WTC) collapse. Ten months after the collapse, induced sputum (IS) samples were obtained from 39 highly exposed FDNY-FFs (caught in the dust cloud during the collapse on 11 September 2001) and compared to controls to determine whether a unique pattern of inflammation and particulate matter deposition, compatible with WTC dust, was present. Control subjects were 12 Tel-Aviv, Israel, firefighters (TA-FFs) and 8 Israeli healthcare workers who were not exposed to WTC dust. All controls volunteered for this study, had never smoked, and did not have respiratory illness. IS was processed by conventional methods. Retrieved cells were differentially counted, and metalloproteinase-9 (MMP-9), particle size distribution (PSD), and mineral composition were measured. Differential cell counts of FDNY-FF IS differed from those of health care worker controls (p < 0.05) but not from those of TA-FFs. Percentages of neutrophils and eosinophils increased with greater intensity of WTC exposure (< 10 workdays or ≥ 10 workdays; neutrophils p = 0.046; eosinophils p = 0.038). MMP-9 levels positively correlated to neutrophil counts (p = 0.002; r = 0.449). Particles were larger and more irregularly shaped in FDNY-FFs (1–50 μm; zinc, mercury, gold, tin, silver) than in TA-FFs (1–10 μm; silica, clays). PSD was similar to that of WTC dust samples. In conclusion, IS from highly exposed FDNY-FFs demonstrated inflammation, PSD, and particle composition that was different from nonexposed controls and consistent with WTC dust exposure.

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Section: Discussionsupporting

confidence: 88%

“…Firefighters were not the only ones affected. Respiratory symptoms and pulmonary dysfunction has been reported in other WTC rescue workers (Safirstein et al 2003; Saltzman et al 2004; Skloot et al 2004) and in Manhattan residents living near the site. (CDC 2002c; Szema et al 2004).…”

mentioning

confidence: 86%

Induced Sputum Assessment in New York City Firefighters Exposed to World Trade Center Dust

Fireman

Lerman

Ganor

et al. 2004

Environ Health Perspect

113

View full text Add to dashboard Cite

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“…8,20 This was supported by an initial case of acute eosinophilic pneumonia in an FDNY fi refi ghter in the fi rst weeks after September 11, 2001, 21 and reports of sarcoidosis in FDNY rescue workers and other rescue/recovery workers post-September 11, 2001. [22][23][24] We now report our experience with 1,720 WTCexposed FDNY rescue workers referred for subspecialty pulmonary evaluation for reports of functional impairment or abnormalities in screening spirometry or chest radiographs. These criteria refl ect the standard of care found in a screening/monitoring program or primary care practice.…”

Section: Discussionmentioning

confidence: 99%

Obstructive Airways Disease With Air Trapping Among Firefighters Exposed to World Trade Center Dust

Weiden

Ferrier

Nolan

et al. 2010

Chest

106

132

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“…There have been isolated case reports of other lung diseases, such as eosinophilic pneumonia [43], interstitial fibrosis with predominantly peribronchiolar changes [12••, 19], and granulomatous pneumonitis [44]. Overall, cases of interstitial lung disease of any type, including sarcoidosis, remain few and heterogeneous when compared with the thousands of WTC-exposed individuals with upper and lower airway disease, but surveillance systems are (and need to stay) in place to try to identify additional incident cases.…”

Section: Other Pulmonary Diseasesmentioning

confidence: 99%

Occupational Asthma and Lower Airway Disease Among World Trade Center Workers and Volunteers

Hoz

2010

Curr Allergy Asthma Rep

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The World Trade Center (WTC) disaster and its recovery work involved a range of hazardous occupational exposures that have not been fully characterized but can be reasonably assumed to have the potential to cause mucosal inflammation in the upper and lower airways. A high prevalence of lower airway disease (LAD) symptoms was reported by several early surveys. Clinical studies further categorized the diagnoses as irritant-induced asthma (of subacute onset), nonspecific chronic bronchitis, chronic bronchiolitis, or aggravated preexistent obstructive pulmonary disease in a substantial proportion of patients. Risk factors for WTC-related LAD included early (on September 11 or 12, 2001) arrival at the WTC site and work at the pile of the collapsed towers. Cigarette smoking (but not atopy) also seemed to be a risk factor for LAD. No data thus far suggest an increased incidence of neoplastic or interstitial lung disease, but ongoing surveillance is clearly necessary.

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Granulomatous Pneumonitis Following Exposure to the World Trade Center Collapse

Cited by 45 publications

References 7 publications

Induced Sputum Assessment in New York City Firefighters Exposed to World Trade Center Dust

Induced Sputum Assessment in New York City Firefighters Exposed to World Trade Center Dust

Obstructive Airways Disease With Air Trapping Among Firefighters Exposed to World Trade Center Dust

Occupational Asthma and Lower Airway Disease Among World Trade Center Workers and Volunteers

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