Long-term respiratory symptoms in World Trade Center responders

Mauer, Matthew P.; Cummings, Karen R.; Hoen, Rebecca

doi:10.1093/occmed/kqp176

Cited by 26 publications

(20 citation statements)

References 20 publications

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“…Mauer et al (2010 a,b, and c) described long-term respiratory symptoms in NYS employees who were WTC responders on or after 9/11/2001. They were initially mailed self-administered questionnaires (initial, Year 1, and Year 2) and then they completed a telephone interview in Year 3.…”

Section: Populations With Work-related or Residential Exposures To Wtmentioning

confidence: 99%

Health effects of World Trade Center (WTC) Dust: An unprecedented disaster with inadequate risk management

Lippmann¹,

Cohen²,

Chen³

2015

Critical Reviews in Toxicology

105

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The World Trade Center (WTC) twin towers in New York City collapsed on 9/11/2001, converting much of the buildings’ huge masses into dense dust clouds of particles that settled on the streets and within buildings throughout Lower Manhattan. About 80–90% of the settled WTC Dust, ranging in particle size from ~2.5 μm upward, was a highly alkaline mixture of crushed concrete, gypsum, and synthetic vitreous fibers (SVFs) that was readily resuspendable by physical disturbance and low-velocity air currents. High concentrations of coarse and supercoarse WTC Dust were inhaled and deposited in the conductive airways in the head and lungs, and subsequently swallowed, causing both physical and chemical irritation to the respiratory and gastroesophageal epithelia. There were both acute and chronic adverse health effects in rescue/recovery workers; cleanup workers; residents; and office workers, especially in those lacking effective personal respiratory protective equipment. The numerous health effects in these people were not those associated with the monitored PM2.5 toxicants, which were present at low concentrations, that is, asbestos fibers, transition and heavy metals, polyaromatic hydrocarbons or PAHs, and dioxins. Attention was never directed at the very high concentrations of the larger-sized and highly alkaline WTC Dust particles that, in retrospect, contained the more likely causal toxicants. Unfortunately, the initial focus of the air quality monitoring and guidance on exposure prevention programs on low-concentration components was never revised. Public agencies need to be better prepared to provide reliable guidance to the public on more appropriate means of exposure assessment, risk assessment, and preventive measures.

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Section: Populations With Work-related or Residential Exposures To Wtmentioning

confidence: 99%

Health effects of World Trade Center (WTC) Dust: An unprecedented disaster with inadequate risk management

Lippmann¹,

Cohen²,

Chen³

2015

Critical Reviews in Toxicology

105

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“…Adverse health effects from these exposures are well described for rescue and recovery workers with work-related exposure, as well as for community members including local workers in the WTC towers and in surrounding commercial spaces, and residents of the surrounding buildings (1–9) (10–11). Community members, including over 360,000 local workers and over 57,000 residents south of Canal Street in lower Manhattan alone have been estimated to have had potential for dust and fume exposure (12).…”

Section: Introductionmentioning

confidence: 99%

“…These symptoms have been described to persist at least five years after their exposure (7–8, 10, 13, 15). Most patients in screening or treatment programs for rescue workers or community members with potential for WTC dust/fume exposures have been described to have normal spirometry, with only one third displaying abnormalities on screening spirometry (3) (15).…”

Section: Introductionmentioning

confidence: 99%

Elevated Peripheral Eosinophils Are Associated with New-Onset and Persistent Wheeze and Airflow Obstruction in World Trade Center-Exposed Individuals

et al. 2012

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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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“…Among NYC firefighters cough and sore throat markedly declined over 4 years after the WTC disaster, but rates remained much higher than before 9/11 [Webber et al, 2009]. New York State employees who responded to the WTC disaster had higher rates of persistent lower respiratory symptoms 5 years after 9/11, compared to non‐exposed controls [Mauer et al, 2010].…”

Section: Introductionmentioning

confidence: 99%

Respiratory protective equipment, mask use, and respiratory outcomes among World Trade Center rescue and recovery workers

et al. 2011

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Long-term respiratory symptoms in World Trade Center responders

Abstract: Our findings suggest that even in a moderately exposed responder population, lower respiratory effects were a persistent problem 5 years post-9/11, indicating that some WTC responders require ongoing monitoring.

Cited by 26 publications

References 20 publications

Health effects of World Trade Center (WTC) Dust: An unprecedented disaster with inadequate risk management

Health effects of World Trade Center (WTC) Dust: An unprecedented disaster with inadequate risk management

Elevated Peripheral Eosinophils Are Associated with New-Onset and Persistent Wheeze and Airflow Obstruction in World Trade Center-Exposed Individuals

Respiratory protective equipment, mask use, and respiratory outcomes among World Trade Center rescue and recovery workers

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