Upper Respiratory Symptoms and Other Health Effects among Residents Living Near the World Trade Center Site after September 11, 2001

Abstract

The authors investigated changes in respiratory health after September 11, 2001 ("9/11") among residents of the area near the World Trade Center (WTC) site in New York City as compared with residents of a control area. In 2002, self-administered questionnaires requesting information on the presence and persistence of respiratory symptoms, unplanned medical visits, and medication use were sent to 9,200 households (22.3% responded) within 1.5 km of the WTC site (affected area) and approximately 1,000 residences (23.3% responded) in Upper Manhattan, more than 9 km from the site (control area). Residents of the affected area reported higher rates of new-onset upper respiratory symptoms after 9/11 (cumulative incidence ratio = 2.22, 95% confidence interval (CI): 1.88, 2.63). Most of these symptoms persisted 1 year after 9/11 in the affected area. Previously healthy residents of the affected area had more respiratory-related unplanned medical visits (prevalence ratio = 1.73, 95% CI: 1.13, 2.64) and more new medication use (prevalence ratio = 2.89, 95% CI: 1.75, 4.76) after 9/11. Greater impacts on respiratory functional limitations were also found in the affected area. Although bias may have contributed to these increases, other analyses of WTC-related pollutants support their biologic plausibility. Further analyses are needed to examine whether these increases were related to environmental exposures and to monitor long-term health effects.

Pulmonary Function after Exposure to the World Trade Center Collapse in the New York City Fire Department

“…In contrast to our current study, prior WTC-related reports (3)(4)(5)(6)(7)(8)(9)(10)(11)(12) have been limited by (1 ) cross-sectional design, (2 ) small sample sizes, or (3 ) lack of objective lung function documentation before the WTC exposure. Our study analyzed spirometric measurements for 83% of all FDNY rescue workers and included all measurements in a 6-yr longitudinal design.…”

“…Average FEV 1 losses are adjusted for sex, race, height, age, and smoking status. dents have respiratory symptoms and physiologic airway abnormalities (4)(5)(6)(7)(8)(9)(10)(11)(12). This study demonstrates substantial reductions in average adjusted FEV 1 and FVC in FDNY rescue workers during the year after 09/11/2001.…”

“…Induced sputum from FDNY firefighters and cellular and animal models all demonstrate inflammation (21)(22)(23). Resulting clinical (cough, wheeze, dyspnea, chest tightness, gastroesophageal reflux) and physiologic (low FEV 1 and FVC, bronchodilator response, nonspecific hyperreactivity) correlates have been reported in smaller occupational (3, 5-9, 11, 12) and communitybased cohorts (4,10,24) during the first year after 09/11/2001.…”

“…Appropriate respiratory protection was initially not readily available; later, compliance was suboptimal (3). WTC exposure has since been implicated in "WTC cough," and upper and lower airway inflammation with airway obstruction and bronchial hyperreactivity (4)(5)(6)(7)(8)(9)(10)(11)(12).…”

Destruction of the World Trade Center Towers. Lessons Learned from an Environmental Health Disaster

“…Despite these barriers, 2,812 residents completed surveys. Increased rates of new-onset upper and lower respiratory health symptoms were reported in the local residential population (17)(18)(19).…”