Medline ® Abstracts for References 32,33
of 'Reactive airways dysfunction syndrome and irritant-induced asthma'
Asthma diagnosed after 11 September 2001 among rescue and recovery workers: findings from the World Trade Center Health Registry.
Wheeler K, McKelvey W, Thorpe L, Perrin M, Cone J, Kass D, Farfel M, Thomas P, Brackbill R
Environ Health Perspect. 2007;115(11):1584.
BACKGROUND: Studies have consistently documented declines in respiratory health after 11 September 2001 (9/11) among surviving first responders and other World Trade Center (WTC) rescue, recovery, and clean-up workers.
OBJECTIVES: The goal of this study was to describe the risk of newly diagnosed asthma among WTC site workers and volunteers and to characterize its association with WTC site exposures.
METHODS: We analyzed 2003-2004 interview data from the World Trade Center Health Registry for workers who did not have asthma before 9/11 (n = 25,748), estimating the risk of newly diagnosed asthma and its associations with WTC work history, including mask or respirator use.
RESULTS: Newly diagnosed asthma was reported by 926 workers (3.6%). Earlier arrival and longer duration of work were significant risk factors, with independent dose responses (p<0.001), as were exposure to the dust cloud and pile work. Amongworkers who arrived on 11 September, longer delays in the initial use of masks or respirators were associated with increased risk of asthma; adjusted odds ratios ranged from 1.63 [95% confidence interval (CI), 1.03-2.56) for 1 day of delay to 3.44 (95% CI, 1.43-8.25) for 16-40 weeks delay.
CONCLUSIONS: The rate of self-reported newly diagnosed asthma was high in the study population and significantly associated with increased exposure to the WTC disaster site. Although we could not distinguish appropriate respiratory protection from inappropriate, we observed a moderate protective effect of mask or respirator use. The findings underscore the need for adequate and timely distribution of appropriate protective equipment and the enforcement of its use when other methods of controlling respiratory exposures are not feasible.
New York City Department of Health and Mental Hygiene, New York, New York 10013, USA.
Pulmonary disease in rescue workers at the World Trade Center site.
Banauch GI, Dhala A, Prezant DJ
Curr Opin Pulm Med. 2005;11(2):160.
PURPOSE OF REVIEW: The catastrophic collapse of the World Trade Center (WTC) towers on September 11, 2001 created a large-scale disaster site in a densely populated urban environment. Over the ensuing months, tens of thousands of rescue, recovery and cleanup workers, volunteers, and residents of the adjacent community were exposed to a complex mixture of airborne pollutants. This review focuses on currently described respiratory syndromes, symptoms, and physiologic derangements in WTC rescue, recovery, and cleanup workers, discusses potential long-term effects on respiratory health, and draws parallels to community findings.
RECENT FINDINGS: Detailed qualitative and quantitative analyses of airborne pollutants with their changing composition during initial rescue/recovery and subsequent cleanup have been published. Major concerns include persistent aerodigestive tract inflammatory syndromes, such as reactive airways dysfunction syndrome (RADS), reactive upper airways dysfunction syndrome (RUDS), gastroesophageal reflux disease (GERD), and inflammatory pulmonary parenchymal syndromes, as well as respiratory tract and nonrespiratory malignancies. Aerodigestive tract inflammatory syndromes have now been documented in WTC exposed occupational groups, and syndrome incidence has been linked to WTC airborne pollutant exposure intensity. Community based investigations have yielded similar findings.
SUMMARY: While it is too early to ascertain long-term effects of WTC dust exposure, current studies already demonstrate a definite link between exposure to WTC-derived airborne pollutants and respiratory disease, both in the occupational and the community setting. A better understanding of causes and effects of this exposure will help in developing appropriate preventative tools for rescue workers in future disasters.
Albert Einstein College of Medicine, Bronx, New York, USA. email@example.com