Medline ® Abstracts for References 36,37
of 'Reactive airways dysfunction syndrome and irritant-induced asthma'
Atopy and upper and lower airway disease among former World Trade Center workers and volunteers.
de la Hoz RE, Shohet MR, Wisnivesky JP, Bienenfeld LA, Afilaka AA, Herbert R
J Occup Environ Med. 2009 Sep;51(9):992-5.
OBJECTIVE: A large number of workers seemed to have developed upper and lower airway disease (UAD and LAD, respectively) in relation to their occupational exposures at the World Trade Center (WTC) disaster site. This study examined atopy as a risk factor for presumably WTC-related UAD and LAD.
METHODS: Atopy was examined in 136 former WTC workers and volunteers by radioallergosorbent test, skin prick testing, or both. Overall prevalence of atopy was estimated, and bivariate and multivariate logistic regression analyses were conducted to examine associations of atopy with WTC-related UAD and LAD.
RESULTS: Atopy was prevalent in 54.4% of these WTC workers. Atopy was associated with higher symptom severity scores for both WTC-related UAD and LAD. Atopy was a predictor of WTC-related UAD but not LAD. Early arrival at the WTC site, and pre-2001 asthma diagnosis were predictors of LAD.
CONCLUSION: The prevalence of atopy inthis population is similar to what has been described for the general U.S. population. Atopy seemed to be a risk factor for presumably WTC-related UAD but not for LAD.
Department of Community and Preventive Medicine, The Mount Sinai School of Medicine, New York, NY 10029, USA. rafael.delaHoz@mssm.edu
Firefighting acutely increases airway responsiveness.
Sherman CB, Barnhart S, Miller MF, Segal MR, Aitken M, Schoene R, Daniell W, Rosenstock L
Am Rev Respir Dis. 1989;140(1):185.
The acute effects of the products of combustion and pyrolysis on airway responsiveness among firefighters are poorly documented. To study this relationship, spirometry and methacholine challenge testing (MCT) were performed on 18 active Seattle firefighters before and 5 to 24 h after firefighting. Body plethysmography was used to measure changes in specific airway conductance (SGaw), and results of MCT were analyzed using PD35-SGaw, the cumulative dose causing a 35% decrease in SGaw. Subjects who did not react by the end of the protocol were assigned a value of 640 inhalational units, the largest cumulative dose. Fire exposure was defined as the total time (hours) spent without a self-contained breathing apparatus at the firesite and was categorized as mild (less than 1 h, n = 7), moderate (1 to 2 h, n = 5), or severe (greater than 2 h, n = 6). Mean age of the 18 firefighters was 36.7 +/- 6.7 yr (range, 25 to 51), with a mean of 9.1 +/- 7.9 active years in the trade (range, zero to 22). None was known to be asthmatic. After firefighting, FEV1 % predicted (%pred) and FEF25-75 %pred significantly decreased by means of 3.4 +/- 1.1% and 5.6 +/- 2.6%, respectively. The mean decline in PD35-SGaw after firefighting was 184.5 +/- 53.2 units (p = 0.003). This observed decline in PD35-SGaw could not be explained by decrements in prechallenge SGaw, FEV1, or FVC.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Medicine, University of Washington, Seattle.