Medline ® Abstracts for References 48,61

of 'Reactive airways dysfunction syndrome and irritant-induced asthma'

48
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Effects of accidental chlorine inhalation on pulmonary function.
AU
Charan NB, Lakshminarayan S, Myers GC, Smith DD
SO
West J Med. 1985;143(3):333.
 
In an industrial accident, 19 previously healthy workers were briefly exposed to high concentrations of chlorine gas. Pulmonary function tests were done at intervals for about two years but complete follow-up data were available in only 11 subjects. Immediately following the exposure, airway obstruction was detected in 10 of 19 patients; 700 days later this was found in only 3 of 11 patients. Two of these three patients had a history of smoking, however. The mean residual volume was 141% +/- 97 (mean +/- standard error of the mean) on day 1. In subsequent follow-up studies, the residual volume progressively fell in all patients, and 700 days later the mean residual volume was 90% +/- 5. In 5 of the 19 subjects, all pulmonary function test results were within normal limits on day 1. Apparently in some subjects acute exposure to chlorine gas may cause immediate changes in the lung functions, but these changes gradually resolve. Because of the small number of patients in our series, however, the long-term effects of chlorine are less apparent.
AD
PMID
61
TI
Lung function in rescue workers at the World Trade Center after 7 years.
AU
Aldrich TK, Gustave J, Hall CB, Cohen HW, Webber MP, Zeig-Owens R, Cosenza K, Christodoulou V, Glass L, Al-Othman F, Weiden MD, Kelly KJ, Prezant DJ
SO
N Engl J Med. 2010;362(14):1263.
 
BACKGROUND: The terrorist attacks on the World Trade Center on September 11, 2001, exposed thousands of Fire Department of New York City (FDNY) rescue workers to dust, leading to substantial declines in lung function in the first year. We sought to determine the longer-term effects of exposure.
METHODS: Using linear mixed models, we analyzed the forced expiratory volume in 1 second (FEV(1)) of both active and retired FDNY rescue workers on the basis of spirometry routinely performed at intervals of 12 to 18 months from March 12, 2000, to September 11, 2008.
RESULTS: Of the 13,954 FDNY workers who were present at the World Trade Center between September 11, 2001, and September 24, 2001, a total of 12,781 (91.6%) participated in this study, contributing 61,746 quality-screened spirometric measurements. The median follow-up was 6.1 years for firefighters and 6.4 years for emergency-medical-services (EMS) workers. In the first year, the mean FEV(1) decreased significantly for all workers, more for firefighterswho had never smoked (a reduction of 439 ml; 95% confidence interval [CI], 408 to 471) than for EMS workers who had never smoked (a reduction of 267 ml; 95% CI, 263 to 271) (P<0.001 for both comparisons). There was little or no recovery in FEV(1) during the subsequent 6 years, with a mean annualized reduction in FEV(1) of 25 ml per year for firefighters and 40 ml per year for EMS workers. The proportion of workers who had never smoked and who had an FEV(1) below the lower limit of the normal range increased during the first year, from 3% to 18% for firefighters and from 12% to 22% for EMS workers, stabilizing at about 13% for firefighters and 22% for EMS workers during the subsequent 6 years.
CONCLUSIONS: Exposure to World Trade Center dust led to large declines in FEV(1) for FDNY rescue workers during the first year. Overall, these declines were persistent, without recovery over the next 6 years, leaving a substantial proportion of workers with abnormal lung function.
AD
Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA.
PMID