Blood eosinophils and world trade center exposure predict surgery in chronic rhinosinusitis a 13.5-year longitudinal study

Sophia Kwon, Barbara Putman, Jessica Weakley, Charles B. Hall, Rachel Zeig-Owens, Theresa Schwartz, Brianne Olivieri, Ankura Singh, Maryann Huie, Debra Morrison, Mayris P. Webber, Hillel W. Cohen, Kerry J. Kelly, Thomas K. Aldrich, Anna Nolan, David J. Prezant, Michael R. Shohet, Michael D. Weiden

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Rationale: The World Trade Center (WTC) collapse generated caustic airborne particulates that caused chronic rhinosinusitis in exposed Fire Department of New York firefighters. Surgery was performed when symptoms remained uncontrolled despite medical management. Objectives: To identify predictors of surgical intervention for chronic rhinosinusitis in firefighters exposed to airborne irritants at the WTC collapse site. Methods: We assessed in 8,227 firefighters with WTC exposure betweenSeptember11,2001(9/11),andSeptember25,2001,including WTC-site arrival time, months of rescue and recovery work, and eosinophil concentration measured between 9/11 and March 10, 2003. We assessed the association of serum cytokines and immunoglobulins with eosinophil concentration and surgery for rhinosinusitis in 112 surgical cases and 376 control subjects with serum available from the first 6 months after exposure to the WTC collapse site. Measurements and Main Results: Between 9/11 and March 10, 2015, the surgery rate was 0.47 cases per 100 person-years. In the first 18 months post-9/11, surgical patients had higher mean blood eosinophillevelsthanstudycohortpatients(219 ± 155vs.191 ± 134; P < 0.0001). Increased surgery risk was associated with increasing blood eosinophil counts (hazard ratio [HR], 1.12 per 100 cells/ml; 95% confidence interval [CI], 1.07-1.17; P < 0.001); arriving at the WTC site on 9/11 or September 12, 2001 (HR, 1.43; 95% CI, 1.04-1.99; P = 0.03); and working 6 months or longer at the WTC site (HR, 1.48; 95% CI, 1.14-1.93; P < 0.01). Median blood eosinophil levels for surgical patients were above levels for the cohort in all 18-month intervals March 11, 2000, through March 10, 2015, using 51,163 measurements representing 97,733 person-years of observation. Increasing age, increasing IL-17A, and low IgA in serum from 2001 to 2002 predicted blood eosinophil concentration in surgical patients but not in control subjects (R2 = 0.26, P < 0.0001; vs. R2 = 0.008, P = 0.56). Conclusions: Increasing blood eosinophil concentration predicts surgical intervention for chronic rhinosinusitis, particularly in those withintenseacuteandprolongedexposuretoairborneirritants.WTCexposed Fire Department of New York firefighters who underwent irritant-associated sinus surgery are immunologically different from the cohort. Surgical patients have a higher blood eosinophil levels that is associated with mediators of mucosal immunity.

Original languageEnglish (US)
Pages (from-to)1253-1261
Number of pages9
JournalAnnals of the American Thoracic Society
Volume13
Issue number8
DOIs
StatePublished - 2016

Fingerprint

Eosinophils
Longitudinal Studies
Firefighters
Irritants
Confidence Intervals
Rescue Work
Serum
Caustics
Mucosal Immunity
Interleukin-17
Immunoglobulin A
Immunoglobulins
Observation
Cytokines

Keywords

  • Cohort studies
  • Eosinophils
  • Otolaryngology surgery
  • Particulate matter
  • Sinusitis

ASJC Scopus subject areas

  • Medicine(all)
  • Pulmonary and Respiratory Medicine

Cite this

Blood eosinophils and world trade center exposure predict surgery in chronic rhinosinusitis a 13.5-year longitudinal study. / Kwon, Sophia; Putman, Barbara; Weakley, Jessica; Hall, Charles B.; Zeig-Owens, Rachel; Schwartz, Theresa; Olivieri, Brianne; Singh, Ankura; Huie, Maryann; Morrison, Debra; Webber, Mayris P.; Cohen, Hillel W.; Kelly, Kerry J.; Aldrich, Thomas K.; Nolan, Anna; Prezant, David J.; Shohet, Michael R.; Weiden, Michael D.

In: Annals of the American Thoracic Society, Vol. 13, No. 8, 2016, p. 1253-1261.

Research output: Contribution to journalArticle

Kwon, S, Putman, B, Weakley, J, Hall, CB, Zeig-Owens, R, Schwartz, T, Olivieri, B, Singh, A, Huie, M, Morrison, D, Webber, MP, Cohen, HW, Kelly, KJ, Aldrich, TK, Nolan, A, Prezant, DJ, Shohet, MR & Weiden, MD 2016, 'Blood eosinophils and world trade center exposure predict surgery in chronic rhinosinusitis a 13.5-year longitudinal study', Annals of the American Thoracic Society, vol. 13, no. 8, pp. 1253-1261. https://doi.org/10.1513/AnnalsATS.201511-742OC
Kwon, Sophia ; Putman, Barbara ; Weakley, Jessica ; Hall, Charles B. ; Zeig-Owens, Rachel ; Schwartz, Theresa ; Olivieri, Brianne ; Singh, Ankura ; Huie, Maryann ; Morrison, Debra ; Webber, Mayris P. ; Cohen, Hillel W. ; Kelly, Kerry J. ; Aldrich, Thomas K. ; Nolan, Anna ; Prezant, David J. ; Shohet, Michael R. ; Weiden, Michael D. / Blood eosinophils and world trade center exposure predict surgery in chronic rhinosinusitis a 13.5-year longitudinal study. In: Annals of the American Thoracic Society. 2016 ; Vol. 13, No. 8. pp. 1253-1261.
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abstract = "Rationale: The World Trade Center (WTC) collapse generated caustic airborne particulates that caused chronic rhinosinusitis in exposed Fire Department of New York firefighters. Surgery was performed when symptoms remained uncontrolled despite medical management. Objectives: To identify predictors of surgical intervention for chronic rhinosinusitis in firefighters exposed to airborne irritants at the WTC collapse site. Methods: We assessed in 8,227 firefighters with WTC exposure betweenSeptember11,2001(9/11),andSeptember25,2001,including WTC-site arrival time, months of rescue and recovery work, and eosinophil concentration measured between 9/11 and March 10, 2003. We assessed the association of serum cytokines and immunoglobulins with eosinophil concentration and surgery for rhinosinusitis in 112 surgical cases and 376 control subjects with serum available from the first 6 months after exposure to the WTC collapse site. Measurements and Main Results: Between 9/11 and March 10, 2015, the surgery rate was 0.47 cases per 100 person-years. In the first 18 months post-9/11, surgical patients had higher mean blood eosinophillevelsthanstudycohortpatients(219 ± 155vs.191 ± 134; P < 0.0001). Increased surgery risk was associated with increasing blood eosinophil counts (hazard ratio [HR], 1.12 per 100 cells/ml; 95{\%} confidence interval [CI], 1.07-1.17; P < 0.001); arriving at the WTC site on 9/11 or September 12, 2001 (HR, 1.43; 95{\%} CI, 1.04-1.99; P = 0.03); and working 6 months or longer at the WTC site (HR, 1.48; 95{\%} CI, 1.14-1.93; P < 0.01). Median blood eosinophil levels for surgical patients were above levels for the cohort in all 18-month intervals March 11, 2000, through March 10, 2015, using 51,163 measurements representing 97,733 person-years of observation. Increasing age, increasing IL-17A, and low IgA in serum from 2001 to 2002 predicted blood eosinophil concentration in surgical patients but not in control subjects (R2 = 0.26, P < 0.0001; vs. R2 = 0.008, P = 0.56). Conclusions: Increasing blood eosinophil concentration predicts surgical intervention for chronic rhinosinusitis, particularly in those withintenseacuteandprolongedexposuretoairborneirritants.WTCexposed Fire Department of New York firefighters who underwent irritant-associated sinus surgery are immunologically different from the cohort. Surgical patients have a higher blood eosinophil levels that is associated with mediators of mucosal immunity.",
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author = "Sophia Kwon and Barbara Putman and Jessica Weakley and Hall, {Charles B.} and Rachel Zeig-Owens and Theresa Schwartz and Brianne Olivieri and Ankura Singh and Maryann Huie and Debra Morrison and Webber, {Mayris P.} and Cohen, {Hillel W.} and Kelly, {Kerry J.} and Aldrich, {Thomas K.} and Anna Nolan and Prezant, {David J.} and Shohet, {Michael R.} and Weiden, {Michael D.}",
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TY - JOUR

T1 - Blood eosinophils and world trade center exposure predict surgery in chronic rhinosinusitis a 13.5-year longitudinal study

AU - Kwon, Sophia

AU - Putman, Barbara

AU - Weakley, Jessica

AU - Hall, Charles B.

AU - Zeig-Owens, Rachel

AU - Schwartz, Theresa

AU - Olivieri, Brianne

AU - Singh, Ankura

AU - Huie, Maryann

AU - Morrison, Debra

AU - Webber, Mayris P.

AU - Cohen, Hillel W.

AU - Kelly, Kerry J.

AU - Aldrich, Thomas K.

AU - Nolan, Anna

AU - Prezant, David J.

AU - Shohet, Michael R.

AU - Weiden, Michael D.

PY - 2016

Y1 - 2016

N2 - Rationale: The World Trade Center (WTC) collapse generated caustic airborne particulates that caused chronic rhinosinusitis in exposed Fire Department of New York firefighters. Surgery was performed when symptoms remained uncontrolled despite medical management. Objectives: To identify predictors of surgical intervention for chronic rhinosinusitis in firefighters exposed to airborne irritants at the WTC collapse site. Methods: We assessed in 8,227 firefighters with WTC exposure betweenSeptember11,2001(9/11),andSeptember25,2001,including WTC-site arrival time, months of rescue and recovery work, and eosinophil concentration measured between 9/11 and March 10, 2003. We assessed the association of serum cytokines and immunoglobulins with eosinophil concentration and surgery for rhinosinusitis in 112 surgical cases and 376 control subjects with serum available from the first 6 months after exposure to the WTC collapse site. Measurements and Main Results: Between 9/11 and March 10, 2015, the surgery rate was 0.47 cases per 100 person-years. In the first 18 months post-9/11, surgical patients had higher mean blood eosinophillevelsthanstudycohortpatients(219 ± 155vs.191 ± 134; P < 0.0001). Increased surgery risk was associated with increasing blood eosinophil counts (hazard ratio [HR], 1.12 per 100 cells/ml; 95% confidence interval [CI], 1.07-1.17; P < 0.001); arriving at the WTC site on 9/11 or September 12, 2001 (HR, 1.43; 95% CI, 1.04-1.99; P = 0.03); and working 6 months or longer at the WTC site (HR, 1.48; 95% CI, 1.14-1.93; P < 0.01). Median blood eosinophil levels for surgical patients were above levels for the cohort in all 18-month intervals March 11, 2000, through March 10, 2015, using 51,163 measurements representing 97,733 person-years of observation. Increasing age, increasing IL-17A, and low IgA in serum from 2001 to 2002 predicted blood eosinophil concentration in surgical patients but not in control subjects (R2 = 0.26, P < 0.0001; vs. R2 = 0.008, P = 0.56). Conclusions: Increasing blood eosinophil concentration predicts surgical intervention for chronic rhinosinusitis, particularly in those withintenseacuteandprolongedexposuretoairborneirritants.WTCexposed Fire Department of New York firefighters who underwent irritant-associated sinus surgery are immunologically different from the cohort. Surgical patients have a higher blood eosinophil levels that is associated with mediators of mucosal immunity.

AB - Rationale: The World Trade Center (WTC) collapse generated caustic airborne particulates that caused chronic rhinosinusitis in exposed Fire Department of New York firefighters. Surgery was performed when symptoms remained uncontrolled despite medical management. Objectives: To identify predictors of surgical intervention for chronic rhinosinusitis in firefighters exposed to airborne irritants at the WTC collapse site. Methods: We assessed in 8,227 firefighters with WTC exposure betweenSeptember11,2001(9/11),andSeptember25,2001,including WTC-site arrival time, months of rescue and recovery work, and eosinophil concentration measured between 9/11 and March 10, 2003. We assessed the association of serum cytokines and immunoglobulins with eosinophil concentration and surgery for rhinosinusitis in 112 surgical cases and 376 control subjects with serum available from the first 6 months after exposure to the WTC collapse site. Measurements and Main Results: Between 9/11 and March 10, 2015, the surgery rate was 0.47 cases per 100 person-years. In the first 18 months post-9/11, surgical patients had higher mean blood eosinophillevelsthanstudycohortpatients(219 ± 155vs.191 ± 134; P < 0.0001). Increased surgery risk was associated with increasing blood eosinophil counts (hazard ratio [HR], 1.12 per 100 cells/ml; 95% confidence interval [CI], 1.07-1.17; P < 0.001); arriving at the WTC site on 9/11 or September 12, 2001 (HR, 1.43; 95% CI, 1.04-1.99; P = 0.03); and working 6 months or longer at the WTC site (HR, 1.48; 95% CI, 1.14-1.93; P < 0.01). Median blood eosinophil levels for surgical patients were above levels for the cohort in all 18-month intervals March 11, 2000, through March 10, 2015, using 51,163 measurements representing 97,733 person-years of observation. Increasing age, increasing IL-17A, and low IgA in serum from 2001 to 2002 predicted blood eosinophil concentration in surgical patients but not in control subjects (R2 = 0.26, P < 0.0001; vs. R2 = 0.008, P = 0.56). Conclusions: Increasing blood eosinophil concentration predicts surgical intervention for chronic rhinosinusitis, particularly in those withintenseacuteandprolongedexposuretoairborneirritants.WTCexposed Fire Department of New York firefighters who underwent irritant-associated sinus surgery are immunologically different from the cohort. Surgical patients have a higher blood eosinophil levels that is associated with mediators of mucosal immunity.

KW - Cohort studies

KW - Eosinophils

KW - Otolaryngology surgery

KW - Particulate matter

KW - Sinusitis

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