Bronchial hyperreactivity and other inhalation lung injuries in rescue/recovery workers after the World Trade Center collapse

Gisela I. Banauch, Atiya Dhala, Dawn Alleyne, Rakesh Alva, Ganesha Santhyadka, Anatoli Krasko, Michael Weiden, Kerry J. Kelly, David J. Prezant

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Background: The collapse of the World Trade Center (WTC) on September 11, 2001 created a large-scale disaster site in a dense urban environment. In the days and months thereafter, thousands of rescue/recovery workers, volunteers, and residents were exposed to a complex mixture of airborne pollutants. Methods: We review current knowledge of aerodigestive inhalation lung injuries resulting from this complex exposure and present new data on the persistence of nonspecific bronchial hyperreactivity (methacholine PC20 ≤8 mg/mL) in a representative sample of 179 Fire Department of the City of New York (FDNY) rescue workers stratified by exposure intensity (according to arrival time) who underwent challenge testing at 1, 3, 6, and 12 months post-collapse. Results: Aerodigestive tract inflammatory injuries, such as declines in pulmonary function, reactive airways dysfunction syndrome (RADS), asthma, reactive upper airways dysfunction syndrome (RUDS), gastroesophageal reflux disease (GERD), and rare cases of inflammatory pulmonary parenchymal diseases, have been documented in WTC rescue/recovery workers and volunteers. In FDNY rescue workers, we found persistent hyperreactivity associated with exposure intensity, independent of airflow obstruction. One year post-collapse, 23% of highly exposed subjects were hyperreactive as compared with only 11% of moderately exposed and 4% of controls. At 1 yr, 16% met the criteria for RADS. Conclusions: While it is too early to ascertain all of the long-term effects of WTC exposures, continued medical monitoring and treatment is needed to help those exposed and to improve our prevention, diagnosis, and treatment protocols for future disasters.

Original languageEnglish (US)
JournalCritical Care Medicine
Volume33
Issue number1 SUPPL.
DOIs
StatePublished - Jan 2005
Externally publishedYes

Fingerprint

Bronchial Hyperreactivity
Lung Injury
Inhalation
Disasters
Volunteers
Methacholine Chloride
Clinical Protocols
Gastroesophageal Reflux
Complex Mixtures
Lung Diseases
Asthma
Lung
Wounds and Injuries
Therapeutics

Keywords

  • Airborne particulates
  • Firefighters
  • Inhalation lung injury
  • Nonspecific bronchial hyperreactivity
  • Rescue workers
  • World Trade Center

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Bronchial hyperreactivity and other inhalation lung injuries in rescue/recovery workers after the World Trade Center collapse. / Banauch, Gisela I.; Dhala, Atiya; Alleyne, Dawn; Alva, Rakesh; Santhyadka, Ganesha; Krasko, Anatoli; Weiden, Michael; Kelly, Kerry J.; Prezant, David J.

In: Critical Care Medicine, Vol. 33, No. 1 SUPPL., 01.2005.

Research output: Contribution to journalArticle

Banauch, Gisela I. ; Dhala, Atiya ; Alleyne, Dawn ; Alva, Rakesh ; Santhyadka, Ganesha ; Krasko, Anatoli ; Weiden, Michael ; Kelly, Kerry J. ; Prezant, David J. / Bronchial hyperreactivity and other inhalation lung injuries in rescue/recovery workers after the World Trade Center collapse. In: Critical Care Medicine. 2005 ; Vol. 33, No. 1 SUPPL.
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AU - Dhala, Atiya

AU - Alleyne, Dawn

AU - Alva, Rakesh

AU - Santhyadka, Ganesha

AU - Krasko, Anatoli

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AU - Kelly, Kerry J.

AU - Prezant, David J.

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AB - Background: The collapse of the World Trade Center (WTC) on September 11, 2001 created a large-scale disaster site in a dense urban environment. In the days and months thereafter, thousands of rescue/recovery workers, volunteers, and residents were exposed to a complex mixture of airborne pollutants. Methods: We review current knowledge of aerodigestive inhalation lung injuries resulting from this complex exposure and present new data on the persistence of nonspecific bronchial hyperreactivity (methacholine PC20 ≤8 mg/mL) in a representative sample of 179 Fire Department of the City of New York (FDNY) rescue workers stratified by exposure intensity (according to arrival time) who underwent challenge testing at 1, 3, 6, and 12 months post-collapse. Results: Aerodigestive tract inflammatory injuries, such as declines in pulmonary function, reactive airways dysfunction syndrome (RADS), asthma, reactive upper airways dysfunction syndrome (RUDS), gastroesophageal reflux disease (GERD), and rare cases of inflammatory pulmonary parenchymal diseases, have been documented in WTC rescue/recovery workers and volunteers. In FDNY rescue workers, we found persistent hyperreactivity associated with exposure intensity, independent of airflow obstruction. One year post-collapse, 23% of highly exposed subjects were hyperreactive as compared with only 11% of moderately exposed and 4% of controls. At 1 yr, 16% met the criteria for RADS. Conclusions: While it is too early to ascertain all of the long-term effects of WTC exposures, continued medical monitoring and treatment is needed to help those exposed and to improve our prevention, diagnosis, and treatment protocols for future disasters.

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