Abstract
Background: The World Trade Center (WTC) collapse produced a massive exposure to respirable particulates in New York City Fire Department (FDNY) rescue workers. This group had spirometry examinations pre-September 11, 2001, and post-September 11, 2001, demonstrating declines in lung function with parallel declines in FEV1 and FVC. To date, the underlying pathophysiologic cause for this has been open to question. Methods: Of 13,234 participants in the FDNY-WTC Monitoring Program, 1,720 (13%) were referred for pulmonary subspecialty evaluation at a single institution. Evaluation included 919 full pulmonary function tests, 1,219 methacholine challenge tests, and 982 high-resolution chest CT scans. Results: At pulmonary evaluation (median 34 months post-September 11, 2001), median values were FEV1 93% predicted (interquartile range [IQR], 83%-101%), FVC 98% predicted (IQR, 89%-106%), and FEV 1 /FVC 0.78 (IQR, 0.72-0.82). The residual volume (RV) was 123% predicted (IQR, 106%-147%) with nearly all participants having normal total lung capacity, functional residual capacity, and diffusing capacity of carbon monoxide. Also, 1,051/1,720 (59%) had obstructive airways disease based on at least one of the following: FEV1 /FVC, bronchodilator responsiveness, hyperreactivity, or elevated RV. After adjusting for age, gender, race, height and weight, and tobacco use, the decline in FEV1 post-September 11, 2001, was significantly correlated with increased RV percent predicted ( P < .0001), increased bronchodilator responsiveness ( P < .0001), and increased hyperreactivity ( P = .0056). CT scans demonstrated bronchial wall thickening that was significantly associated with the decline in FEV1 post-September 11, 2001 ( P = .024), increases in hyperreactivity ( P < .0001), and increases in RV ( P < .0001). Few had evidence for interstitial disease. Conclusions: Airways obstruction was the predominant physiologic finding underlying the reduction in lung function post-September 11, 2001, in FDNY WTC rescue workers presenting for pulmonary evaluation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 566-574 |
| Number of pages | 9 |
| Journal | Chest |
| Volume | 137 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2010 |
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ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Critical Care and Intensive Care Medicine
- Cardiology and Cardiovascular Medicine
Cite this
Obstructive airways disease with air trapping among firefighters exposed to world trade center dust. / Weiden, Michael D.; Ferrier, Natalia; Nolan, Anna; Rom, William N.; Comfort, Ashley; Gustave, Jackson; Zeig-Owens, Rachel; Zheng, Shugi; Goldring, Roberta M.; Berger, Kenneth I.; Cosenza, Kaitlyn; Lee, Roy; Webber, Mayris P.; Kelly, Kerry J.; Aldrich, Thomas K.; Prezant, David J.
In: Chest, Vol. 137, No. 3, 01.03.2010, p. 566-574.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Obstructive airways disease with air trapping among firefighters exposed to world trade center dust
AU - Weiden, Michael D.
AU - Ferrier, Natalia
AU - Nolan, Anna
AU - Rom, William N.
AU - Comfort, Ashley
AU - Gustave, Jackson
AU - Zeig-Owens, Rachel
AU - Zheng, Shugi
AU - Goldring, Roberta M.
AU - Berger, Kenneth I.
AU - Cosenza, Kaitlyn
AU - Lee, Roy
AU - Webber, Mayris P.
AU - Kelly, Kerry J.
AU - Aldrich, Thomas K.
AU - Prezant, David J.
PY - 2010/3/1
Y1 - 2010/3/1
N2 - Background: The World Trade Center (WTC) collapse produced a massive exposure to respirable particulates in New York City Fire Department (FDNY) rescue workers. This group had spirometry examinations pre-September 11, 2001, and post-September 11, 2001, demonstrating declines in lung function with parallel declines in FEV1 and FVC. To date, the underlying pathophysiologic cause for this has been open to question. Methods: Of 13,234 participants in the FDNY-WTC Monitoring Program, 1,720 (13%) were referred for pulmonary subspecialty evaluation at a single institution. Evaluation included 919 full pulmonary function tests, 1,219 methacholine challenge tests, and 982 high-resolution chest CT scans. Results: At pulmonary evaluation (median 34 months post-September 11, 2001), median values were FEV1 93% predicted (interquartile range [IQR], 83%-101%), FVC 98% predicted (IQR, 89%-106%), and FEV 1 /FVC 0.78 (IQR, 0.72-0.82). The residual volume (RV) was 123% predicted (IQR, 106%-147%) with nearly all participants having normal total lung capacity, functional residual capacity, and diffusing capacity of carbon monoxide. Also, 1,051/1,720 (59%) had obstructive airways disease based on at least one of the following: FEV1 /FVC, bronchodilator responsiveness, hyperreactivity, or elevated RV. After adjusting for age, gender, race, height and weight, and tobacco use, the decline in FEV1 post-September 11, 2001, was significantly correlated with increased RV percent predicted ( P < .0001), increased bronchodilator responsiveness ( P < .0001), and increased hyperreactivity ( P = .0056). CT scans demonstrated bronchial wall thickening that was significantly associated with the decline in FEV1 post-September 11, 2001 ( P = .024), increases in hyperreactivity ( P < .0001), and increases in RV ( P < .0001). Few had evidence for interstitial disease. Conclusions: Airways obstruction was the predominant physiologic finding underlying the reduction in lung function post-September 11, 2001, in FDNY WTC rescue workers presenting for pulmonary evaluation.
AB - Background: The World Trade Center (WTC) collapse produced a massive exposure to respirable particulates in New York City Fire Department (FDNY) rescue workers. This group had spirometry examinations pre-September 11, 2001, and post-September 11, 2001, demonstrating declines in lung function with parallel declines in FEV1 and FVC. To date, the underlying pathophysiologic cause for this has been open to question. Methods: Of 13,234 participants in the FDNY-WTC Monitoring Program, 1,720 (13%) were referred for pulmonary subspecialty evaluation at a single institution. Evaluation included 919 full pulmonary function tests, 1,219 methacholine challenge tests, and 982 high-resolution chest CT scans. Results: At pulmonary evaluation (median 34 months post-September 11, 2001), median values were FEV1 93% predicted (interquartile range [IQR], 83%-101%), FVC 98% predicted (IQR, 89%-106%), and FEV 1 /FVC 0.78 (IQR, 0.72-0.82). The residual volume (RV) was 123% predicted (IQR, 106%-147%) with nearly all participants having normal total lung capacity, functional residual capacity, and diffusing capacity of carbon monoxide. Also, 1,051/1,720 (59%) had obstructive airways disease based on at least one of the following: FEV1 /FVC, bronchodilator responsiveness, hyperreactivity, or elevated RV. After adjusting for age, gender, race, height and weight, and tobacco use, the decline in FEV1 post-September 11, 2001, was significantly correlated with increased RV percent predicted ( P < .0001), increased bronchodilator responsiveness ( P < .0001), and increased hyperreactivity ( P = .0056). CT scans demonstrated bronchial wall thickening that was significantly associated with the decline in FEV1 post-September 11, 2001 ( P = .024), increases in hyperreactivity ( P < .0001), and increases in RV ( P < .0001). Few had evidence for interstitial disease. Conclusions: Airways obstruction was the predominant physiologic finding underlying the reduction in lung function post-September 11, 2001, in FDNY WTC rescue workers presenting for pulmonary evaluation.
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U2 - 10.1378/chest.09-1580
DO - 10.1378/chest.09-1580
M3 - Article
VL - 137
SP - 566
EP - 574
JO - Chest
JF - Chest
SN - 0012-3692
IS - 3
ER -