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.
N1 - Funding Information:
Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: the authors received federal funding from National Institute of Occupational Safety and Health and the National Institutes of Health.
Funding Information:
Funding/Support: This study was funded by the Centers for Disease Control and Prevention [U1Q/CCU221158] and the National Institute of Occupational Safety and Health [ U10-OH008243 , U10-OH008242 , and R01-OH07350 ], NIH [ M01 00096 , K23HL084191 , K24A1080298 , and R01HL057879 ].
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
C2 - 19820077
AN - SCOPUS:77949508517
VL - 137
SP - 566
EP - 574
JO - Diseases of the chest
JF - Diseases of the chest
SN - 0012-3692
IS - 3
ER -