title: Bronchial hyperreactivity and other inhalation lung injuries in rescue/recovery workers after the World Trade Center collapse.
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 < or =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.
authors.affiliation: Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Gisela I
authors.initials: GI
authors.lastname: Banauch
authors.forename: Atiya
authors.initials: A
authors.lastname: Dhala
authors.forename: Dawn
authors.initials: D
authors.lastname: Alleyne
authors.forename: Rakesh
authors.initials: R
authors.lastname: Alva
authors.forename: Ganesha
authors.initials: G
authors.lastname: Santhyadka
authors.forename: Anatoli
authors.initials: A
authors.lastname: Krasko
authors.forename: Michael
authors.initials: M
authors.lastname: Weiden
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Kelly
authors.forename: David J
authors.initials: DJ
authors.lastname: Prezant
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects; D016535:Bronchial Hyperreactivity / Q000453:epidemiology / Q000209:etiology*; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D009519:New York City; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects; D018635:Rescue Work; D012128:Respiratory Distress Syndrome / Q000453:epidemiology / Q000209:etiology*; D047851:September 11 Terrorist Attacks; D014838:Volunteers
chemical_list: D000393:Air Pollutants