title: Pulmonary function after exposure to the World Trade Center collapse in the New York City Fire Department.
abstract: BACKGROUND
  On September 11, 2001, the World Trade Center collapse created an enormous urban disaster site with high levels of airborne pollutants. First responders, rescue and recovery workers, and residents have since reported respiratory symptoms and developed pulmonary function abnormalities.
  
  
  OBJECTIVE
  To quantify respiratory health effects of World Trade Center exposure in the New York City Fire Department.
  
  
  METHODS
  Longitudinal study of pulmonary function in 12,079 New York City Fire Department rescue workers employed on or before 09/11/2001. Between 01/01/1997 and 09/11/2002, 31,994 spirometries were obtained and the FEV(1) and FVC were analyzed for differences according to estimated World Trade Center exposure intensity. Adjusted average FEV(1) during the first year after 09/11/2001 was compared with the 5 yr before 09/11/2001. Median time between 09/11/2001 and a worker's first spirometry afterwards was 3 mo; 90% were assessed within 5 mo.
  
  
  RESULTS
  World Trade Center-exposed workers experienced a substantial reduction in adjusted average FEV(1) during the year after 09/11/2001 (372 ml; 95% confidence interval, 364-381 ml; p < 0.001) This exposure-related FEV(1) decrement equaled 12 yr of aging-related FEV(1) decline. Moreover, exposure intensity assessed by initial arrival time at the World Trade Center site correlated linearly with FEV(1) reduction in an exposure intensity-response gradient (p = 0.048). Respiratory symptoms also predicted a further FEV(1) decrease (p < 0.001). Similar findings were observed for adjusted average FVC.
  
  
  CONCLUSIONS
  World Trade Center exposure produced a substantial reduction in pulmonary function in New York City Fire Department rescue workers during the first year after 09/11/2001.
authors.affiliation: Pulmonary Division, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA. gbanauch@montefiore.org
authors.forename: Gisela I
authors.initials: GI
authors.lastname: Banauch
authors.forename: Charles
authors.initials: C
authors.lastname: Hall
authors.forename: Michael
authors.initials: M
authors.lastname: Weiden
authors.forename: Hillel W
authors.initials: HW
authors.lastname: Cohen
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Aldrich
authors.forename: Vasillios
authors.initials: V
authors.lastname: Christodoulou
authors.forename: Nicole
authors.initials: N
authors.lastname: Arcentales
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Kelly
authors.forename: David J
authors.initials: DJ
authors.lastname: Prezant
mesh_terms: D000328:Adult; D000393:Air Pollutants / Q000009:adverse effects*; D004391:Dust; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects* / Q000032:analysis; D008297:Male; D009519:New York City; D009784:Occupational Diseases / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects*; D018635:Rescue Work; D012134:Respiratory Protective Devices / Q000706:statistics & numerical data; D047851:September 11 Terrorist Attacks; D013147:Spirometry; D013997:Time Factors
chemical_list: D000393:Air Pollutants; D004391:Dust