Upper and lower respiratory diseases after occupational and environmental disasters.
Respiratory consequences from occupational and environmental disasters are the result of inhalation exposures to chemicals, particulate matter (dusts and fibers) and/or the incomplete products of combustion that are often liberated during disasters such as fires, building collapses, explosions and volcanoes. Unfortunately, experience has shown that environmental controls and effective respiratory protection are often unavailable during the first days to week after a large-scale disaster. The English literature was reviewed using the key words-disaster and any of the following: respiratory disease, pulmonary, asthma, bronchitis, sinusitis, pulmonary fibrosis, or sarcoidosis. Respiratory health consequences after aerosolized exposures to high-concentrations of particulates and chemicals can be grouped into 4 major categories: 1) upper respiratory disease (chronic rhinosinusitis and reactive upper airways dysfunction syndrome), 2) lower respiratory diseases (reactive [lower] airways dysfunction syndrome, irritant-induced asthma, and chronic obstructive airways diseases), 3) parenchymal or interstitial lung diseases (sarcoidosis, pulmonary fibrosis, and bronchiolitis obliterans, and 4) cancers of the lung and pleura. This review describes several respiratory consequences of occupational and environmental disasters and uses the World Trade Center disaster to illustrate in detail the consequences of chronic upper and lower respiratory inflammation.
Prezant
David J
DJ
Office of Medical Affairs, Fire Department of the City of New York (FDNY), Brooklyn, NY, USA. prezand@fdny.nyc.gov
Levin
Stephen
S
Kelly
Kerry J
KJ
Aldrich
Thomas K
TK
D004190:Disasters; D004781:Environmental Exposure / Q000009:adverse effects*; D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000209:etiology; D006285:Health Planning; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects; D009519:New York City / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects; D052638:Particulate Matter / Q000009:adverse effects*; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000209:etiology; D047851:September 11 Terrorist Attacks
D052638:Particulate Matter