title: Occupational rhinosinusitis and upper airway disease: the world trade center experience.
abstract: The World Trade Center disaster and its recovery work involved a range of hazardous occupational exposures that have not been fully characterized but that can be reasonably assumed to have the potential to cause mucosal inflammation, preferentially (but not exclusively) in the upper airway. A high prevalence of rhinosinusitis and upper airway disease (UAD) symptoms was reported by several early surveys. Clinical studies demonstrated objective, clinically significant, and persistent chronic perennial rhinosinusitis and UAD-with or without seasonal exacerbation-in a large proportion of patients. Demonstration of an association between UAD and available exposure indicators has been limited. Atopy seemed to be associated with increased UAD symptom severity and to be a risk factor for upper, but not lower, airway disease. World Trade Center-related UAD is considered an irritant-induced disease but not, in many cases, of acute onset. No data thus far suggest an increased upper airway cancer incidence.
authors.affiliation: Department of Preventive Medicine, Mount Sinai School of Medicine, Box 1059, One Gustave L. Levy Place, New York, NY 10029, USA. rafael.delahoz@mssm.edu
authors.forename: Rafael E
authors.initials: RE
authors.lastname: de la Hoz
authors.forename: Michael R
authors.initials: MR
authors.lastname: Shohet
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Cohen
mesh_terms: D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology; D019570:Inhalation Exposure / Q000009:adverse effects*; D007827:Laryngitis / Q000453:epidemiology; D009369:Neoplasms / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D010612:Pharyngitis / Q000453:epidemiology; D015995:Prevalence; D020545:Respiratory Mucosa / Q000276:immunology / Q000503:physiopathology; D012137:Respiratory System / Q000276:immunology / Q000503:physiopathology; D012220:Rhinitis / Q000453:epidemiology*; D047851:September 11 Terrorist Attacks; D012852:Sinusitis / Q000453:epidemiology*
chemical_list: D000395:Air Pollutants, Occupational