title: Emerging exposures and respiratory health: World Trade Center dust.
abstract: The attack on the World Trade Center (WTC) on 9/11/2001 produced a massive dust cloud with acute exposure, and the rubble pile burning over 3 months exposed more than 300,000 residents, rescue workers, and clean-up workers. Firefighters in the New York City Fire Department had significant respiratory symptoms characterized by cough, dyspnea, gastroesophageal reflux, and nasal stuffiness with a significant 1-year decline in FVC and FEV(1). Bronchial hyperreactivity measured by methacholine challenge correlated with bronchial wall thickening on CT scans. Compared with the NHANES III data for FVC and FEV(1), 32% of 2,000 WTC dust-exposed residents and clean-up workers were below the lower 5th percentile. The most common abnormality was a low FVC pattern, a finding similar to that also described for individuals in rescue and recovery activities. Among those complaining of respiratory symptoms and normal spirometry, almost half had abnormalities detected with impedance oscillometry consistent with distal airways' disease. Follow-up with the WTC Health Registry and the WTC Environmental Health Center will help discern whether treatment with anti-inflammatory medications or bronchodilators in those with respiratory symptoms may prevent the development of chronic obstructive pulmonary disease.
authors.affiliation: MPH, Division of Pulmonary and Critical Care Medicine, Department of Medicine, New York University School of Medicine, 550 1st Ave., New York, NY 10016, USA. william.rom@med.nyu.edu
authors.forename: William N
authors.initials: WN
authors.lastname: Rom
authors.forename: Joan
authors.initials: J
authors.lastname: Reibman
authors.forename: Linda
authors.initials: L
authors.lastname: Rogers
authors.forename: Michael D
authors.initials: MD
authors.lastname: Weiden
authors.forename: Beno
authors.initials: B
authors.lastname: Oppenheimer
authors.forename: Kenneth
authors.initials: K
authors.lastname: Berger
authors.forename: Roberta
authors.initials: R
authors.lastname: Goldring
authors.forename: Denise
authors.initials: D
authors.lastname: Harrison
authors.forename: David
authors.initials: D
authors.lastname: Prezant
mesh_terms: D003252:Construction Materials / Q000009:adverse effects*; D004391:Dust; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans; D009519:New York City / Q000453:epidemiology; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D047851:September 11 Terrorist Attacks
chemical_list: D004391:Dust