title: Oscillometry complements spirometry in evaluation of subjects following toxic inhalation.
abstract: The World Trade Center (WTC) destruction released dust and fumes into the environment. Although many community members developed respiratory symptoms, screening spirometry was usually normal. We hypothesised that forced oscillation testing would identify functional abnormalities undetected by spirometry and that symptom severity would relate to magnitude of abnormalities measured by oscillometry. A symptomatic cohort (n=848) from the Bellevue Hospital WTC Environmental Health Center was evaluated and compared to an asymptomatic cohort (n=475) from the New York City Department of Health WTC Health Registry. Spirometry and oscillometry were performed. Oscillometry measurements included resistance (R5) and frequency dependence of resistance (R5-20). Spirometry was normal for the majority of subjects (73.2% symptomaticversus87.6% asymptomatic, p<0.0001). In subjects with normal spirometry,R5andR5-20were higher in symptomaticversusasymptomatic subjects (median (interquartile range)R50.436 (0.206)versus0.314 (0.129) kPa·L-1·s-1, p<0.001;R5-200.075 (0.085)versus0.004 (0.042) kPa·L-1·s-1, p<0.0001). In symptomatic subjects,R5andR5-20increased with increasing severity and frequency of wheeze (p<0.05). Measurement ofR5-20correlated with the presence and severity of symptoms even when spirometry was within normal limits. These findings are in accord with small airway abnormalities as a potential explanation of the respiratory symptoms.
authors.affiliation: Dept of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, NY, USA; André Cournand Pulmonary Physiology Laboratory, Bellevue Hospital, New York, NY, USA; These authors contributed equally to this manuscript.
authors.forename: Kenneth I
authors.initials: KI
authors.lastname: Berger
authors.affiliation: Dept of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, NY, USA; These authors contributed equally to this manuscript.
authors.forename: Meredith
authors.initials: M
authors.lastname: Turetz
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY, USA.
authors.forename: Mengling
authors.initials: M
authors.lastname: Liu
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY, USA.
authors.forename: Yongzhao
authors.initials: Y
authors.lastname: Shao
authors.affiliation: Dept of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, NY, USA.
authors.forename: Angeliki
authors.initials: A
authors.lastname: Kazeros
authors.affiliation: Dept of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, NY, USA.
authors.forename: Sam
authors.initials: S
authors.lastname: Parsia
authors.affiliation: Dept of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, NY, USA.
authors.forename: Caralee
authors.initials: C
authors.lastname: Caplan-Shaw
authors.affiliation: New York City Department of Health and Mental Hygiene, New York, NY, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Friedman
authors.affiliation: New York City Department of Health and Mental Hygiene, New York, NY, USA.
authors.forename: Carey B
authors.initials: CB
authors.lastname: Maslow
authors.affiliation: Department of Population Health, New York University School of Medicine, New York, NY, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Marmor
authors.affiliation: Dept of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, NY, USA; André Cournand Pulmonary Physiology Laboratory, Bellevue Hospital, New York, NY, USA.
authors.forename: Roberta M
authors.initials: RM
authors.lastname: Goldring
authors.affiliation: Dept of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, New York University School of Medicine, New York, NY, USA.
authors.forename: Joan
authors.initials: J
authors.lastname: Reibman