Characteristics of a Residential and Working Community With Diverse Exposure to World Trade Center Dust, Gas, and Fumes

Department of Medicine, New York University School of Medicine, New York, NY 10011, USA.
Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine (Impact Factor: 1.63). 05/2009; 51(5):534-41. DOI: 10.1097/JOM.0b013e3181a0365b
Source: PubMed


To describe physical symptoms in those local residents, local workers, and cleanup workers who were enrolled in a treatment program and had reported symptoms and exposure to the dust, gas, and fumes released with the destruction of the World Trade Center (WTC) on September 11, 2001.
Symptomatic individuals underwent standardized evaluation and subsequent treatment.
One thousand eight hundred ninety-eight individuals participated in the WTC Environmental Health Center between September 2005 and May 2008. Upper and lower respiratory symptoms that began after September 11, 2001 and persisted at the time of examination were common in each exposure population. Many (31%) had spirometry measurements below the lower limit of normal.
Residents and local workers as well as those with work-associated exposure to WTC dust have new and persistent respiratory symptoms with lung function abnormalities 5 or more years after the WTC destruction.

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    • "During more than a decade after the 9/11 event, a number of studies from the three centers [1]–[13] and from other WTC research programs [14],[15] investigated a range of physical and mental health conditions among both responders and civilians. Among the mental health conditions, probable posttraumatic stress disorder (PTSD), measured with check-lists tailored to the event, stands out as one of the major syndromes that appears to have endured over the decade following the disaster [16],[17]. "
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    ABSTRACT: The World Trade Center (WTC) disaster on September 11, 2001 was an unprecedented traumatic event with long-lasting health consequences among the affected populations in the New York metropolitan area. This meta-analysis aimed to estimate the risk of probable posttraumatic stress disorder (PTSD) associated with specific types of WTC exposures. Meta-analytical findings from 10 studies of 3,271 to 20,294 participants yielded 37 relevant associations. The pooled summary odds ratio (OR) was 2.05 (95% confidence interval (CI): 1.82, 2.32), with substantial heterogeneity linked to exposure classification, cohort type, data source, PTSD assessment instrument/criteria, and lapse time since 9/11. In general, responders (e.g. police, firefighters, rescue/recovery workers and volunteers) had a lower probable PTSD risk (OR = 1.61; 95% CI: 1.39, 1.87) compared to civilians (e.g. residents, office workers, and passersby; OR = 2.71, 95% CI: 2.35, 3.12). The differences in ORs between responders and civilians were larger for physical compared to psychosocial exposure types. We also found that injury, lost someone, and witnessed horror were the three (out of six) most pernicious exposures. These findings suggest that these three exposures should be a particular focus in psychological evaluation and treatment programs in WTC intervention and future emergency preparedness efforts.
    PLoS ONE 07/2014; 9(7):e101491. DOI:10.1371/journal.pone.0101491 · 3.23 Impact Factor
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    • "This acute, intense dust exposure has resulted in a remarkable increase in symptoms characterized by cough, wheeze, chest tightness, gastroesophageal reflux, and so forth in firefighters, rescue workers, and clean-up workers. Residents who returned to their apartments and cleaned up the dust have also been affected [23]. Asthma has been found to have been worsened, and there is an increase in newly diagnosed asthma. "
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    ABSTRACT: Oxidants such as superoxide anion, hydrogen peroxide, and myeloperoxidase from activated inflammatory cells in the lower respiratory tract contribute to inflammation and injury. Etiologic agents include inorganic particulates such as asbestos, silica, or coal mine dust or mixtures of inorganic dust and combustion materials found in World Trade Center dust and smoke. These etiologic agents are phagocytosed by alveolar macrophages or bronchial epithelial cells and release chemotactic factors that recruit inflammatory cells to the lung. Chemotactic factors attract and activate neutrophils, eosinophils, mast cells, and lymphocytes and further activate macrophages to release more oxidants. Inorganic dusts target alveolar macrophages, World Trade Center dust targets bronchial epithelial cells, and eosinophils characterize tropical pulmonary eosinophilia (TPE) caused by filarial organisms. The technique of bronchoalveolar lavage in humans has recovered alveolar macrophages (AMs) in dust diseases and eosinophils in TPE that release increased amounts of oxidants in vitro. Interestingly, TPE has massively increased eosinophils in the acute form and after treatment can still have ongoing eosinophilic inflammation. A course of prednisone for one week can reduce the oxidant burden and attendant inflammation and may be a strategy to prevent chronic TPE and interstitial lung disease.
    Mediators of Inflammation 10/2011; 2011:407657. DOI:10.1155/2011/407657 · 3.24 Impact Factor
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    ABSTRACT: We report a sentinel case of acute eosinophilic pneumonia in a firefighter exposed to high concentrations of World Trade Center dust during the rescue effort from September 11 to 24. The firefighter presented with a Pa(O2) of 53 mm Hg and responded to oxygen and corticosteroids. Computed tomography scan showed patchy ground glass density, thickened bronchial walls, and bilateral pleural effusions. Bronchoalveolar lavage recovered 70% eosinophils, with only 1% eosinophils in peripheral blood. Eosinophils were not degranulated and increased levels of interleukin-5 were measured in bronchoalveolar lavage and serum. Mineralogic analysis counted 305 commercial asbestos fibers/10(6) macrophages including those with high aspect ratios, and significant quantities of fly ash and degraded fibrous glass. Acute eosinophilic pneumonia is a rare consequence of acute high dust exposure. World Trade Center dust consists of large particle-size silicates, but fly ash and asbestos fibers may be found in bronchoalveolar lavage cells.
    American Journal of Respiratory and Critical Care Medicine 10/2002; 166(6):797-800. DOI:10.1164/rccm.200206-576OC · 13.00 Impact Factor
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