Induced Sputum Assessment in New York City Firefighters Exposed to World Trade Center Dust

Institute for Pulmonary and Allergic Diseases, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Environmental Health Perspectives (Impact Factor: 7.98). 11/2004; 112(15):1564-9. DOI: 10.1289/ehp.7233
Source: PubMed


New York City Firefighters (FDNY-FFs) were exposed to particulate matter and combustion/pyrolysis products during and after the World Trade Center (WTC) collapse. Ten months after the collapse, induced sputum (IS) samples were obtained from 39 highly exposed FDNY-FFs (caught in the dust cloud during the collapse on 11 September 2001) and compared to controls to determine whether a unique pattern of inflammation and particulate matter deposition, compatible with WTC dust, was present. Control subjects were 12 Tel-Aviv, Israel, firefighters (TA-FFs) and 8 Israeli healthcare workers who were not exposed to WTC dust. All controls volunteered for this study, had never smoked, and did not have respiratory illness. IS was processed by conventional methods. Retrieved cells were differentially counted, and metalloproteinase-9 (MMP-9), particle size distribution (PSD), and mineral composition were measured. Differential cell counts of FDNY-FF IS differed from those of health care worker controls (p < 0.05) but not from those of TA-FFs. Percentages of neutrophils and eosinophils increased with greater intensity of WTC exposure (< 10 workdays or greater than or equal to 10 workdays; neutrophils p = 0.046; eosinophils p = 0.038). MMP-9 levels positively correlated to neutrophil counts (p = 0.002; r = 0.449). Particles were larger and more irregularly shaped in FDNY-FFs (1-50 microm; zinc, mercury, gold, tin, silver) than in TA-FFs (1-10 microm; silica, clays). PSD was similar to that of WTC dust samples. In conclusion, IS from highly exposed FDNY-FFs demonstrated inflammation, PSD, and particle composition that was different from nonexposed controls and consistent with WTC dust exposure.

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    • "Particle size analysis was performed from the sputum pellet samples according to a laser technique based on the time of transition (TOT) theory using a DIPA 2000 Analyzer (Donner Technologies Ltd Israel) (Fireman et al. 2004, 2008, 2010). Briefly, DIPA 2000 is a computerized inspection system for particle size analysis in the range of 0.5–3600 μ and employs laser and video measurements. "
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    ABSTRACT: Conventional environmental monitoring is not surrogate of personal exposure. In contrast, biomonitoring provides information on the presence of substances in the human body, making it highly relevant to the assessment of exposure to toxic substances. Induced sputum (IS) is a noninvasive technique for detecting inflammation and reflecting particulate matter content in the airways. In this study, we mapped particulate matter dispersion in metropolitan Tel Aviv by both biomonitoring techniques employing IS samples and by environmental monitoring. All adults referred to the Pulmonary Lab for respiratory symptom evaluation in 2007 and in 2009 were enrolled. Pulmonary function tests were performed by conventional methods. Particulate size distribution in IS was analyzed, and maps of air pollution were created. Biomonitoring was more informative and enabled mapping of wider areas. Integration of biomonitoring and environmental monitoring should be considered in forming public health policy on containment of airborne particles of toxic substances.
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    • "In a study of major fire accidents, firefighters who were working in the field were exposed to more xylene, lead, antimony, and perchloroethylene than the comparison group, and firefighters who were closer to the field had greater exposures to these substances than those who were farther from the field did [26]. In addition, firefighters who participated in major fire accidents had more titanium, zinc, and calcite in their sputum [27]. In South Korea, the types of harmful factors present during a fire are unknown because they can differ at each fire site [28]. "
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    • "Much of the extensive research in the particulates field has been conducted in vitro, but humans exposed to fuel oil ash have evidence of inflammation, with increased IL8 and polymorphs in nasal lavage fluid [114]. Induced sputum studies of fire fighters 10 months after the World trade centre disaster found levels of neutrophils and eosinophils increased in relation to the intensity of dust exposure [115]. "
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