Blood Leukocyte Concentrations, FEV₁ Decline, and Airflow Limitation. A 15-Year Longitudinal Study of World Trade Center–exposed Firefighters

Abstract

Higher post-9/11 blood neutrophil and eosinophil concentrations were associated with subsequent accelerated FEV decline in WTC-exposed firefighters. Both higher blood eosinophil concentrations and accelerated FEV decline were associated with incident airflow limitation in WTC-exposed firefighters.

Predictors of Asthma/COPD Overlap in FDNY Firefighters With World Trade Center Dust Exposure

“…5 A subset of this population received at least one clinically-indicated BD-PFT performed according to American Thoracic Society (ATS) standards 15 at a hospital-based pulmonary function laboratory between 9/11/2001 and 9/10/2017. We excluded 57 participants whose BD-PFT occurred before their first post-9/11 medical monitoring examination.…”

“…The source population consisted of 9,598 male firefighters who were actively employed by the FDNY on 9/11, first arrived at the WTC between 9/11–9/24/2001, and had ≥3 post-9/11 forced expiratory volume at one second (FEV 1 ) measurements from routine medical monitoring PFTs taken at FDNY. 5 A subset of this population received at least one clinically-indicated BD-PFT performed according to American Thoracic Society (ATS) standards 15 at a hospital-based pulmonary function laboratory between 9/11/2001 and 9/10/2017. We excluded 57 participants whose BD-PFT occurred before their first post-9/11 medical monitoring examination.…”

“…4 Firefighters with elevated post-exposure blood eosinophil concentrations were at increased risk of developing chronic obstructive pulmonary disease (COPD). 5 …”

Mortality among Fire Department of the City of New York Rescue and Recovery Workers Exposed to the World Trade Center Disaster, 2001–2017

“…The disaster’s intense dust cloud contained a huge variety of irritants, including partially combusted and/or pulverized wood, paper, and jet fuel; construction materials including asbestos, glass, silica, fiberglass, and concrete; complex organic chemicals; lead and other metals [ 1 , 2 ]. Subsequently, several physical and mental health conditions were linked to 9/11/2001-related exposures, such as high rates of airway injury including excessive loss of lung function [ 3 ], excess cancer risks [ 4 , 5 , 6 ], aerodigestive illnesses or gastroesophageal reflux disease (GERD) [ 7 ], long-term cardiovascular disease risk [ 8 ] and increased risks of post-traumatic stress disorder (PTSD) [ 9 ], depression [ 10 ], and binge drinking [ 11 , 12 ] among rescue/recovery workers and area residents. Substantial comorbidities between these health conditions have also been documented [ 13 , 14 , 15 ].…”

Bronchodilator Response Predicts Longitudinal Improvement in Small Airway Function in World Trade Center Dust Exposed Community Members

“…There are multiple reports of changes in spirometry associated with LRS, and importantly, small airway abnormalities have been associated with LRS even in the presence of normal spirometry [4,5,6,8,11,12,13]. Longitudinal improvement in LRS and spirometry is reported in many, although symptoms have often persisted [3,5,14,15]. Of note, structural changes within the airways and/or parenchyma have been demonstrated in community members, suggesting a potentially irreversible component of lung injury [16].…”