9/11 Residential Exposures: The Impact of World Trade Center Dust on Respiratory Outcomes of Lower Manhattan Residents

Abstract

Thousands of lower Manhattan residents sustained damage to their homes following the collapse of the Twin Towers on 11 September 2001. Respiratory outcomes have been reported in this population. We sought to describe patterns of home damage and cleaning practices in lower Manhattan and their impacts on respiratory outcomes among World Trade Center Health Registry (WTCHR) respondents. Data were derived from WTCHR Wave 1 (W1) (9/2003–11/2004) and Wave 2 (W2) (11/2006–12/2007) surveys. Outcomes of interest were respiratory symptoms (shortness of breath (SoB), wheezing, persistent chronic cough, upper respiratory symptoms (URS)) first occurring or worsening after 9/11 W1 and still present at W2 and respiratory diseases (asthma and chronic obstructive pulmonary disease (COPD)) first diagnosed after 9/11 W1 and present at W2. We performed descriptive statistics, multivariate logistic regression and geospatial analyses, controlling for demographics and other exposure variables. A total of 6447 residents were included. Mean age on 9/11 was 45.1 years (±15.1 years), 42% were male, 45% had ever smoked cigarettes, and 44% reported some or intense dust cloud exposure on 9/11. The presence of debris was associated with chronic cough (adjusted OR (aOR) = 1.56, CI: 1.12–2.17), and upper respiratory symptoms (aOR = 1.56, CI: 1.24–1.95). A heavy coating of dust was associated with increased shortness of breath (aOR = 1.65, CI: 1.24–2.18), wheezing (aOR = 1.43, CI: 1.03–1.97), and chronic cough (aOR = 1.59, CI: 1.09–2.28). Dusting or sweeping without water was the cleaning behavior associated with the largest number of respiratory outcomes, such as shortness of breath, wheezing, and URS. Lower Manhattan residents who suffered home damage following the 9/11 attacks were more likely to report respiratory symptoms and diseases compared to those who did not report home damage.

Twenty-Year Reflection on the Impact of World Trade Center Exposure on Pulmonary Outcomes in Fire Department of the City of New York (FDNY) Rescue and Recovery Workers

“…Pulmonary function testing conducted immediately after 9/11 identified airway obstruction and hyperreactivity associated with WTC exposure [27]. Similar to findings in the non-FDNY volunteer/responder [28][29][30] and survivor cohorts [9,31], this relationship was strongly associated with exposure intensity in FDNY rescue/recovery workers [27]. Even after 6 months, FDNY workers most highly exposed (arrived on the morning of 9/11) were over six times more likely to have airway hyperreactivity based on methacholine challenge testing (MCT) than those with moderate exposure or no exposure in the first 2 weeks after 9/11 [32].…”

COPD in Smoking and Non-Smoking Community Members Exposed to the World Trade Center Dust and Fumes

“…Community members included those escaping the towers, local residents, local workers, people involved in clean-up activities, as well as those passing by the WTC area on 9/11. Numerous reports now document the onset of lower respiratory symptoms of shortness of breath, cough, and wheeze in these populations [ 9 , 10 , 11 ]. Our prior data suggest that most symptomatic community members had normal spirometry; however, a subset of community members had abnormalities in small airway function and some had severe abnormalities in spirometry, which fits the criteria for COPD [ 12 , 13 , 14 ].…”

Health-Related Quality of Life (HRQoL) of Residents with Persistent Lower Respiratory Symptoms or Asthma Following a Sulphur Stockpile Fire Incident

“…PLRS following incidental exposure to high levels of chemicals has also been reported in workers cleaning up after an oil spill up to five years following exposure [ 6 ]. Workers and communities exposed to chemicals following the World Trade Centre explosion in New York also demonstrated persistent respiratory symptoms during follow-up surveillance medical examinations [ 7 , 8 , 9 , 10 ]. Individuals affected by such exposures and resultant respiratory morbidity may experience reduced health health-related quality of life (HrQoL) [ 11 ].…”