Pulmonary Function in a Cohort of New York City Police Department Emergency Responders Since the 2001 World Trade Center Disaster

Kleinman, Eli J.; Cucco, Robert A.; Martinez, Charles; Romanelli, John; Berkowitz, Israel; Lanes, Norman; Lichtenstein, David R.; Frazer, Somjen; Lit, Maggie P.; Moran, William F.

doi:10.1097/jom.0b013e31821f2c83

Cited by 16 publications

(8 citation statements)

References 19 publications

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“…Recognizing these limitations, our findings of abnormal FEV 1 , obstructed pattern, and low vital capacity, mirror those identified in adults exposed to the dust cloud (Banauch et al, 2006; Friedman et al, 2011; Kleinman et al, 2011). The absence of an association of heavy dust cloud exposure with decrements in spirometry is counterintuitive.…”

Section: Discussionsupporting

confidence: 75%

Associations of World Trade Center exposures with pulmonary and cardiometabolic outcomes among children seeking care for health concerns

Trasande

Fiorino

Attinà

et al. 2013

Science of The Total Environment

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Objective Prior research on the physical health of children exposed to the World Trade Center (WTC) attacks has largely relied on parental report via questionnaire. We examined the impact of clinically-reported exposures on the physical health of children who lived and/or attended school in downtown Manhattan on September 11, 2001. Study design We performed a cross-sectional study of 148 patients who presented to the WTC Environmental Health Center/Survivors Health Program, and were ≤18 years old on September 11, 2001. Results 38.5% were caught in the dust cloud from the collapsing buildings on September 11; over 80% spent ≥1 day in their home between September 11 and 18, 2001; and 25.7% reported home dust exposure. New-onset nasal/sinus congestion was reported in 52.7%, while nearly one-third reported new gastroesophageal reflux (GERD) symptoms. Prehypertension or hypertension was identified in 45.5%. Multivariable regression with exposure variables, body mass index category, and age as covariates identified strongest associations of dust cloud with spirometry (17.1% decrease in maximum midexpiratory flow). Younger children experienced increased peripheral eosinophils (+0.098% per year, p=0.023), while older children experienced more new-onset GERD (OR 1.17, p=0.004), headaches (OR 1.10, p=0.011), and prehypertension (OR 1.09, p=0.024). Home dust exposure was associated with reduced high-density lipoprotein (−10.3 mg/dL, p=0.027) and elevated triglycerides (+36.3 mg/dL, p=0.033). Conclusions While these findings cannot be assumed to generalize to all children exposed to the WTC attacks, they strongly suggest the need for more extensive study of respiratory, metabolic, and cardiovascu lar consequences.

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Section: Discussionsupporting

confidence: 75%

Associations of World Trade Center exposures with pulmonary and cardiometabolic outcomes among children seeking care for health concerns

Trasande

Fiorino

Attinà

et al. 2013

Science of The Total Environment

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“…Kleinman et al (2011a,b) compared pulmonary function since the 2001 WTC disaster, with pre-exposure function data, in a NYC Police Department (NYPD) Emergency Responder cohort, without history of repetitive respiratory exposures. For the 206 unit members who reported arrival time, exposure location, duration, smoking history, respirator mask usage, and respiratory symptoms, and who underwent clinical evaluation and follow-up spirometry in 2002 and 2007 there was a mean long-term decline in FVC of 190 ml (3.7%) 1-year post-exposure in 2002, and 330 ml (6.4%) in 2007, compared with baseline data.…”

Section: Groups With Results Based On Clinical Observationsmentioning

confidence: 99%

Health effects of World Trade Center (WTC) Dust: An unprecedented disaster with inadequate risk management

Lippmann¹,

Cohen²,

Chen³

2015

Critical Reviews in Toxicology

100

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The World Trade Center (WTC) twin towers in New York City collapsed on 9/11/2001, converting much of the buildings’ huge masses into dense dust clouds of particles that settled on the streets and within buildings throughout Lower Manhattan. About 80–90% of the settled WTC Dust, ranging in particle size from ~2.5 μm upward, was a highly alkaline mixture of crushed concrete, gypsum, and synthetic vitreous fibers (SVFs) that was readily resuspendable by physical disturbance and low-velocity air currents. High concentrations of coarse and supercoarse WTC Dust were inhaled and deposited in the conductive airways in the head and lungs, and subsequently swallowed, causing both physical and chemical irritation to the respiratory and gastroesophageal epithelia. There were both acute and chronic adverse health effects in rescue/recovery workers; cleanup workers; residents; and office workers, especially in those lacking effective personal respiratory protective equipment. The numerous health effects in these people were not those associated with the monitored PM2.5 toxicants, which were present at low concentrations, that is, asbestos fibers, transition and heavy metals, polyaromatic hydrocarbons or PAHs, and dioxins. Attention was never directed at the very high concentrations of the larger-sized and highly alkaline WTC Dust particles that, in retrospect, contained the more likely causal toxicants. Unfortunately, the initial focus of the air quality monitoring and guidance on exposure prevention programs on low-concentration components was never revised. Public agencies need to be better prepared to provide reliable guidance to the public on more appropriate means of exposure assessment, risk assessment, and preventive measures.

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“…It is the only observational cohort worldwide that is evaluating the possible health effects of TETRA use, and is also the only large-scale cohort study of police employees worldwide. Only a few small cohort studies have been set up in the police forces of other countries including the United States (Fekedulegn et al, 2013;Franke et al, 1998;Kleinman et al, 2011), the Netherlands (van der Velden et al, 2013) and Israel (Amster et al, 2013). The Airwave Health Monitoring Study cohort includes both men and women from all regions of Great Britain.…”

Section: Discussionmentioning

confidence: 99%

The Airwave Health Monitoring Study of police officers and staff in Great Britain: Rationale, design and methods

Elliott

Vergnaud

Singh

et al. 2014

Environmental Research

136

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Pulmonary Function in a Cohort of New York City Police Department Emergency Responders Since the 2001 World Trade Center Disaster

Abstract: Abnormal spirometry was observed in (5.3%) of subjects, particularly individuals experiencing higher Exposure Intensity, Duration, or Respiratory Symptoms. The small number of smokers and subjects failing to wear protective respiratory masks showed greater declines.

Cited by 16 publications

References 19 publications

Associations of World Trade Center exposures with pulmonary and cardiometabolic outcomes among children seeking care for health concerns

Associations of World Trade Center exposures with pulmonary and cardiometabolic outcomes among children seeking care for health concerns

Health effects of World Trade Center (WTC) Dust: An unprecedented disaster with inadequate risk management

The Airwave Health Monitoring Study of police officers and staff in Great Britain: Rationale, design and methods

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