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Abstract: Slide Presentations |

ACCELERATED PULMONARY FUNCTION DECLINE AFTER WORLD TRADE CENTER PARTICULATE EXPOSURE IN THE NEW YORK CITY FIRE DEPARTMENT WORKFORCE FREE TO VIEW

Gisela Banauch, MD*; Michael Weiden, MD; Charles Hall, PhD; Hillel W. Cohen; Thomas K. Aldrich, MD; Nicole Arcentales, BS; Kerry J. Kelly, MD; David J. Prezant, MD
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Albert Einstein College of Medicine, New York, NY


Chest


Chest. 2005;128(4_MeetingAbstracts):213S. doi:10.1378/chest.128.4_MeetingAbstracts.213S-b
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Abstract

PURPOSE:  On September 11th 2001, the World Trade Center (WTC) collapse created an enormous urban disaster site with high levels of “WTC-Dust” (respirable particulates and combustion by-products). Rescue workers and residents have since developed respiratory symptoms and pulmonary function abnormalities. We investigated whether WTC-Dust exposure affected spirometric decline rates (forced expiratory volume in one second [FEV1], forced vital capacity [FVC]) in the New York City Fire Department (FDNY) workforce.

METHODS:  Longitudinal cohort study of pulmonary function before and after 09/11/2001 in 12,079 FDNY rescue workers employed on/before 09/11/2001. Declines were computed separately for pre- and post-9/11 periods and analyzed for differences according to WTC-Dust exposure intensity. Exposure intensity was assessed with (1) initial arrival time at the WTC site (early arrival before/during WTC collapse, intermediate after collapse during 09/11/2001-09/12/2001, late after 09/12/2001; non-exposed never present) and (2) work assignment (Special Operations Command [SOC] vs. non-SOC).

RESULTS:  FEV1 decline after 09/11/2001 correlated linearly (p for trend<0.001) with arrival time-based WTC-Dust exposure intensity and was fastest for those with early, high exposure, reaching more than twice the magnitude for the non-exposed group (-845cc/yr for early vs. -405cc/yr for non-exposed, p<0.001; figure 1A&2A). The intermediate exposure group had a decline between that of early and late groups. The late group had a decline 50% above the non-exposed. In addition, SOC workers experienced 50% faster decline than non-SOC workers (-926cc/yr for SOC vs. -615cc/yr for non-SOC; p=0.007; figure 1B&2B).

CONCLUSION:  WTC-Dust exposure produced accelerated declines in spirometric measures of lung function in 12,079 WTC exposed FDNY rescue workers during the first year following 09/11/2001.

CLINICAL IMPLICATIONS:  Findings are of potential relevance for less exposed populations. The long-term time course of spirometric decline is not certain. For these reasons, WTC-exposed occupational and community cohorts merit continued close medical monitoring.

DISCLOSURE:  Gisela Banauch, None.

10:30 AM - 12:00 PM


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