help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Published ahead of print on February 25, 2003, doi:10.1164/rccm.200211-1329OC
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
200211-1329OCv1
168/1/54    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Banauch, G. I.
Right arrow Articles by Prezant, D. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Banauch, G. I.
Right arrow Articles by Prezant, D. J.
American Journal of Respiratory and Critical Care Medicine Vol 168. pp. 54-62, (2003)
© 2003 American Thoracic Society

Original Article

Persistent Hyperreactivity and Reactive Airway Dysfunction in Firefighters at the World Trade Center

Gisela I. Banauch, Dawn Alleyne, Raoul Sanchez, Kattia Olender, Hillel W. Cohen, Michael Weiden, Kerry J. Kelly and David J. Prezant

Pulmonary Division, Montefiore Medical Center, and Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx; Bureau of Health Services, New York City Fire Department, Brooklyn; and Pulmonary Division, New York University School of Medicine, New York, New York

Correspondence and requests for reprints should be addressed to Dr. David Prezant, M.D., Professor of Medicine, Montefiore Medical Center, Pulmonary Division, Centennial 423, Bronx, NY 10467. E-mail: Prezd{at}dnamail.com

New York City Fire Department rescue workers experienced massive exposure to airborne particulates at the World Trade Center site. Aims of this longitudinal study were to (1) determine if bronchial hyperreactivity was present, persistent, and independently associated with exposure intensity, (2) identify objective measures shortly after the collapse that would predict persistent hyperreactivity and a diagnosis of reactive airways dysfunction 6 months post-collapse. A representative sample of 179 rescue workers stratified by exposure intensity (high, moderate, and control) without current smoking or prior respiratory disease was enrolled. Highly exposed workers arrived within 2 hours of collapse, moderately exposed workers arrived later on Days 1–2; control subjects were not exposed. Hyperreactivity at 1, 3, and 6 months post-collapse was associated with exposure intensity, independent of ex-smoking and airflow obstruction. Six months post-collapse, highly exposed workers were 6.8 times more likely than moderately exposed workers and control subjects to be hyperreactive (95% confidence interval, 1.8–25.2; p = 0.004), and hyperreactivity persisted in 55% of those hyperreactive at 1 and/or 3 months. In highly exposed subjects, hyperreactivity 1 or 3 months post-collapse was the sole predictor for reactive airways dysfunction (p = 0.021). In conclusion, development and persistence of hyperreactivity and reactive airways dysfunction were strongly and independently associated with exposure intensity. Hyperreactivity shortly post-collapse predicted reactive airways dysfunction at 6 months in highly exposed workers; this has important implications for disaster management.

Key Words: inorganic particulate matter • nonspecific bronchial hyperreactivity • reactive airways dysfunction syndrome • firefighters • World Trade Center collapse




This article has been cited by other articles:


Home page
 Occup Med (Lond)Home page
M. P. Mauer, K. R. Cummings, and R. Hoen
Long-term respiratory symptoms in World Trade Center responders
Occup. Med., December 24, 2009; (2009) kqp176v1.
[Abstract] [Full Text] [PDF]

Home page
 AJPHHome page
M. Corrigan, R. McWilliams, K. J. Kelly, J. Niles, C. Cammarata, K. Jones, D. Wartenberg, W. K. Hallman, H. M. Kipen, L. Glass, et al.
A Computerized, Self-Administered Questionnaire to Evaluate Posttraumatic Stress Among Firefighters After the World Trade Center Collapse
Am J Public Health, November 1, 2009; 99(S3): S702 - S709.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
R. M. Brackbill, J. L. Hadler, L. DiGrande, C. C. Ekenga, M. R. Farfel, S. Friedman, S. E. Perlman, S. D. Stellman, D. J. Walker, D. Wu, et al.
Asthma and Posttraumatic Stress Symptoms 5 to 6 Years Following Exposure to the World Trade Center Terrorist Attack
JAMA, August 5, 2009; 302(5): 502 - 516.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
S. M. Tarlo, J.-L. Malo, and on behalf of the Third Jack Pepys Workshop on Asth
An Official ATS Proceedings: Asthma in the Workplace: The Third Jack Pepys Workshop on Asthma in the Workplace: Answered and Unanswered Questions
Proceedings of the ATS, August 1, 2009; 6(4): 339 - 349.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
G. S. Skloot, C. B. Schechter, R. Herbert, J. M. Moline, S. M. Levin, L. E. Crowley, B. J. Luft, I. G. Udasin, and P. L. Enright
Longitudinal Assessment of Spirometry in the World Trade Center Medical Monitoring Program
Chest, February 1, 2009; 135(2): 492 - 498.
[Abstract] [Full Text] [PDF]

Home page
 Chronic Respiratory DiseaseHome page
C. Barber and D Fishwick
Chronic cough - occupational considerations
Chronic Respiratory Disease, November 1, 2008; 5(4): 211 - 221.
[Abstract] [PDF]

Home page
 Occup Med (Lond)Home page
M. S. Shakeri, F. D. Dick, and J. G. Ayres
Which agents cause reactive airways dysfunction syndrome (RADS)? A systematic review
Occup. Med., May 1, 2008; 58(3): 205 - 211.
[Abstract] [Full Text] [PDF]

Home page
 Chronic Respiratory DiseaseHome page
O.P. Kurmi and J.G. Ayres
Review Series: Occupational and environmental lung disease: The non-occupational environment and the lung: opportunities for intervention
Chronic Respiratory Disease, November 1, 2007; 4(4): 227 - 236.
[Abstract] [PDF]

Home page
 ChestHome page
B. W. Oppenheimer, R. M. Goldring, M. E. Herberg, I. S. Hofer, P. A. Reyfman, S. Liautaud, W. N. Rom, J. Reibman, and K. I. Berger
Distal Airway Function in Symptomatic Subjects With Normal Spirometry Following World Trade Center Dust Exposure
Chest, October 1, 2007; 132(4): 1275 - 1282.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
D. Miedinger, P. N. Chhajed, D. Stolz, C. Gysin, A-B. Wanzenried, C. Schindler, C. Surber, H. C. Bucher, M. Tamm, and J. D. Leuppi
Respiratory symptoms, atopy and bronchial hyperreactivity in professional firefighters
Eur. Respir. J., September 1, 2007; 30(3): 538 - 544.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
G. Izbicki, R. Chavko, G. I. Banauch, M. D. Weiden, K. I. Berger, T. K. Aldrich, C. Hall, K. J. Kelly, and D. J. Prezant
World Trade Center "Sarcoid-Like" Granulomatous Pulmonary Disease in New York City Fire Department Rescue Workers
Chest, May 1, 2007; 131(5): 1414 - 1423.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
T. S. Nawrot, A. Nemmar, and B. Nemery
Update in Environmental and Occupational Medicine 2006
Am. J. Respir. Crit. Care Med., April 15, 2007; 175(8): 758 - 762.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. R. Balmes
The world trade center collapse: a continuing tragedy for lung health?
Am. J. Respir. Crit. Care Med., August 1, 2006; 174(3): 235 - 236.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
G. I. Banauch, C. Hall, M. Weiden, H. W. Cohen, T. K. Aldrich, V. Christodoulou, N. Arcentales, K. J. Kelly, and D. J. Prezant
Pulmonary Function after Exposure to the World Trade Center Collapse in the New York City Fire Department
Am. J. Respir. Crit. Care Med., August 1, 2006; 174(3): 312 - 319.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
S. M. Tarlo
Cough: Occupational and Environmental Considerations: ACCP Evidence-Based Clinical Practice Guidelines
Chest, January 1, 2006; 129(1_suppl): 186S - 196S.
[Abstract] [Full Text] [PDF]

Home page
 Occup Med (Lond)Home page
S. M. Tarlo and G. M. Liss
Prevention of occupational asthma--practical implications for occupational physicians
Occup. Med., December 1, 2005; 55(8): 588 - 594.
[Abstract] [Full Text] [PDF]

Home page
 Am J EpidemiolHome page
S. Lin, J. Reibman, J. A. Bowers, S.-A. Hwang, A. Hoerning, M. I. Gomez, and E. F. Fitzgerald
Upper Respiratory Symptoms and Other Health Effects among Residents Living Near the World Trade Center Site after September 11, 2001
Am. J. Epidemiol., September 15, 2005; 162(6): 499 - 507.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
C. E. Mapp, P. Boschetto, P. Maestrelli, and L. M. Fabbri
Occupational Asthma
Am. J. Respir. Crit. Care Med., August 1, 2005; 172(3): 280 - 305.
[Abstract] [Full Text] [PDF]

Home page
 Proc Am Thorac SocHome page
D. C. Grootendorst and K. F. Rabe
Mechanisms of Bronchial Hyperreactivity in Asthma and Chronic Obstructive Pulmonary Disease
Proceedings of the ATS, April 1, 2004; 1(2): 77 - 87.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
T. Truncale, S. Brooks, D. J. Prezant, G. I. Banauch, and B. Nemery
World Trade Center Dust and Airway Reactivity
Am. J. Respir. Crit. Care Med., April 1, 2004; 169(7): 883 - 885.
[Full Text] [PDF]

Home page
 ChestHome page
G. Skloot, M. Goldman, D. Fischler, C. Goldman, C. Schechter, S. Levin, and A. Teirstein
Respiratory Symptoms and Physiologic Assessment of Ironworkers at the World Trade Center Disaster Site
Chest, April 1, 2004; 125(4): 1248 - 1255.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. Tobin
Tuberculosis, Lung Infections, Interstitial Lung Disease, Social Issues and Journalology in AJRCCM 2003
Am. J. Respir. Crit. Care Med., January 15, 2004; 169(2): 288 - 300.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
B. Nemery
Reactive Fallout of World Trade Center Dust
Am. J. Respir. Crit. Care Med., July 1, 2003; 168(1): 2 - 3.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2003 American Thoracic Society 		  Registrer for the conference