Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-11T02:59:55.306Z Has data issue: false hasContentIssue false
  • English
  • Français

Epidemiology of Respiratory Health Outcomes Among World Trade Center Disaster Workers: Review of the Literature 10 Years After the September 11, 2001 Terrorist Attacks

Published online by Cambridge University Press:  08 April 2013

Christine C. Ekenga  and
George Friedman-Jiménez
Get access Rights & Permissions [Opens in a new window]

Abstract

Tens of thousands of workers participated in rescue, recovery, and cleanup activities at the World Trade Center (WTC) site in lower Manhattan after the terrorist attacks on September 11, 2001 (9/11). The collapse of the WTC resulted in the release of a variety of airborne toxicants. To date, respiratory symptoms and diseases have been among the most examined health outcomes in studies of WTC disaster workers. A systematic review of the literature on respiratory health outcomes was undertaken to describe the available information on new onset of respiratory symptoms and diseases among WTC disaster workers after September 11, 2001. Independent risk factors for respiratory health outcomes included being caught in the dust and debris cloud, early arrival at the WTC site, longer duration of work, and delaying mask and respirator use. Methodological challenges in epidemiologic studies of WTC disaster workers involved study design, exposure misclassification, and limited information on potential confounders and effect modifiers. In the 10 years after 9/11, epidemiologic studies of WTC disaster workers have been essential in investigating the respiratory health consequences of WTC exposure. Longitudinal studies along with continued medical surveillance will be vital in understanding the long-term respiratory burden associated with occupational WTC exposure. (Disaster Med Public Health Preparedness. 2011;5:S189–S196)

Keywords

September 11 terrorist attacksepidemiologyoccupational diseasesrespiratory tract diseasesdisastersterrorismdisaster responseoccupational healthrespiratory tract diseasespulmonary diseases, chronic obstructive
Type
Special Focus
Information
Disaster Medicine and Public Health Preparedness , Volume 5 , Issue S2 , September 2011 , pp. S189 - S196
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Lioy, PJ, Georgopoulos, P.The anatomy of the exposures that occurred around the World Trade Center site: 9/11 and beyond. Ann N Y Acad Sci. 2006;1076:54–79.Google Scholar
2.Lorber, M, Gibb, H, Grant, L, Pinto, J, Pleil, J, Cleverly, D.Assessment of inhalation exposures and potential health risks to the general population that resulted from the collapse of the World Trade Center towers. Risk Anal. 2007;27 (5):1203–1221.CrossRefGoogle Scholar
3.Landrigan, PJ, Lioy, PJ, Thurston, GNIEHS World Trade Center Working Group. Health and environmental consequences of the world trade center disaster. Environ Health Perspect. 2004;112 (6):731–739.Google Scholar
4. McGee, JK, Chen, LC, Cohen, MD.Chemical analysis of World Trade Center fine particulate matter for use in toxicologic assessment. Environ Health Perspect. 2003;111 (7):972–980.Google Scholar
5.Berríos-Torres, SI, Greenko, JA, Phillips, M, Miller, JR, Treadwell, T, Ikeda, RM.World Trade Center rescue worker injury and illness surveillance, New York, 2001. Am J Prev Med. 2003;25 (2):79–87.Google Scholar
6.Centers for Disease Control and Prevention (CDC). Injuries and illnesses among New York City Fire Department rescue workers after responding to the World Trade Center attacks. MMWR Morb Mortal Wkly Rep. 2002;51 (Spec No):1–5.Google Scholar
7.Centers for Disease Control and Prevention (CDC). Physical health status of World Trade Center rescue and recovery workers and volunteers - New York City, July 2002-August 2004. MMWR Morb Mortal Wkly Rep. 2004;53 (35):807–812.Google Scholar
8.Prezant, DJ, Weiden, M, Banauch, GI.Cough and bronchial responsiveness in firefighters at the World Trade Center site. N Engl J Med. 2002;347 (11):806–815.Google Scholar
9.Webber, MP, Gustave, J, Lee, R.Trends in respiratory symptoms of firefighters exposed to the world trade center disaster: 2001-2005. Environ Health Perspect. 2009;117 (6):975–980.Google Scholar
10.Banauch, GI, Alleyne, D, Sanchez, R.Persistent hyperreactivity and reactive airway dysfunction in firefighters at the World Trade Center. Am J Respir Crit Care Med. 2003;168 (1):54–62.Google Scholar
11.Banauch, GI, Hall, C, Weiden, M.Pulmonary function after exposure to the World Trade Center collapse in the New York City Fire Department. Am J Respir Crit Care Med. 2006;174 (3):312–319.Google Scholar
12.Salzman, SH, Moosavy, FM, Miskoff, JA, Friedmann, P, Fried, G, Rosen, MJ.Early respiratory abnormalities in emergency services police officers at the World Trade Center site. J Occup Environ Med. 2004;46 (2):113–122.Google Scholar
13.Buyantseva, LV, Tulchinsky, M, Kapalka, GM.Evolution of lower respiratory symptoms in New York police officers after 9/11: a prospective longitudinal study. J Occup Environ Med. 2007;49 (3):310–317.Google Scholar
14.Skloot, G, Goldman, M, Fischler, D.Respiratory symptoms and physiologic assessment of ironworkers at the World Trade Center disaster site. Chest. 2004;125 (4):1248–1255.Google Scholar
15.Tao, XG, Massa, J, Ashwell, L, Davis, K, Schwab, M, Geyh, A.The world trade center clean up and recovery worker cohort study: respiratory health amongst cleanup workers approximately 20 months after initial exposure at the disaster site. J Occup Environ Med. 2007;49 (10):1063–1072.Google Scholar
16.Herbert, R, Moline, J, Skloot, G.The World Trade Center disaster and the health of workers: five-year assessment of a unique medical screening program. Environ Health Perspect. 2006;114 (12):1853–1858.CrossRefGoogle ScholarPubMed
17.Wheeler, K, McKelvey, W, Thorpe, L.Asthma diagnosed after 11 September 2001 among rescue and recovery workers: findings from the World Trade Center Health Registry. Environ Health Perspect. 2007;115 (11):1584–1590.Google Scholar
18.Wu, MX, Gordon, RE, Herbert, R.Case report: Lung disease in World Trade Center responders exposed to dust and smoke: carbon nanotubes found in the lungs of World Trade Center patients and dust samples. Environ Health Perspect. 2010;118 (4):499–504.CrossRefGoogle ScholarPubMed
19.Rom, WN, Weiden, M, Garcia, R.Acute eosinophilic pneumonia in a New York City firefighter exposed to World Trade Center dust. Am J Respir Crit Care Med. 2002;166 (6):797–800.Google Scholar
20.Mann, JM, Sha, KK, Kline, G, Breuer, FU, Miller, A.World Trade Center dyspnea: bronchiolitis obliterans with functional improvement: a case report. Am J Ind Med. 2005;48 (3):225–229.Google Scholar
21.Bowers, B, Hasni, S, Gruber, BL.Sarcoidosis in World Trade Center rescue workers presenting with rheumatologic manifestations. J Clin Rheumatol. 2010;16 (1):26–27.Google Scholar
22.Izbicki, G, Chavko, R, Banauch, GI.World Trade Center “sarcoid-like” granulomatous pulmonary disease in New York City Fire Department rescue workers. Chest. 2007;131 (5):1414–1423.Google Scholar
23.Crowley, LE, Herbert, R, Moline, JM.“Sarcoid like” granulomatous pulmonary disease in World Trade Center disaster responders. Am J Ind Med. 2011;54 (3):175–184.Google Scholar
24.de la Hoz, RE, Shohet, MR, Chasan, R.Occupational toxicant inhalation injury: the World Trade Center (WTC) experience. Int Arch Occup Environ Health. 2008;81 (4):479–485.CrossRefGoogle ScholarPubMed
25.de la Hoz, RE, Shohet, MR, Wisnivesky, JP, Bienenfeld, LA, Afilaka, AA, Herbert, R.Atopy and upper and lower airway disease among former World Trade Center workers and volunteers. J Occup Environ Med. 2009;51 (9):992–995.CrossRefGoogle ScholarPubMed
26.Aldrich, TK, Gustave, J, Hall, CB.Lung function in rescue workers at the World Trade Center after 7 years. N Engl J Med. 2010;362 (14):1263–1272.Google Scholar
27.Weiden, MD, Ferrier, N, Nolan, A.Obstructive airways disease with air trapping among firefighters exposed to World Trade Center dust. Chest. 2010;137 (3):566–574.Google Scholar
28.Skloot, GS, Schechter, CB, Herbert, R.Longitudinal assessment of spirometry in the World Trade Center medical monitoring program. Chest. 2009;135 (2):492–498.Google Scholar
29.Mauer, MP, Cummings, KR, Carlson, GA.Health effects in New York State personnel who responded to the World Trade Center disaster. J Occup Environ Med. 2007;49 (11):1197–1205.Google Scholar
30.Mauer, MP, Herdt-Losavio, ML, Carlson, GA.Asthma and lower respiratory symptoms in New York State employees who responded to the World Trade Center disaster. Int Arch Occup Environ Health. 2010;83 (1):21–27.Google Scholar
31.Mauer, MP, Cummings, KR, Hoen, R.Long-term respiratory symptoms in World Trade Center responders. Occup Med (Lond). 2010;60 (2):145–151.Google Scholar
32.Herdt-Losavio, ML, Mauer, MP, Carlson, GA.Development of an exposure assessment method for epidemiological studies of New York State personnel who responded to the World Trade Center disaster. Ann Occup Hyg. 2008;52 (2):83–93.Google Scholar
33.Mauer, MP, Cummings, KR.Impulse oscillometry and respiratory symptoms in World Trade Center responders, 6 years post-9/11. Lung. 2010;188 (2):107–113.Google Scholar
34.Farfel, M, DiGrande, L, Brackbill, R.An overview of 9/11 experiences and respiratory and mental health conditions among World Trade Center Health Registry enrollees. J Urban Health. 2008;85 (6):880–909.Google Scholar
35.Brackbill, RM, Hadler, JL, DiGrande, L.Asthma and posttraumatic stress symptoms 5 to 6 years following exposure to the World Trade Center terrorist attack. JAMA. 2009;302 (5):502–516.CrossRefGoogle Scholar
36.Herbstman, JB, Frank, R, Schwab, M.Respiratory effects of inhalation exposure among workers during the clean-up effort at the World Trade Center disaster site. Environ Res. 2005;99 (1):85–92.Google Scholar
37.Greenland, S, Rothman, KJMeasures of occurrence.In: Rothman KJ, Greenland S, Lash TL, eds. Modern Epidemiology. 3rd ed. New York: Lippincott Williams & Wilkins; 2008:47-48.Google Scholar
38.Rothman, KJ, Greenland, S, Lash, TLValidity in epidemiologic studies.In: Rothman KJ, Greenland S, Lash TL, eds. Modern Epidemiology. 3rd ed. New York: Lippincott Williams & Wilkins; 2008:134-135.Google Scholar
39.Murphy, J, Brackbill, RM, Thalji, L, Dolan, M, Pulliam, P, Walker, DJ.Measuring and maximizing coverage in the World Trade Center Health Registry. Stat Med. 2007;26 (8):1688–1701.Google Scholar
40.Savitz, DA, Oxman, RT, Metzger, KB.Epidemiologic research on man-made disasters: strategies and implications of cohort definition for World Trade Center worker and volunteer surveillance program. Mt Sinai J Med. 2008;75 (2):77–87.Google Scholar
41.Feldman, DM, Baron, SL, Bernard, BP.Symptoms, respirator use, and pulmonary function changes among New York City firefighters responding to the World Trade Center disaster. Chest. 2004;125 (4):1256–1264.Google Scholar
42.Lioy, PJ, Weisel, CP, Millette, JR.Characterization of the dust/smoke aerosol that settled east of the World Trade Center (WTC) in lower Manhattan after the collapse of the WTC 11 September 2001. Environ Health Perspect. 2002;110 (7):703–714.CrossRefGoogle Scholar
43.Centers for Disease Control and Prevention (CDC). Occupational exposures to air contaminants at the World Trade Center disaster site–New York, September-October, 2001. MMWR Morb Mortal Wkly Rep. 2002;51 (21):453–456.Google Scholar
44.Geyh, AS, Chillrud, S, Williams, DL.Assessing truck driver exposure at the World Trade Center disaster site: personal and area monitoring for particulate matter and volatile organic compounds during October 2001 and April 2002. J Occup Environ Hyg. 2005;2 (3):179–193.Google Scholar
45.Brooks, SM, Weiss, MA, Bernstein, IL.Reactive airways dysfunction syndrome (RADS). Persistent asthma syndrome after high level irritant exposures. Chest. 1985;88 (3):376–384.Google Scholar
46.Truncale, T, Brooks, SM, Prezant, DJ, Banauch, GI, Nemery, B.World Trade Center dust and airway reactivity. Am J Respir Crit Care Med. 2004;169 (7):883–884, author reply 884-885.Google Scholar
47.Mannino, DM.COPD: epidemiology, prevalence, morbidity and mortality, and disease heterogeneity. Chest. 2002;121 5(Suppl)121S–126S.Google Scholar
48.Cohen, S, Janicki-Deverts, D, Miller, GE.Psychological stress and disease. JAMA. 2007;298 (14):1685–1687.Google Scholar
49.Stellman, JM, Smith, RP, Katz, CL.Enduring mental health morbidity and social function impairment in world trade center rescue, recovery, and cleanup workers: the psychological dimension of an environmental health disaster. Environ Health Perspect. 2008;116 (9):1248–1253.Google Scholar
50.Bills, CB, Dodson, N, Stellman, JM.Stories behind the symptoms: a qualitative analysis of the narratives of 9/11 rescue and recovery workers. Psychiatr Q. 2009;80 (3):173–189.CrossRefGoogle ScholarPubMed
51.Niles, JK, Webber, MP, Gustave, J.Co-morbid trends in World Trade Center cough syndrome and probable PTSD in firefighters. Chest. 2011 May5Epub ahead of print21546435.Google Scholar
52.Perrin, MA, DiGrande, L, Wheeler, K, Thorpe, L, Farfel, M, Brackbill, R.Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers. Am J Psychiatry. 2007;164 (9):1385–1394.Google Scholar
53.Berninger, A, Webber, MP, Cohen, HW.Trends of elevated PTSD risk in firefighters exposed to the World Trade Center disaster: 2001-2005. Public Health Rep. 2010;125 (4):556–566.Google Scholar