Pulmonary Function after Exposure to the World Trade Center Collapse in the New York City Fire Department

• Published in: American journal of respiratory and critical care medicine Vol. 174; no. 3; pp. 312 - 319
• Main Authors: Banauch, Gisela I, Hall, Charles, Weiden, Michael, Cohen, Hillel W, Aldrich, Thomas K, Christodoulou, Vasillios, Arcentales, Nicole, Kelly, Kerry J, Prezant, David J
• Format: Journal Article
• Language: English
• Published: New York, NY Am Thoracic Soc 01.08.2006; American Lung Association; American Thoracic Society
• Subjects: Adult; Air Pollutants - adverse effects; Airway management; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; D. Environmental and Occupational Lung Disease; Dust; Emergency and intensive care: techniques, logistics; Female; Fire departments; Fires; Forced Expiratory Volume; Health services; Humans; Inhalation Exposure - adverse effects; Inhalation Exposure - analysis; Intensive care medicine; Intensive care unit. Emergency transport systems. Emergency, hospital ward; Longitudinal studies; Male; Medical sciences; Medical screening; New York City; Occupational Diseases - epidemiology; Occupational Exposure - adverse effects; Pepper spray; Pneumology; Pollutants; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases; Questionnaires; Rescue Work; Respiratory Protective Devices - utilization; September 11 Terrorist Attacks; Spirometry; Time Factors; Workers; New York; United States; North America; America; New York City; United States > US; New York City New York; FEV1 decline; Rescue; Intensive care; rescue worker; respiratory health consequences of 09/11/2001; Fire; building collapse; Resuscitation
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/rccm.200511-1736OC

On September 11, 2001, the World Trade Center collapse created an enormous urban disaster site with high levels of airborne pollutants. First responders, rescue and recovery workers, and residents have since reported respiratory symptoms and developed pulmonary function abnormalities. To quantify respiratory health effects of World Trade Center exposure in the New York City Fire Department. Longitudinal study of pulmonary function in 12,079 New York City Fire Department rescue workers employed on or before 09/11/2001. Between 01/01/1997 and 09/11/2002, 31,994 spirometries were obtained and the FEV(1) and FVC were analyzed for differences according to estimated World Trade Center exposure intensity. Adjusted average FEV(1) during the first year after 09/11/2001 was compared with the 5 yr before 09/11/2001. Median time between 09/11/2001 and a worker's first spirometry afterwards was 3 mo; 90% were assessed within 5 mo. World Trade Center-exposed workers experienced a substantial reduction in adjusted average FEV(1) during the year after 09/11/2001 (372 ml; 95% confidence interval, 364-381 ml; p < 0.001) This exposure-related FEV(1) decrement equaled 12 yr of aging-related FEV(1) decline. Moreover, exposure intensity assessed by initial arrival time at the World Trade Center site correlated linearly with FEV(1) reduction in an exposure intensity-response gradient (p = 0.048). Respiratory symptoms also predicted a further FEV(1) decrease (p < 0.001). Similar findings were observed for adjusted average FVC. World Trade Center exposure produced a substantial reduction in pulmonary function in New York City Fire Department rescue workers during the first year after 09/11/2001.