Cough and Bronchial Responsiveness in Firefighters at the World Trade Center Site

• Published in: The New England journal of medicine Vol. 347; no. 11; pp. 806 - 815
• Main Authors: Prezant, David J, Weiden, Michael, Banauch, Gisela I, McGuinness, Georgeann, Rom, William N, Aldrich, Thomas K, Kelly, Kerry J
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 12.09.2002
• Subjects: Adult; Airway management; Biological and medical sciences; Bronchial Hyperreactivity - classification; Bronchial Hyperreactivity - epidemiology; Bronchial Hyperreactivity - etiology; Cough - classification; Cough - epidemiology; Cough - etiology; Disabled Persons - statistics & numerical data; Gastroesophageal Reflux - epidemiology; Health services; Humans; Logistic Models; Lung - diagnostic imaging; Male; Medical sciences; Middle Aged; New York City - epidemiology; Occupational Diseases - classification; Occupational Diseases - epidemiology; Occupational Diseases - etiology; Pneumology; Questionnaires; Rescue Work; Respiratory Mechanics; Respiratory Protective Devices - utilization; Respiratory system : syndromes and miscellaneous diseases; Spirometry; Terrorism; Tomography, X-Ray Computed; New York; United States; North America; America; United States > US; Collapse; Human; Lung disease; Dyspnea; Hyperreactivity; Terrorism; Respiratory disease; Bronchus; Bronchus disease; Firefighter; Occupational exposure; Occupational medicine
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa021300

The collapse of and fires at the World Trade Center in New York on September 11, 2001, resulted in large quantities of airborne material. The authors report on a syndrome characterized by severe cough, reductions in forced vital capacity and forced expiratory volume in one second, and bronchial hyperresponsiveness in 332 firefighters who worked at the site. In most, the cough lasted more than six weeks but resolved spontaneously or with treatment. Computed tomographic scans showed air trapping and bronchial-wall thickening. A syndrome of severe cough and bronchial hyperresponsiveness affected firefighters who worked at the site. The September 11, 2001, terrorist attack that resulted in the collapse of New York City's World Trade Center led to an intense, short-term exposure to inorganic dust, products of pyrolysis, and other respirable materials. The Fire Department of New York City (FDNY) operated a continuous rescue and recovery effort at the site involving approximately 11,000 firefighters, who were exposed to such respiratory irritants, 1 which have been implicated in the development of airflow obstruction. 2 , 3 We identified conditions associated with airway obstruction — namely, severe, persistent cough (“World Trade Center cough”) and airway reactivity — in exposed firefighters by assessing a . . .