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Cough and bronchial responsiveness in firefighters at the World Trade Center site.

Authors
Prezant-DJ; Weiden-M; Banauch-GI; McGuinness-G; Rom-WN; Aldrich-TK; Kelly-KJ
Source
N Engl J Med 2002 Sep; 347(11):806-815
NIOSHTIC No.
20029562
Abstract
BACKGROUND: Workers from the Fire Department of New York City were exposed to a variety of inhaled materials during and after the collapse of the World Trade Center. We evaluated clinical features in a series of 332 firefighters in whom severe cough developed after exposure and the prevalence and severity of bronchial hyperreactivity in firefighters without severe cough classified according to the level of exposure. METHODS: "World Trade Center cough" was defined as a persistent cough that developed after exposure to the site and was accompanied by respiratory symptoms severe enough to require medical leave for at least four weeks. Evaluation of exposed firefighters included completion of a standard questionnaire, spirometry, airway-responsiveness testing, and chest imaging. RESULTS: In the first six months after September 11, 2001, World Trade Center cough occurred in 128 of 1636 firefighters with a high level of exposure (8 percent), 187 of 6958 with a moderate level of exposure (3 percent), and 17 of 1320 with a low level of exposure (1 percent). In addition, 95 percent had symptoms of dyspnea, 87 percent had gastroesophageal reflux disease, and 54 percent had nasal congestion. Of those tested before treatment of World Trade Center cough, 63 percent of firefighters (149 of 237) had a response to a bronchodilator and 24 percent (9 of 37) had bronchial hyperreactivity. Chest radiographs were unchanged from precollapse findings in 319 of the 332 with World Trade Center cough. Among the cohort without severe cough, bronchial hyperreactivity was present in 77 firefighters with a high level of exposure (23 percent) and 26 with a moderate level of exposure (8 percent). CONCLUSIONS: Intense, short-term exposure to materials generated during the collapse of the World Trade Center was associated with bronchial responsiveness and the development of cough. Clinical and physiological severity was related to the intensity of exposure.
Keywords
Airway-obstruction; Airway-resistance; Fire-fighters; Fire-fighting; Rescue-workers; Occupational-exposure; Airborne-particles; Airborne-dusts; Sampling; Sampling-methods; Exposure-levels; Exposure-assessment; Inorganic-compounds; Particulates; Particulate-dust
Contact
Dr. Prezant, Montefiore Medical Center, Pulmonary Division, Centennial 423, Bronx, NY 10467
CODEN
NEJMAG
Publication Date
20020912
Document Type
Journal Article
Email Address
prezand@fdny.nyc.gov
Funding Type
Grant
Fiscal Year
2002
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-007350; Cooperative-Agreement-Number-U10-OH-008243; Cooperative-Agreement-Number-U10-OH-008242
Issue of Publication
11
ISSN
0028-4793
Source Name
New England Journal of Medicine
State
NY
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