Skip directly to search Skip directly to A to Z list Skip directly to page options Skip directly to site content

NIOSHTIC-2 Publications Search

Search Results

Accelerated spirometric decline in New York City firefighters with alpha 1-antitrypsin deficiency.

Authors
Banauch-GI; Brantly-M; Izbicki-G; Hall-C; Shanske-A; Chavko-R; Santhyadka-G; Christodoulou-V; Weiden-MD; Prezant-DJ
Source
Chest 2010 Nov; 138(5):1116-1124
NIOSHTIC No.
20038127
Abstract
BACKGROUND: On September 11, 2001, the World Trade Center (WTC) collapse caused massive air pollution, producing variable amounts of lung function reduction in the New York City Fire Department (FDNY) rescue workforce. alpha1-Antitrypsin (AAT) deficiency is a risk factor for obstructive airway disease. METHODS: This prospective, longitudinal cohort study of the first 4 years post-September 11, 2001, investigated the influence of AAT deficiency on adjusted longitudinal spirometric change (FEV1) in 90 FDNY rescue workers with WTC exposure. Workers with protease inhibitor (Pi) Z heterozygosity were considered moderately AAT deficient. PiS homozygosity or PiS heterozygosity without concomitant PiZ heterozygosity was considered mild deficiency, and PiM homozygosity was considered normal. Alternately, workers had low AAT levels if serum AAT was = 20 Ámol/L. RESULTS: In addition to normal aging-related decline (37 mL/y), significant FEV(1) decline accelerations developed with increasing AAT deficiency severity (110 mL/y for moderate and 32 mL/y for mild) or with low AAT serum levels (49 mL/y). Spirometric rates pre-September 11, 2001, did not show accelerations with AAT deficiency. Among workers with low AAT levels, cough persisted in a significant number of participants at 4 years post-September 11, 2001. CONCLUSIONS: FDNY rescue workers with AAT deficiency had significant spirometric decline accelerations and persistent airway symptoms during the first 4 years after WTC exposure, representing a novel gene-by-environment interaction. Clinically meaningful decline acceleration occurred even with the mild serum AAT level reductions associated with PiS heterozygosity (without concomitant PiZ heterozygosity).
Keywords
Airborne-particles; Clinical-diagnosis; Epidemiology; Exposure-assessment; Fire-fighters; Health-hazards; Health-surveys; Lung; Lung-disorders; Pollutants; Pulmonary-disorders; Pulmonary-system; Pulmonary-system-disorders; Rescue-workers; Respiratory-irritants; Respiratory-system-disorders; Risk-analysis; Statistical-analysis; Work-analysis; Work-environment; Worker-health; Work-operations; Work-performance; Emergency-responders
Contact
Gisela I. Banauch, MD, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Room S6-842, University of Massachusetts Memorial Hospital Center, 55 Lake Ave N, Worcester, MA 01655
CODEN
CHETBF
Publication Date
20101101
Document Type
Journal Article
Email Address
banauchg@ummhc.org
Funding Type
Cooperative Agreement
Fiscal Year
2011
NTIS Accession No.
NTIS Price
Identifying No.
Cooperative-Agreement-Number-U10-OH-008242; Cooperative-Agreement-Number-U10-OH-008243
Issue of Publication
5
ISSN
0012-3692
Priority Area
Services
Source Name
Chest
State
NY; MA
Performing Organization
New York City Fire Department
TOP