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Elevated peripheral eosinophils are associated with new-onset and persistent wheeze and airflow obstruction in World Trade Center-exposed individuals.

Authors
Kazeros-A; Maa-M-T; Patrawalla-P; Liu-M; Shao-Y; Qian-M; Turetz-M; Parsia-S; Caplan-Shaw-C; Berger-KI; Goldring-R; Rogers-L; Reibman-J
Source
J Asthma 2013 Feb; 50(1):25-32
NIOSHTIC No.
20042104
Abstract
Background. Exposure to World Trade Center (WTC) dust and fumes is associated with the onset of asthma-like respiratory symptoms in rescue and recovery workers and exposed community members. Eosinophilic inflammation with increased lung and peripheral eosinophils has been described in subpopulations with asthma. We hypothesized that persistent asthma-like symptoms in WTC-exposed individuals would be associated with systemic inflammation characterized by peripheral eosinophils. Methods. The WTC Environmental Health Center (WTC EHC) is a treatment program for local residents, local workers, and cleanup workers with presumed WTC-related symptoms. Patients undergo a standardized evaluation including questionnaires and complete blood count. Between September 2005 and March 2009, 2462 individuals enrolled in the program and were available for analysis. Individuals with preexisting respiratory symptoms or lung disease diagnoses prior to September 2001 and current or significant tobacco use were excluded, Results. One thousand five hundred and seventeen individuals met the inclusion criteria. Patients had a mean age of 47 years, were mostly female (51%), and had a diverse race/ethnicity. Respiratory symptoms that developed after WTC dust/fume exposure and remained persistent included dyspnea on exertion (68%), cough (57%), chest tightness (47%), and wheeze (33%). A larger percentage of patients with wheeze had elevated peripheral eosinophils compared with those without wheeze (21% vs. 13%, p < .0001). Individuals with elevated peripheral eosinophils were more likely to have airflow obstruction on spirometry (16% vs. 7%, p = .0003). Conclusion. Peripheral eosinophils were associated with wheeze and airflow obstruction in a diverse WTC-exposed population. These data suggest that eosinophils may participate in lung inflammation in this population with symptoms consistent with WTC-related asthma.
Keywords
Emergency-response; Dust-exposure; Fumes; Emergency-responders; Rescue-workers; Respiratory-system-disorders; Airway-obstruction; Leukocytes; Immune-reaction; Bronchial-asthma; Pulmonary-system-disorders; Lung-disorders; Lung-function; Lung-irritants; Hazardous-waste-cleanup; Medical-treatment; Spirometry; Author Keywords: asthma; eosinophil; spirometry; World Trade Center
Contact
Joan Reibman, M.D., Department of Medicine, New York University School of Medicine, 550 1st Avenue, Room NBV-7N24, New York, NY 10016, USA
CODEN
JOUADU
Publication Date
20130201
Document Type
Journal Article
Email Address
Joan.Reibman@nyumc.org
Funding Type
Grant; Contract
Fiscal Year
2013
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-E11-OH-009630; Contract-200-2011-39413; B20130206
Issue of Publication
1
ISSN
0277-0903
Source Name
Journal of Asthma
State
NY
Performing Organization
New York City Health and Hospitals Corporation
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