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The upper respiratory pyramid: early factors and later treatment utilization in World Trade Center exposed firefighters.

Authors
Niles-JK; Webber-MP; Liu-X; Zeig-Owens-R; Hall-CB; Cohen-HW; Glaser-MS; Weakley-J; Schwartz-TM; Weiden-MD; Nolan-A; Aldrich-TK; Glass-L; Kelly-KJ; Prezant-DJ
Source
Am J Ind Med 2014 Aug; 57(8):857-865
NIOSHTIC No.
20044476
Abstract
Background: We investigated early post 9/11 factors that could predict rhinosinusitis healthcare utilization costs up to 11 years later in 8,079 World Trade Center-exposed rescue/recovery workers. Methods: We used bivariate and multivariate analytic techniques to investigate utilization outcomes; we also used a pyramid framework to describe rhinosinusitis healthcare groups at early (by 9/11/2005) and late (by 9/11/2012) time points. Results: Multivariate models showed that pre-9/11/2005 chronic rhinosinusitis diagnoses and nasal symptoms predicted final year healthcare utilization outcomes more than a decade after WTC exposure. The relative proportion of workers on each pyramid level changed significantly during the study period. Conclusions: Diagnoses of chronic rhinosinusitis within 4 years of a major inhalation event only partially explain future healthcare utilization. Exposure intensity, early symptoms and other factors must also be considered when anticipating future healthcare needs
Keywords
Fire-fighters; Humans; Men; Women; Exposure-levels; Risk-factors; Stress; Smoke-inhalation; Respiration; Respiratory-rate; Respiratory-system-disorders; Rescue-workers; Models; Nasal-disorders; Health-care; Exposure-levels; Author Keywords: world trade center; firefighters; chronic rhinosinusitis; sinus symptoms; treatment outcomes
Contact
Mayris P.Webber, Dr PH ,MPH, Department of Epidemiology and Population Health, Montefiore Medical Center/Albert Einstein College of Medicine & Director of WTC Epidemiology Bureau of Health Services, Fire Department of the City of New York, Bronx, NY
CODEN
AJIMD8
Publication Date
20140801
Document Type
Journal Article
Email Address
webberm@fdny.nyc.gov
Funding Type
Contract
Fiscal Year
2014
NTIS Accession No.
NTIS Price
Identifying No.
Contract-200-2011-39383; Contract-200-2011-39378; M062014
Issue of Publication
8
ISSN
0271-3586
Source Name
American Journal of Industrial Medicine
State
NY
Performing Organization
New York City Fire Department
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