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Odor identification ability and self-reported upper respiratory symptoms in workers at the post-9/11 World Trade Center site.

Altman KW; Desai SC; Moline J; de la Hoz RE; Herbert R; Gannon PJ; Doty RL
Int Arch Occup Environ Health 2011 Feb; 84(2):131-137
Following the World Trade Center (WTC) collapse on September 11, 2001, more than 40,000 people were exposed to a complex mixture of inhalable nanoparticles and toxic chemicals. While many developed chronic respiratory symptoms, to what degree olfaction was compromised is unclear. A previous WTC Medical Monitoring and Treatment Program study found that olfactory and nasal trigeminal thresholds were altered by the toxic exposure, but not scores on a 20-odor smell identification test. OBJECTIVES: To employ a well-validated 40-item smell identification test to definitively establish whether the ability to identify odors is compromised in a cohort of WTC-exposed individuals and, if so, whether the degree of compromise is associated with self-reported severity of rhinitic symptoms. METHODS: The University of Pennsylvania Smell Identification Test (UPSIT) was administered to 99 WTC-exposed persons and 99 matched normal controls. The Sino-Nasal Outcomes Test (SNOT-20) was administered to the 99 WTC-exposed persons and compared to the UPSIT scores. RESULTS: The mean (SD) UPSIT scores were lower in the WTC-exposed group than in age-, sex-, and smoking history-matched controls [respective scores: 30.05 (5.08) vs 35.94 (3.76); p = 0.003], an effect present in a subgroup of 19 subjects additionally matched on occupation (p < 0.001). Fifteen percent of the exposed subjects had severe microsmia, but only 3% anosmia. SNOT-20 scores were unrelated to UPSIT scores (r = 0.20; p = 0.11). CONCLUSION: Exposure to WTC air pollution was associated with a decrement in the ability to identify odors, implying that such exposure had a greater influence on smell function than previously realized.
Olfactory-disorders; Nasal-disorders; Odors; Toxic-dose; Toxic-materials; Toxic-effects; Environmental-exposure; Air-contamination; Emergency-responders; Author Keywords: Anosmia; Hyposmia; Rhinosinusitis; World Trade Center; SNOT-20; UPSIT; Smell; Rhinology; Occupational medicine
Kenneth W. Altman, Department of Otolaryngology-Head and Neck Surgery, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1189, New York, NY, 10029
Publication Date
Document Type
Journal Article
Email Address
Funding Type
Cooperative Agreement
Fiscal Year
Identifying No.
Cooperative-Agreement-Number-U10-OH-008225; Cooperative-Agreement-Number-U10-OH-008232
Issue of Publication
Source Name
International Archives of Occupational and Environmental Health
Performing Organization
Mount Sinai School of Medicine of New York University
Page last reviewed: July 1, 2022
Content source: National Institute for Occupational Safety and Health Education and Information Division