The World Trade Organization is an organization that deals with international trade. It was established on 1st of January in the year 1995. It was formed after replacing the GATT (General Agreement on Tariffs and Trade) which was established in the year 1948.
Rationale: On September 11, 2001, the World Trade Center collapse created an enormous urban disaster site with high levels of airborne pollutants. First responders, rescue and recovery workers, and residents have since reported respiratory symptoms and developed pulmonary function abnormalities.
Objectives: To quantify respiratory health effects of World Trade Center exposure in the New York City Fire Department.
Measurements: Longitudinal study of pulmonary function in 12,079 New York City Fire Department rescue workers employed on or before 09/11/2001. Between 01/01/1997 and 09/11/2002, 31,994 spirometries were obtained and the FEV1 and FVC were analyzed for differences according to estimated World Trade Center exposure intensity. Adjusted average FEV1 during the first year after 09/11/2001 was compared with the 5 yr before 09/11/2001. Median time between 09/11/2001 and a worker’s first spirometry afterwards was 3 mo; 90% were assessed within 5 mo.
Main Results: World Trade Center–exposed workers experienced a substantial reduction in adjusted average FEV1 during the year after 09/11/2001 (372 ml; 95% confidence interval, 364–381 ml; p < 0.001) This exposure-related FEV1 decrement equaled 12 yr of aging-related FEV1 decline. Moreover, exposure intensity assessed by initial arrival time at the World Trade Center site correlated linearly with FEV1 reduction in an exposure intensity–response gradient (p = 0.048). Respiratory symptoms also predicted a further FEV1 decrease (p < 0.001). Similar findings were observed for adjusted average FVC.
Conclusions: World Trade Center exposure produced a substantial reduction in pulmonary function in New York City Fire Department rescue workers during the first year after 09/11/2001.
KEYWORDS: building collapse, FEV1 decline, rescue worker, respiratory health consequences of 09/11/2001
After September 11, 2001, the dust and smoke clouds produced during and after the World Trade Center (WTC) collapse raised serious health concerns among rescue workers and residents. Throughout the rescue and recovery effort, survivors were exposed to WTC-derived airborne pollutants, including particulate matter composed of pulverized building materials and combustion products (1, 2). Almost 12,000 of the approximately 14,000 Fire Department of New York City (FDNY) workforce (approximately 11,500 fire and approximately 2,500 emergency medical service [EMS] workers) were present at the WTC site within the first week after 09/11/2001 and reported extensive exposures. Appropriate respiratory protection was initially not readily available; later, compliance was suboptimal (3). WTC exposure has since been implicated in “WTC cough,” and upper and lower airway inflammation with airway obstruction and bronchial hyperreactivity (4–12).
In a previous cross-sectional stratified random sample of 319 WTC-exposed FDNY rescue workers 3 wk after 09/11/2001, we described pulmonary function declines that correlated with WTC dust exposure intensity (3). To define better the respiratory consequences of WTC exposure, we now report our analysis of longitudinal pulmonary function course from 1997 to 2002 in the entire FDNY WTC medical screening cohort (n = 12,079). Study objectives were to determine whether pulmonary function changed after 09/11/2001, and whether WTC exposure intensity affected pulmonary function and respiratory symptoms in an exposure intensity–response pattern after 09/11/2001. Some of the results of this study have previously been reported in the form of an abstract (13).
eAnswers Team
The World Trade Organization is an organization that deals with international trade. It was established on 1st of January in the year 1995. It was formed after replacing the GATT (General Agreement on Tariffs and Trade) which was established in the year 1948.
Rationale: On September 11, 2001, the World Trade Center collapse created an enormous urban disaster site with high levels of airborne pollutants. First responders, rescue and recovery workers, and residents have since reported respiratory symptoms and developed pulmonary function abnormalities.
Objectives: To quantify respiratory health effects of World Trade Center exposure in the New York City Fire Department.
Measurements: Longitudinal study of pulmonary function in 12,079 New York City Fire Department rescue workers employed on or before 09/11/2001. Between 01/01/1997 and 09/11/2002, 31,994 spirometries were obtained and the FEV1 and FVC were analyzed for differences according to estimated World Trade Center exposure intensity. Adjusted average FEV1 during the first year after 09/11/2001 was compared with the 5 yr before 09/11/2001. Median time between 09/11/2001 and a worker’s first spirometry afterwards was 3 mo; 90% were assessed within 5 mo.
Main Results: World Trade Center–exposed workers experienced a substantial reduction in adjusted average FEV1 during the year after 09/11/2001 (372 ml; 95% confidence interval, 364–381 ml; p < 0.001) This exposure-related FEV1 decrement equaled 12 yr of aging-related FEV1 decline. Moreover, exposure intensity assessed by initial arrival time at the World Trade Center site correlated linearly with FEV1 reduction in an exposure intensity–response gradient (p = 0.048). Respiratory symptoms also predicted a further FEV1 decrease (p < 0.001). Similar findings were observed for adjusted average FVC.
Conclusions: World Trade Center exposure produced a substantial reduction in pulmonary function in New York City Fire Department rescue workers during the first year after 09/11/2001.
KEYWORDS: building collapse, FEV1 decline, rescue worker, respiratory health consequences of 09/11/2001
After September 11, 2001, the dust and smoke clouds produced during and after the World Trade Center (WTC) collapse raised serious health concerns among rescue workers and residents. Throughout the rescue and recovery effort, survivors were exposed to WTC-derived airborne pollutants, including particulate matter composed of pulverized building materials and combustion products (1, 2). Almost 12,000 of the approximately 14,000 Fire Department of New York City (FDNY) workforce (approximately 11,500 fire and approximately 2,500 emergency medical service [EMS] workers) were present at the WTC site within the first week after 09/11/2001 and reported extensive exposures. Appropriate respiratory protection was initially not readily available; later, compliance was suboptimal (3). WTC exposure has since been implicated in “WTC cough,” and upper and lower airway inflammation with airway obstruction and bronchial hyperreactivity (4–12).
In a previous cross-sectional stratified random sample of 319 WTC-exposed FDNY rescue workers 3 wk after 09/11/2001, we described pulmonary function declines that correlated with WTC dust exposure intensity (3). To define better the respiratory consequences of WTC exposure, we now report our analysis of longitudinal pulmonary function course from 1997 to 2002 in the entire FDNY WTC medical screening cohort (n = 12,079). Study objectives were to determine whether pulmonary function changed after 09/11/2001, and whether WTC exposure intensity affected pulmonary function and respiratory symptoms in an exposure intensity–response pattern after 09/11/2001. Some of the results of this study have previously been reported in the form of an abstract (13).