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Clinical InvestigationsWORLD TRADE CENTERRespiratory Symptoms and Physiologic Assessment of Ironworkers at the World Trade Center Disaster Site
Section snippets
Subjects
One hundred four male ironworkers involved in rescue and recovery efforts and prolonged cleanup of the WTC site were recruited via distribution of an exposure questionnaire to union members. Subjects were > 18 years old and had spent at least 3 days at the disaster site with a start date between September 11, 2001, and September 15, 2001. Many were still working at the site at the time of this evaluation. Eight individuals were excluded due either to a shorter duration of exposure or to a start
Results
Table 2 summarizes the medical history and exposure data. Seventy-four of the 96 ironworkers had one or more respiratory complaints. The most common symptom was cough (n = 62), followed by dyspnea (n = 48) and chest tightness and wheezing (n = 44 each). Sinus complaints occurred in 50 individuals. Upper and lower respiratory symptoms were present concurrently in almost half the cohort (n = 45). Few subjects had prior self-reported asthma (n = 7) or sinus disease (n = 1). More than half of the
Discussion
The initial goal of the present study was to characterize the extent of pulmonary disease in a convenience sample of ironworkers who responded to an invitation to undergo medical evaluation 5 months after the disaster. A second important goal was to compare the techniques of FO and routine spirometry as screening modalities for airways dysfunction in this cohort. Our results demonstrate a high prevalence of respiratory symptoms in exposed workers with fewer abnormalities on physical
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The role of modifiable health-related behaviors in the association between PTSD and respiratory illness
2019, Behaviour Research and TherapyCitation Excerpt :Another important consideration when studying respiratory illness is that self-reported symptoms and objectively-assessed pulmonary function are only modestly related (Curtis & Patrick, 2003; Tsiligianni, Kocks, Tzanakis, Siafakas, & van der Molen, 2011), a finding replicated in the WTC population (Kotov et al., 2015; Luft et al., 2012). This low agreement might be due to different strengths of each approach: while the spirometry assessment is objective and unaffected by potential reporting biases, self-report might be more sensitive to capturing a wider range of respiratory symptoms (e.g. cough frequency) and to rare respiratory events that monitoring is likely to miss, as well as symptoms that have not yet resulted in chronic restriction or obstruction (Skloot et al., 2004). For this reason, to fully understand the association between PTSD and respiratory illness, a multimethod approach should be used.
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This work was performed at The Mount Sinai School of Medicine and was supported by grants from the Vivian Richenthal Institute of Pulmonary and Critical Care Medicine and The Catherine and Henry J. Gaisman Foundation.
Dr. Michael Goldman is a paid consultant to Jaeger, the company that manufactures the oscillation spirometry equipment.