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标题：Chronic and Acute Exposures to the World Trade Center Disaster and Lower Respiratory Symptoms: Area Residents and Workers
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作者：Carey B. Maslow ; Stephen M. Friedman ; Parul S. Pillai 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2012
卷号：102
期号：6
页码：1186-1194
DOI：10.2105/AJPH.2011.300561
语种：English
出版社：American Public Health Association
摘要：Objectives. We assessed associations between new-onset (post–September 11, 2001 [9/11]) lower respiratory symptoms reported on 2 surveys, administered 3 years apart, and acute and chronic 9/11-related exposures among New York City World Trade Center–area residents and workers enrolled in the World Trade Center Health Registry. Methods. World Trade Center–area residents and workers were categorized as case participants or control participants on the basis of lower respiratory symptoms reported in surveys administered 2 to 3 and 5 to 6 years after 9/11. We created composite exposure scales after principal components analyses of detailed exposure histories obtained during face-to-face interviews. We used multivariate logistic regression models to determine associations between lower respiratory symptoms and composite exposure scales. Results. Both acute and chronic exposures to the events of 9/11 were independently associated, often in a dose-dependent manner, with lower respiratory symptoms among individuals who lived and worked in the area of the World Trade Center. Conclusions. Study findings argue for detailed assessments of exposure during and after events in the future from which potentially toxic materials may be released and for rapid interventions to minimize exposures and screen for potential adverse health effects. The attack on the New York World Trade Center on September 11, 2001 (9/11), and its effects on the surrounding area have been well documented. Pulverized materials from the collapse of buildings, products of combustion during and for several months after 9/11, and continual resuspension of particulate matter during rescue, recovery, and cleanup operations exposed hundreds of thousands of individuals to environmental contaminants well after 9/11. Known respiratory irritants and other toxic agents have been identified in samples of ambient air 1 and dust 2–4 that settled both outdoors and inside buildings. From aerial photographs, estimates of peak concentrations of particulate matter of all sizes were as high as 1000 micrograms per cubic meter. 5 The proportion of respirable (< 2.5 μm) particles identified in samples of smoke 5 and settled dust 3,5,6 ranged from 1% to 4%, with concentrations of respirable particles near Ground Zero estimated at between 5 and 60 micrograms per cubic meter. Although these measurements cannot be used to estimate actual exposure to individuals, it is assumed that individuals who lived (residents) or worked (area workers) in the area are likely to have experienced both acute exposure to these contaminants on 9/11 and chronic exposure in and around homes and workplaces during the following months. Acute and chronic exposures to the effects of 9/11 have been consistently implicated as risk factors for adverse respiratory outcomes, including asthma and respiratory symptoms, among residents 7–11 and area workers 11–14 up to 8 years after 9/11. Changes in lung function associated with 9/11 can be identified only in the subset of the exposed population (i.e., New York City firefighters) for whom pre-9/11 results are available, 15,16 although elevated rates of lung function abnormalities were reported in both residents and area workers up to 8 years after 9/11. 7,11 Few studies have assessed the effects of acute and chronic 9/11-related exposures on residents and area workers simultaneously or have estimated the effects of each while adjusting for the effects of the other. In addition, most studies linking 9/11-related exposures and respiratory symptoms have assessed symptoms on a single occasion. This study was designed to assess associations between repeatedly reported lower respiratory symptoms and detailed measures of both acute and chronic 9/11-related exposures.