Case-Control Study of Paresthesia Among World Trade Center-Exposed Community Members

ObjectivesHead and neck cancers (HNCs) may be among the health consequences of involvement in the World Trade Center (WTC) response on and after 11 September 2001. We conducted a nested case–control study of WTC Health Program (WTCHP) general responders to examine the effects of WTC exposures and behavioural risk factors on HNC.MethodsWe enrolled 64 cases and 136 controls, matched on age, sex and race/ethnicity within risk sets. We assessed tobacco and alcohol use, sexual activity, and occupational exposures prior to, during and after WTC exposure until case diagnosis via questionnaire. We obtained WTC exposure information (duration (first to last day), total days and location of work) from the WTCHP General Responder Data Center. We assessed associations with HNC, and interaction among exposures, using conditional logistic regression.ResultsResponders in protective services versus other occupations had increased odds (OR: 2.51, 95% CI 1.09 to 5.82) of HNC. Among those in non-protective services occupations, arriving to the WTC effort on versus after 11 September 2001 was significantly associated with HNC (OR: 3.77, 95% CI 1.00 to 14.11). Duration of work was not significantly associated with HNC. Lifetime and post-WTC years of cigarette smoking and post-WTC number of sex partners were positively and significantly associated with HNC, while alcohol consumption was not.ConclusionsThese findings suggest opportunities for HNC risk factor mitigation (eg, smoking cessation, human papillomavirus vaccination) and contribute to a risk factor profile which may assist WTCHP clinicians with identifying high-risk responders and improve detection and treatment outcomes in this population.

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Early Elevation of Serum MMP-3 and MMP-12 Predicts Protection from World Trade Center-Lung Injury in New York City Firefighters: A Nested Case-Control Study

PLoS ONE ◽

10.1371/journal.pone.0076099 ◽

2013 ◽

Vol 8 (10) ◽

pp. e76099 ◽

Cited By ~ 8

Author(s):

Sophia Kwon ◽

Michael D. Weiden ◽

Ghislaine C. Echevarria ◽

Ashley L. Comfort ◽

Bushra Naveed ◽

...

Keyword(s):

New York ◽

New York City ◽

World Trade ◽

Case Control Study ◽

World Trade Center ◽

Case Control ◽

Trade Center ◽

Nested Case Control ◽

Control Study ◽

Early Elevation

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Characteristics of Lung Cancer Cases in Community Members Exposed to the Dust and Fumes from the World Trade Center Towers

10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a7129 ◽

2020 ◽

Author(s):

N. Durmus ◽

S. Pehlivan ◽

Y. Zhang ◽

R. Corona ◽

L. Umana ◽

...

Keyword(s):

Lung Cancer ◽

World Trade ◽

World Trade Center ◽

Community Members ◽

The World ◽

Trade Center ◽

World Trade Center Towers

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Characterization of Persistent Uncontrolled Asthma Symptoms in Community Members Exposed to World Trade Center Dust and Fumes

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17186645 ◽

2020 ◽

Vol 17 (18) ◽

pp. 6645

Author(s):

Joan Reibman ◽

Caralee Caplan-Shaw ◽

Yinxiang Wu ◽

Mengling Liu ◽

Milan R. Amin ◽

...

Keyword(s):

World Trade ◽

World Trade Center ◽

Asthma Management ◽

Upper Airway ◽

Dust Exposure ◽

Lower Airway ◽

High Dose ◽

Community Members ◽

Asthma Control Test ◽

Trade Center

The destruction of the World Trade Center (WTC) towers on the 11th of September, 2001 released a vast amount of aerosolized dust and smoke resulting in acute and chronic exposures to community members as well as responders. The WTC Environmental Health Center (WTC EHC) is a surveillance and treatment program for a diverse population of community members, including local residents and local workers with WTC dust exposure. Many of these patients have reported persistent lower respiratory symptoms (LRS) despite treatment for presumed asthma. Our goal was to identify conditions associated with persistent uncontrolled LRS despite standard asthma management. We recruited 60 patients who were uncontrolled at enrollment and, after a three-month run-in period on high-dose inhaled corticosteroid and long acting bronchodilator, reassessed their status as Uncontrolled or Controlled based on a score from the Asthma Control Test (ACT). Despite this treatment, only 11 participants (18%) gained Controlled status as defined by the ACT. We compared conditions associated with Uncontrolled and Controlled status. Those with Uncontrolled symptoms had higher rates of upper airway symptoms. Many patients had persistent bronchial hyper-reactivity (BHR) and upper airway hyper-reactivity as measured by paradoxical vocal fold movement (PVFM). We found a significant increasing trend in the percentage of Controlled with respect to the presence of BHR and PVFM. We were unable to identify significant differences in lung function or inflammatory markers in this small group. Our findings suggest persistent upper and lower airway hyper-reactivity that may respond to standard asthma treatment, whereas others with persistent LRS necessitate additional diagnostic evaluation, including a focus on the upper airway.

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Improvement in severe lower respiratory symptoms and small airway function in World Trade Center dust exposed community members

American Journal of Industrial Medicine ◽

10.1002/ajim.22642 ◽

2016 ◽

Vol 59 (9) ◽

pp. 777-787 ◽

Cited By ~ 3

Author(s):

Caralee Caplan-Shaw ◽

Angeliki Kazeros ◽

Deepak Pradhan ◽

Kenneth Berger ◽

Roberta Goldring ◽

...

Keyword(s):

World Trade ◽

Respiratory Symptoms ◽

World Trade Center ◽

Small Airway ◽

Community Members ◽

Airway Function ◽

Trade Center

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Longitudinal Change of PTSD Symptoms in Community Members after the World Trade Center Destruction

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16071215 ◽

2019 ◽

Vol 16 (7) ◽

pp. 1215 ◽

Cited By ~ 2

Author(s):

Rebecca Rosen ◽

Zhaoyin Zhu ◽

Yongzhao Shao ◽

Mengling Liu ◽

Jia Bao ◽

...

Keyword(s):

World Trade ◽

World Trade Center ◽

Physical Symptoms ◽

Symptom Clusters ◽

Longitudinal Change ◽

Ptsd Symptoms ◽

Community Members ◽

Wide Range ◽

The World ◽

Trade Center

The World Trade Center (WTC) Environmental Health Center (EHC) is a treatment program for community members with exposure to the 9/11 terrorist attack and its physical and emotional aftermath. Compared to the general responders program, the WTC EHC is diverse with equal gender distribution, representation of many races and ethnicities, and a wide range of social economic status. Patients in the WTC EHC were initially enrolled for physical symptoms, most of which were respiratory, however a large portion of the enrollees scored positive for probable posttraumatic stress disorder (PTSD). In this paper we identify patient characteristics associated with probable PTSD. We also determine the characteristics associated with the longitudinal change of PTSD symptoms, including persistence and remittance, using the widely used Posttraumatic Check List-17 (PCL) cut-off value of 44, as well as changes in PCL total score and symptom cluster scores in patients of Low and High PTSD symptom severity. Few patients with elevated scores achieved a score below 44. However, longitudinal improvement in PCL score at follow-up was identified for patients with High PTSD scores (PCL > 57.5). Changes in PCL symptom clusters differed between those with High and Low PCL scores. These data suggest improvement over time in PCL score that differs depending on the severity of the score and variable responses in the PCL symptom clusters.

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