Another WTC follow up study - Health Effects Incident After Exposure Ceased

BrooklynDodger keeps returning to WTC health effects for the lessons learned. The WTC event created a data base of health effects among workers who were at the site. Dodger has repeatedly pointed out that all measures of exposure on the ground were in compliance, well in compliance with OSHA standards. At various times there might have been high exposures to large particle dusts – greater than 10 micron – which are excluded by OSHA sampling methods and which may have been responsible for some of the health effects observed. But there is not a reason to believe the exposures after the first day were quantitatively or qualitatively that much different than a fire, building collapse or demolition that could happen anywhere. The difference was likely duration of exposure for response and construction personnel on the site.

This paper is only in abstract, likely a meeting presentation. Authors are based in Pennsylvania, so it’s yet another research group, different from Mt. Sinai, NYU or Johns Hopkins.

The Dodger can’t tell you what the high, medium or low exposure groups were, or the general exposure period or duration. However, as police officers they were unlikely to be using powered equipment to generate dust, or welding fume.

The observation was that respiratory symptoms got worse between October 2001 and 18 months later. Wheezing, phlegm and shortness of breath increased markedly compared to cough. Frequency was alarmingly high. Response bias is an issue, but it’s hard to see how the exposure response relationship would have emerged from response bias.

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Annals of Epidemiology Volume 15, Issue 8 , September 2005, Page 662 Abstract
Evolution of respiratory symptoms in New York Police Officers over eighteen months post 9/11
L.V. Buyantseva, G. Kampala, G. Leticia, Z.M. Ian, L.L. Engle, R. Gillis, A. Roberts and R. Bosom Penn State College of Medicine, Hershey, PA
Respiratory symptoms have emerged as the most common physical sequel in 9/11 first responders. We assessed evolution of those symptoms over eighteen months in New York Police Officers…
Initial survey (IS) in October 2001 included 1587 Hypos. 575 (36%) agreed to answer the follow-up survey (FUS) eighteen months later. NYPOs 9/11 exposure categories were: light (n = 69), moderate (n = 174) and high (n = 228) [category was not assigned in 70 participants]…. Cough was the most common symptom reported by 43.5% and 43.5% of all officers at IS and FUS (p = 0.7), respectively. Occurrence within exposure groups in the order of severity was 24.6%, 42.5%, and 50% (p < 0.0001) on IS; and 30.9%, 43.7%, and 47.1% (p = 0.059) on FUS. Wheezing was reported by 13.1% and 25.9% on IS and FUS (p < 0.0001), respectively. Its frequency in exposure brackets was 3%, 14.6%, and 15% (p = 0.02) on IS, while increasing to 14.5%, 25.9%, and 29.4% (p = 0.05) on FUS. Phlegm was reported by 14.4% and 67% on IS and FUS (p < 0.0001), respectively. Its frequency in exposure brackets was 1.5%, 13.8%, and 18.9% (p = 0.001) on IS; and 21%, 35.3%, and 30.2% (p = 0.1) on FUS. Shortness of breath (SOB) was reported by 18.9% and 43.6% on IS and FUS (p < 0.0001), respectively. Its frequency in exposure brackets was 10.1%, 13.8%, and 25.4% (p = 0.002) on IS and 31.9%, 45.1%, and 46% (p = 0.1) on FUS. Analysis against risk factors showed that none of the symptoms at eighteen months could be attributed to smoking, and only SOB reported at IS was modified by the use of respiratory protection.
Conclusions
While cough remained the most common and stable respiratory symptom, there was a significant increase in phlegm, wheezing and shortness of breath. This observation raises concern that respiratory injury may have progressed over time and requires further monitoring.

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Annals of EpidemiologyVolume 15, Issue 8




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