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Study exposes risk of 9/11 toxic dust

Asthma rates more than double for World Trade Center first responders

Monday February 6, 2012
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The American Journal of Industrial Medicine recently published a study showing responders to the 9/11 World Trade Center disaster suffer from asthma at more than twice the rate of the general U.S. population as a result of their exposure to the toxic dust from the towers' collapse. Preliminary study results were presented in the journal CHEST in 2009.

Past studies have documented high rates of asthma symptoms among WTC responders. However, a comparison of these increased rates of asthma among responders to the general population had not been done before.

Charlotte Wihlborg, RN, clinical program manager at Vivo Health Work Well in Lake Success, N.Y., part of the North Shore-LIJ Health System, was a clinical research manager for the 2002 study. While working on the research, Wihlborg worked on a second study in which she was responsible for managing the clinical operation of the Staten Island satellite program of the Mount Sinai WTC Health Program, opened in January 2009 to facilitate the monitoring and treatment of WTC responders living in the borough.

"I was actively involved in the screening and monitoring of patients as per the program guidelines, including the administering of baseline and periodic questionnaires, the performance of pulmonary function testing and obtaining necessary blood and urine sampling as per the program's designated protocol," Wihlborg said. "My team and I actively collected program data utilizing the approved questionnaires for the monitoring study. The Staten Island team of nurses and physicians also provided follow-up treatment in the Medical Monitoring Treatment Program for responders when post evaluations were found to have noted abnormalities."

The study population consisted of more than 20,000 responders who received medical screenings from July 2002 to December 2007 in the WTC Medical Monitoring and Treatment Program. Researchers compared the results with data on more than 200,000 adults from the National Health Interview Surveys of the general population for 2000 and 2002-2007. World Trade Center-related data were collected by researchers at the Data and Coordination Center at the Mount Sinai School of Medicine.

Eighty-six percent of WTC responders in this study population were men, and the average duration of work at the WTC sites was 80 days. Forty-two percent of study participants were uniformed and other law enforcement and protective service workers. Other occupations of responders included construction workers and installation, maintenance and repair workers, along with transportation and material-moving workers, who were essential to service restoration, debris removal and cleanup efforts.

When looking at asthma symptoms and attacks that have occurred in the past 12 months, researchers found 6.3% of WTC responders reported asthma symptoms or attacks, while only 3.7% of the U.S. general population reported asthma symptoms or attacks. The asthma rates remained stable among the general population during the entire period, but there were large increases in 12-month asthma rates among WTC responders from 2000-2005. When comparing asthma rates of WTC responders in 2000 (one year before 9/11) with 2005, the 12-month asthma rate increased by 40 times. Furthermore, when comparing 2002 (one year after 9/11) with 2005, the 12-month asthma rate doubled among WTC responders.

Wihlborg's husband, a New York City police officer, was a first responder during 9/11 and is a subject in the original and subsequent studies. She agrees continued monitoring is crucial. "My husband's annual monitoring and treatment visits to the Mount Sinai program give me peace of mind that there is someone looking out for him," she said. Wihlborg said North Shore-LIJ Health System is embarking on a WTC monitoring and treatment program to bring care to first responders who live in Queens.

For information about the study, visit http://onlinelibrary.wiley.com/doi/10.1002/ajim.21025/abstract.


Tracey Boyd contributed to this story. Send letters to editorNY@nurse.com or post a comment.