TY - JOUR
T1 - Risk factors for post-9/11 chronic rhinosinusitis in Fire Department of the City of New York workers
AU - Putman, Barbara
AU - Zeig-Owens, Rachel
AU - Singh, Ankura
AU - Hall, Charles B.
AU - Schwartz, Theresa
AU - Webber, Mayris P.
AU - Cohen, Hillel W.
AU - Prezant, David J.
AU - Bachert, Claus
AU - Weiden, Michael D.
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Objectives Chronic rhinosinusitis (CRS) has high socioeconomic burden but underexplored risk factors. The collapse of the World Trade Center (WTC) towers on 11 September 2001 (9/11) caused dust and smoke exposure, leading to paranasal sinus inflammation and CRS. We aim to determine which job tasks are risk factors for CRS in WTC-exposed Fire Department of the City of New York (FDNY) firefighters and emergency medical services (EMS) workers. Methods This cohort study included a 16-year follow-up of 11 926 WTC-exposed FDNY rescue/recovery workers with data on demographics, WTC exposure, job tasks and first post-9/11 complete blood counts. Using multivariable Cox regression, we assessed the associations of WTC exposure, work assignment (firefighter/EMS), digging and rescue tasks at the WTC site and blood eosinophil counts with subsequent CRS, adjusting for potential confounders. Results The rate of CRS was higher in firefighters than EMS (1.80/100 person-years vs 0.70/100 person-years; p<0.001). The combination of digging and rescue work was a risk factor for CRS (HR 1.54, 95% CI 1.23 to 1.94, p<0.001) independent of work assignment and WTC exposure. Conclusions Compared with EMS, firefighters were more likely to engage in a combination of digging and rescue work, which was a risk factor for CRS. Chronic irritant exposures associated with digging and rescue work may account for higher post-9/11 CRS rates among firefighters.
AB - Objectives Chronic rhinosinusitis (CRS) has high socioeconomic burden but underexplored risk factors. The collapse of the World Trade Center (WTC) towers on 11 September 2001 (9/11) caused dust and smoke exposure, leading to paranasal sinus inflammation and CRS. We aim to determine which job tasks are risk factors for CRS in WTC-exposed Fire Department of the City of New York (FDNY) firefighters and emergency medical services (EMS) workers. Methods This cohort study included a 16-year follow-up of 11 926 WTC-exposed FDNY rescue/recovery workers with data on demographics, WTC exposure, job tasks and first post-9/11 complete blood counts. Using multivariable Cox regression, we assessed the associations of WTC exposure, work assignment (firefighter/EMS), digging and rescue tasks at the WTC site and blood eosinophil counts with subsequent CRS, adjusting for potential confounders. Results The rate of CRS was higher in firefighters than EMS (1.80/100 person-years vs 0.70/100 person-years; p<0.001). The combination of digging and rescue work was a risk factor for CRS (HR 1.54, 95% CI 1.23 to 1.94, p<0.001) independent of work assignment and WTC exposure. Conclusions Compared with EMS, firefighters were more likely to engage in a combination of digging and rescue work, which was a risk factor for CRS. Chronic irritant exposures associated with digging and rescue work may account for higher post-9/11 CRS rates among firefighters.
KW - World Trade Center disaster
KW - chronic rhinosinusitis
KW - longitudinal studies
KW - occupational exposure
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U2 - 10.1136/oemed-2018-105297
DO - 10.1136/oemed-2018-105297
M3 - Article
C2 - 30337339
AN - SCOPUS:85055183846
SN - 1351-0711
VL - 75
SP - 884
EP - 889
JO - Occupational and Environmental Medicine
JF - Occupational and Environmental Medicine
IS - 12
ER -
