The upper respiratory pyramid: Early factors and later treatment utilization in World Trade Center exposed firefighters

Justin K. Niles; Mayris P. Webber; Xiaoxue Liu; Rachel Zeig-Owens; Charles B. Hall; Hillel W. Cohen; Michelle S. Glaser; Jessica Weakley; Theresa M. Schwartz; Michael D. Weiden; Anna Nolan; Thomas K. Aldrich; Lara Glass; Kerry J. Kelly; David J. Prezant

doi:10.1002/ajim.22326

The upper respiratory pyramid: Early factors and later treatment utilization in World Trade Center exposed firefighters

Justin K. Niles, Mayris P. Webber, Xiaoxue Liu, Rachel Zeig-Owens, Charles B. Hall, Hillel W. Cohen, Michelle S. Glaser, Jessica Weakley, Theresa M. Schwartz, Michael D. Weiden, Anna Nolan, Thomas K. Aldrich, Lara Glass, Kerry J. Kelly, David J. Prezant

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Background: We investigated early post 9/11 factors that could predict rhinosinusitis healthcare utilization costs up to 11 years later in 8,079 World Trade Center-exposed rescue/recovery workers. Methods: We used bivariate and multivariate analytic techniques to investigate utilization outcomes; we also used a pyramid framework to describe rhinosinusitis healthcare groups at early (by 9/11/2005) and late (by 9/11/2012) time points. Results: Multivariate models showed that pre-9/11/2005 chronic rhinosinusitis diagnoses and nasal symptoms predicted final year healthcare utilization outcomes more than a decade after WTC exposure. The relative proportion of workers on each pyramid level changed significantly during the study period. Conclusions: Diagnoses of chronic rhinosinusitis within 4 years of a major inhalation event only partially explain future healthcare utilization. Exposure intensity, early symptoms and other factors must also be considered when anticipating future healthcare needs. Am. J. Ind. Med. 57:857-865, 2014.

Original language	English (US)
Pages (from-to)	857-865
Number of pages	9
Journal	American Journal of Industrial Medicine
Volume	57
Issue number	8
DOIs	https://doi.org/10.1002/ajim.22326
State	Published - Aug 2014

Keywords

Chronic rhinosinusitis
Firefighters
Sinus symptoms
Treatment outcomes
World trade center

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/ajim.22326

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Niles, J. K., Webber, M. P., Liu, X., Zeig-Owens, R., Hall, C. B., Cohen, H. W., Glaser, M. S., Weakley, J., Schwartz, T. M., Weiden, M. D., Nolan, A., Aldrich, T. K., Glass, L., Kelly, K. J., & Prezant, D. J. (2014). The upper respiratory pyramid: Early factors and later treatment utilization in World Trade Center exposed firefighters. American Journal of Industrial Medicine, 57(8), 857-865. https://doi.org/10.1002/ajim.22326

Niles, JK, Webber, MP, Liu, X, Zeig-Owens, R , Hall, CB, Cohen, HW, Glaser, MS, Weakley, J, Schwartz, TM, Weiden, MD, Nolan, A, Aldrich, TK, Glass, L, Kelly, KJ & Prezant, DJ 2014, 'The upper respiratory pyramid: Early factors and later treatment utilization in World Trade Center exposed firefighters', American Journal of Industrial Medicine, vol. 57, no. 8, pp. 857-865. https://doi.org/10.1002/ajim.22326

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abstract = "Background: We investigated early post 9/11 factors that could predict rhinosinusitis healthcare utilization costs up to 11 years later in 8,079 World Trade Center-exposed rescue/recovery workers. Methods: We used bivariate and multivariate analytic techniques to investigate utilization outcomes; we also used a pyramid framework to describe rhinosinusitis healthcare groups at early (by 9/11/2005) and late (by 9/11/2012) time points. Results: Multivariate models showed that pre-9/11/2005 chronic rhinosinusitis diagnoses and nasal symptoms predicted final year healthcare utilization outcomes more than a decade after WTC exposure. The relative proportion of workers on each pyramid level changed significantly during the study period. Conclusions: Diagnoses of chronic rhinosinusitis within 4 years of a major inhalation event only partially explain future healthcare utilization. Exposure intensity, early symptoms and other factors must also be considered when anticipating future healthcare needs. Am. J. Ind. Med. 57:857-865, 2014.",

keywords = "Chronic rhinosinusitis, Firefighters, Sinus symptoms, Treatment outcomes, World trade center",

author = "Niles, {Justin K.} and Webber, {Mayris P.} and Xiaoxue Liu and Rachel Zeig-Owens and Hall, {Charles B.} and Cohen, {Hillel W.} and Glaser, {Michelle S.} and Jessica Weakley and Schwartz, {Theresa M.} and Weiden, {Michael D.} and Anna Nolan and Aldrich, {Thomas K.} and Lara Glass and Kelly, {Kerry J.} and Prezant, {David J.}",

year = "2014",

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doi = "10.1002/ajim.22326",

language = "English (US)",

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AU - Hall, Charles B.

AU - Cohen, Hillel W.

AU - Glaser, Michelle S.

AU - Weakley, Jessica

AU - Schwartz, Theresa M.

AU - Weiden, Michael D.

AU - Nolan, Anna

AU - Aldrich, Thomas K.

AU - Glass, Lara

AU - Kelly, Kerry J.

AU - Prezant, David J.

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N2 - Background: We investigated early post 9/11 factors that could predict rhinosinusitis healthcare utilization costs up to 11 years later in 8,079 World Trade Center-exposed rescue/recovery workers. Methods: We used bivariate and multivariate analytic techniques to investigate utilization outcomes; we also used a pyramid framework to describe rhinosinusitis healthcare groups at early (by 9/11/2005) and late (by 9/11/2012) time points. Results: Multivariate models showed that pre-9/11/2005 chronic rhinosinusitis diagnoses and nasal symptoms predicted final year healthcare utilization outcomes more than a decade after WTC exposure. The relative proportion of workers on each pyramid level changed significantly during the study period. Conclusions: Diagnoses of chronic rhinosinusitis within 4 years of a major inhalation event only partially explain future healthcare utilization. Exposure intensity, early symptoms and other factors must also be considered when anticipating future healthcare needs. Am. J. Ind. Med. 57:857-865, 2014.

AB - Background: We investigated early post 9/11 factors that could predict rhinosinusitis healthcare utilization costs up to 11 years later in 8,079 World Trade Center-exposed rescue/recovery workers. Methods: We used bivariate and multivariate analytic techniques to investigate utilization outcomes; we also used a pyramid framework to describe rhinosinusitis healthcare groups at early (by 9/11/2005) and late (by 9/11/2012) time points. Results: Multivariate models showed that pre-9/11/2005 chronic rhinosinusitis diagnoses and nasal symptoms predicted final year healthcare utilization outcomes more than a decade after WTC exposure. The relative proportion of workers on each pyramid level changed significantly during the study period. Conclusions: Diagnoses of chronic rhinosinusitis within 4 years of a major inhalation event only partially explain future healthcare utilization. Exposure intensity, early symptoms and other factors must also be considered when anticipating future healthcare needs. Am. J. Ind. Med. 57:857-865, 2014.

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The upper respiratory pyramid: Early factors and later treatment utilization in World Trade Center exposed firefighters

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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