Environment, Environnement, Hygiene and public health, epidemiology, occupational medicine, Hygiène et santé publique, épidémiologie, médecine du travail, Toxicology, Toxicologie, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Pneumologie, Pneumology, Bronchopneumopathie obstructive chronique, asthme, Chronic obstructive pulmonary disease, asthma, Sante publique. Hygiene-medecine du travail, Public health. Hygiene-occupational medicine, Santé publique. Hygiène, Public health. Hygiene, Environnement. Conditions de vie, Environment. Living conditions, Pathologie des bronches, Bronchus disease, Bronquio patología, Bronchiolite, Bronchiolitis, Bronquiolitis, Etude cas, Case study, Estudio caso, Fumée, Fumes, Humo, Homme, Human, Hombre, Malade, Patient, Enfermo, Nanotube, Nanotubo, Pathologie de l'appareil respiratoire, Respiratory disease, Aparato respiratorio patología, Pathologie des poumons, Lung disease, Pulmón patología, Poumon, Lung, Pulmón, Poussière, Dust, Polvo, Santé et environnement, Health and environment, Salud y medio ambiente, Attentats 11 septembre 2001, Nanomatériau, WTC, bronchiolitis, carbon nanotubes, interstitial lung disease, and small airway disease
CONTEXT: After the collapse of the World Trade Center (WTC) on 11 September 2001, a dense cloud of dust containing high levels of airborne pollutants covered Manhattan and parts of Brooklyn, New York. Between 60,000 and 70,000 responders were exposed. Many reported adverse health effects. CASE PRESENTATION: In this report we describe clinical, pathologic, and mineralogic findings in seven previously healthy responders who were exposed to WTC dust on either 11 September or 12 September 2001, who developed severe respiratory impairment or unexplained radiologic findings and underwent video-assisted thoracoscopic surgical lung biopsy procedures at Mount Sinai Medical Center. WTC dust samples were also examined. We found that three of the seven responders had severe or moderate restrictive disease clinically. Histopathology showed interstitial lung disease consistent with small airways disease, bronchiolocentric parenchymal disease, and nonnecrotizing granulomatous condition. Tissue mineralogic analyses showed variable amounts of sheets of aluminum and magnesium silicates, chrysotile asbestos, calcium phosphate, and calcium sulfate. Small shards of glass containing mostly silica and magnesium were also found. Carbon nanotubes (CNT) of various sizes and lengths were noted. CNT were also identified in four of seven WTC dust samples. DISCUSSION: These findings confirm the previously reported association between WTC dust exposure and bronchiolar and interstitial lung disease. Long-term monitoring of responders will be needed to elucidate the full extent of this problem. The finding of CNT in both WTC dust and lung tissues is unexpected and requires further study.