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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, Sarcoidoses. Granulomatoses d'etiologie indeterminee. Maladies du tissu conjonctif. Maladies du tissu elastique. Vascularites, Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis, Maladie de système, Systemic disease, Enfermedad sistémica, Pathologie de l'appareil respiratoire, Respiratory disease, Aparato respiratorio patología, Capacité vitale forcée, Forced vital capacity, Capacidad vital forzada, Epidémiologie, Epidemiology, Epidemiología, Etiologie, Etiology, Etiología, Etude cas témoin, Case control study, Estudio caso control, Fonction respiratoire, Lung function, Función respiratoria, Granulomatose, Granulomatosis, Homme, Human, Hombre, Médecine catastrophe, Disaster medicine, Medicina catástrofe, Pathologie des poumons, Lung disease, Pulmón patología, Santé publique, Public health, Salud pública, Sarcoïdose, Sarcoidosis, Terrorisme, Terrorism, Terrorismo, Attentats 11 septembre 2001, World Trade Center (WTC), a case control etiologic study of sarcoidosis (ACCESS), forced vital capacity (FVC), granulomatous disease, and sarcoidosis

Background More than 20, 000 responders have been examined through the World Trade Center (WTC) Medical Monitoring and Treatment Program since September 11, 2001. Studies on WTCfirefighters have shown elevated rates of sarcoidosis. The main objective of this study was to report the incidence of sarcoid like granulomatous pulmonary disease in other WTC responders. Methods Cases of sarcoid like granulomatous pulmonary disease were identified by: patient self-report, physician report and ICD-9 codes. Each case was evaluated by three pulmonologists using the ACCESS criteria and only definite cases are reported. Results Thirty-eight patients were classified as definite cases. Six-year incidence was 192/100,000. The peak annual incidence of 54 per 100,000 person-years occurred between 9/11/2003 and 9/11/2004. Incidence in black responders was nearly double that of white responders. Low FVC was the most common spirometric abnormality. Conclusions Sarcoid like granulomatous pulmonary disease is present among the WTC responders. While the incidence is lower than that reported among firefighters, it is higher than expected.

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, Appareil respiratoire : syndromes et maladies diverses, Respiratory system : syndromes and miscellaneous diseases, Exploration, Exploración, Fonction respiratoire, Lung function, Función respiratoria, Homme, Human, Hombre, Pathologie de l'appareil respiratoire, Respiratory disease, Aparato respiratorio patología, Pronostic, Prognosis, Pronóstico, Résultat, Result, Resultado, Santé publique, Public health, Salud pública, Spirométrie, Spirometry, Espirometría, Symptomatologie, Symptomatology, Sintomatología, Attentats 11 septembre 2001, and World Trade Center

Objective: Determine if World Trade Center (WTC) disaster responders had lower lung function and higher bronchodilator responsiveness than those with respiratory symptoms and conditions. Methods: We evaluated cardinal respiratory symptoms (dyspnea, wheezing, dry cough, productive cough) and determined the differences in FEV1, FVC, and bronchodilator responsiveness. Results: All respiratory symptoms were associated with a lower FEV1 and FVC, and a larger bronchodilator response. Responders reporting chronic productive cough, starting during WTC work and persisting, had a mean FEV1 109 mL lower than those without chronic persistent cough; their odds of having abnormally low FEV1 was 1.40 times higher; and they were 1.65 times as likely to demonstrate bronchodilator responsiveness. Conclusions: Responders reporting chronic persistent cough, wheezing or dyspnea at first medical examination were more likely to have lower lung function and bronchodilator responsiveness.

General medicine general surgery, Médecine et chirurgie générales, Sciences biologiques et medicales, Biological and medical sciences, Sciences medicales, Medical sciences, Generalites, General aspects, Sante publique. Hygiene-medecine du travail, Public health. Hygiene-occupational medicine, Santé publique. Hygiène, Public health. Hygiene, Divers, Miscellaneous, Médecine du travail, Occupational medicine, Association morbide, Concomitant disease, Asociación morbosa, Etude cohorte, Cohort study, Estudio cohorte, Homme, Human, Hombre, Médecine du travail, Occupational medicine, Medicina ocupacional, Persistance, Persistence, Persistencia, Polypathologie, Polypathology, Patología múltiple, Récupération, Recovery, Recuperación, Santé publique, Public health, Salud pública, Travailleur, Worker, Trabajador, and Attentats 11 septembre 2001

Background More than 50000 people participated in the rescue and recovery work that followed the Sept 11, 2001 (9/11) attacks on the World Trade Center (WTC). Multiple health problems in these workers were reported in the early years after the disaster. We report incidence and prevalence rates of physical and mental health disorders during the 9 years since the attacks, examine their associations with occupational exposures, and quantify physical and mental health comorbidities. Methods In this longitudinal study of a large cohort of WTC rescue and recovery workers, we gathered data from 27449 participants in the WTC Screening, Monitoring, and Treatment Program. The study population included police officers, firefighters, construction workers, and municipal workers. We used the Kaplan-Meier procedure to estimate cumulative and annual incidence of physical disorders (asthma, sinusitis, and gastro-oesophageal reflux disease), mental health disorders (depression, post-traumatic stress disorder [PTSD], and panic disorder), and spirometric abnormalities. Incidence rates were assessed also by level of exposure (days worked at the WTC site and exposure to the dust cloud). Findings 9-year cumulative incidence of asthma was 27·6% (number at risk: 7027), sinusitis 42·3% (5870), and gastro-oesophageal reflux disease 39·3% (5650). In police officers, cumulative incidence of depression was 7·0% (number at risk: 3648), PTSD 9·3% (3761), and panic disorder 8·4% (3780). In other rescue and recovery workers, cumulative incidence of depression was 27·5% (number at risk: 4200), PTSD 31·9% (4342), and panic disorder 21·2% (4953). 9-year cumulative incidence for spirometric abnormalities was 41·8% (number at risk: 5769); three-quarters of these abnormalities were low forced vital capacity. Incidence of most disorders was highest in workers with greatest WTC exposure. Extensive comorbidity was reported within and between physical and mental health disorders. Interpretation 9 years after the 9/11 WTC attacks, rescue and recovery workers continue to have a substantial burden of physical and mental health problems. These findings emphasise the need for continued monitoring and treatment of the WTC rescue and recovery population. Funding Centers for Disease Control and Prevention and National Institute for Occupational Safety and Health.