Prezant David J, Weiden Michael, Banauch Gisela I, McGuinness Georgeann, Rom William N, Aldrich Thomas K, Kelly Kerry J
Bureau of Health Services, Fire Department of New York City, New York, USA.
N Engl J Med. 2002 Sep 12;347(11):806-15. doi: 10.1056/NEJMoa021300. Epub 2002 Sep 9.
Workers from the Fire Department of New York City were exposed to a variety of inhaled materials during and after the collapse of the World Trade Center. We evaluated clinical features in a series of 332 firefighters in whom severe cough developed after exposure and the prevalence and severity of bronchial hyperreactivity in firefighters without severe cough classified according to the level of exposure.
"World Trade Center cough" was defined as a persistent cough that developed after exposure to the site and was accompanied by respiratory symptoms severe enough to require medical leave for at least four weeks. Evaluation of exposed firefighters included completion of a standard questionnaire, spirometry, airway-responsiveness testing, and chest imaging.
In the first six months after September 11, 2001, World Trade Center cough occurred in 128 of 1636 firefighters with a high level of exposure (8 percent), 187 of 6958 with a moderate level of exposure (3 percent), and 17 of 1320 with a low level of exposure (1 percent). In addition, 95 percent had symptoms of dyspnea, 87 percent had gastroesophageal reflux disease, and 54 percent had nasal congestion. Of those tested before treatment of World Trade Center cough, 63 percent of firefighters (149 of 237) had a response to a bronchodilator and 24 percent (9 of 37) had bronchial hyperreactivity. Chest radiographs were unchanged from precollapse findings in 319 of the 332 with World Trade Center cough. Among the cohort without severe cough, bronchial hyperreactivity was present in 77 firefighters with a high level of exposure (23 percent) and 26 with a moderate level of exposure (8 percent).
Intense, short-term exposure to materials generated during the collapse of the World Trade Center was associated with bronchial responsiveness and the development of cough. Clinical and physiological severity was related to the intensity of exposure.
在世界贸易中心倒塌期间及之后，纽约市消防部门的工作人员接触到了各种吸入性物质。我们评估了332名消防员的临床特征，这些消防员在接触后出现了严重咳嗽，并根据接触程度对无严重咳嗽的消防员的支气管高反应性的患病率和严重程度进行了评估。
“世贸中心咳嗽”定义为接触现场后出现的持续性咳嗽，并伴有严重到足以要求至少四周病假的呼吸道症状。对接触过的消防员的评估包括完成一份标准问卷、肺功能测定、气道反应性测试和胸部成像。
在2001年9月11日后的头六个月里，1636名高接触水平的消防员中有128人出现了世贸中心咳嗽（8%），6958名中度接触水平的消防员中有187人出现了咳嗽（3%），1320名低接触水平的消防员中有17人出现了咳嗽（1%）。此外，95%的人有呼吸困难症状，87%的人有胃食管反流病，54%的人有鼻塞。在接受世贸中心咳嗽治疗前接受测试的消防员中，63%（237人中的149人）对支气管扩张剂有反应，24%（37人中的9人）有支气管高反应性。332名患有世贸中心咳嗽的消防员中，有319人的胸部X光片与倒塌前的检查结果相比没有变化。在无严重咳嗽的队列中，77名高接触水平的消防员（23%）和26名中度接触水平的消防员（8%）存在支气管高反应性。
短期强烈接触世界贸易中心倒塌时产生的物质与支气管反应性和咳嗽的发生有关。临床和生理严重程度与接触强度有关。
