Skloot Gwen, Goldman Michael, Fischler David, Goldman Christine, Schechter Clyde, Levin Stephen, Teirstein Alvin
Division of Pulmonary and Critical Care Medicine, Mount Sinai School of Medicine, New York, NY, USA.
Chest. 2004 Apr;125(4):1248-55. doi: 10.1378/chest.125.4.1248.
To characterize respiratory abnormalities in a convenience sample of ironworkers exposed at the World Trade Center (WTC) disaster site for varying lengths of time between September 11, 2001, and February 8, 2002.
Cross-sectional study.
The Mount Sinai Medical Center, a large tertiary hospital.
Ninety-six ironworkers engaged in rescue and recovery with exposure onset between September 11, 2001, and September 15, 2001, who responded to an invitation to undergo respiratory evaluation.
Medical and exposure history, physical examination, spirometry, forced oscillation (FO), and chest radiographs. The relationships of prevalence of respiratory symptoms and presence of obstructive physiology to smoking, exposure on September 11, duration of exposure, and type of respiratory protection were examined using univariate and linear and logistic regression analyses.
Seventy-four of 96 workers (77%) had one or more respiratory symptoms (similar in smokers [49 of 63 subjects, 78%] and nonsmokers [25 of 33 subjects, 76%]). Cough was the most common symptom (62 of 96 subjects, 65%), and was associated with exposure on September 11. Chest examination and radiograph findings were abnormal in 10 subjects (10%) and 19 subjects (20%), respectively. FO revealed dysfunction in 34 of 64 subjects tested (53%), while spirometry suggested obstruction in only 11 subjects (17%). Lack of a respirator with canister was a risk factor for large airway dysfunction, and cigarette smoking was a risk factor for small airway dysfunction. No other relationships reached statistical significance.
Respiratory symptoms occurred in the majority of ironworkers at the WTC disaster site and were not attributable to smoking. Exposure on September 11 was associated with a greater prevalence of cough. Objective evidence of lung disease was less common. Spirometry underestimated the prevalence of lung function abnormalities in comparison to FO. Continuing evaluation of symptoms, chest radiographs, and airway dysfunction should determine whether long-term clinical sequelae will exist.
对2001年9月11日至2002年2月8日期间在世界贸易中心（WTC）灾难现场暴露时长各异的一组铁工进行便利抽样，以描述其呼吸异常情况。
横断面研究。
西奈山医疗中心，一家大型三级医院。
96名参与救援和清理工作的铁工，暴露起始时间在2001年9月11日至2001年9月15日之间，他们响应邀请接受呼吸评估。
医疗和暴露史、体格检查、肺功能测定、强迫振荡法（FO）以及胸部X光片。采用单变量分析、线性回归分析和逻辑回归分析，研究呼吸症状患病率及阻塞性生理状况与吸烟、9月11日的暴露情况、暴露时长以及呼吸防护类型之间的关系。
96名工人中有74名（77%）出现一种或多种呼吸症状（吸烟者[63名受试者中的49名，78%]和非吸烟者[33名受试者中的25名，76%]情况相似）。咳嗽是最常见的症状（96名受试者中的62名，65%），且与9月11日的暴露有关。胸部检查和X光片检查结果分别在10名受试者（10%）和19名受试者（20%）中异常。在接受测试的64名受试者中，34名（53%）通过FO显示功能障碍，而肺功能测定仅提示11名受试者（17%）存在阻塞。未佩戴带滤毒罐的呼吸器是大气道功能障碍的一个危险因素，吸烟是小气道功能障碍的一个危险因素。没有其他关系达到统计学意义。
世贸中心灾难现场的大多数铁工出现了呼吸症状，且与吸烟无关。9月11日的暴露与咳嗽的较高患病率有关。肺部疾病的客观证据较少见。与FO相比，肺功能测定低估了肺功能异常的患病率。对症状、胸部X光片和气道功能障碍的持续评估应能确定是否会出现长期临床后遗症。
