Gargano Lisa M, Locke Sean, Jordan Hannah T, Brackbill Robert M
New York City Department of Health and Mental Hygiene,New York,NY.
Disaster Med Public Health Prep. 2018 Dec;12(6):697-702. doi: 10.1017/dmp.2017.140. Epub 2018 Jan 21.
In a population with prior exposure to the World Trade Center (WTC) disaster, this study sought to determine the relationship between Hurricane Sandy-related inhalation exposures and post-Sandy lower respiratory symptoms (LRS).
Participants included 3835 WTC Health Registry enrollees who completed Wave 3 (2011-2012) and Hurricane Sandy (2013) surveys. The Sandy-related inhalational exposures examined were: (1) reconstruction exposure; (2) mold or damp environment exposure; and (3) other respiratory irritants exposure. LRS were defined as wheezing, persistent cough, or shortness of breath reported on ≥1 of the 30 days preceding survey completion. Associations between LRS and Sandy exposures, controlling for socio-demographic factors, post-traumatic stress disorder, and previously reported LRS and asthma were examined using multiple logistic regression.
Over one-third of participants (34.4%) reported post-Sandy LRS. Each of the individual exposures was also independently associated with post-Sandy LRS, each having approximately twice the odds of having post-Sandy LRS. We found a dose-response relationship between the number of types of Sandy-related exposures reported and post-Sandy LRS.
This study provides evidence that post-hurricane clean-up and reconstruction exposures can increase the risk for LRS. Public health interventions should emphasize the importance of safe remediation practices and recommend use of personal protective equipment. (Disaster Med Public Health Preparedness. 2018;12:697-702).
在曾暴露于世贸中心灾难的人群中,本研究旨在确定与桑迪飓风相关的吸入性暴露与桑迪飓风过后的下呼吸道症状(LRS)之间的关系。
参与者包括3835名世贸中心健康登记参与者,他们完成了第三轮(2011 - 2012年)和桑迪飓风(2013年)调查。所研究的与桑迪飓风相关的吸入性暴露包括:(1)重建暴露;(2)霉菌或潮湿环境暴露;(3)其他呼吸道刺激物暴露。LRS定义为在调查完成前30天内至少1天报告的喘息、持续性咳嗽或呼吸急促。在控制社会人口统计学因素、创伤后应激障碍以及先前报告的LRS和哮喘的情况下,使用多因素逻辑回归分析LRS与桑迪飓风暴露之间的关联。
超过三分之一的参与者(34.4%)报告了桑迪飓风过后出现LRS。每种单独的暴露也都与桑迪飓风过后的LRS独立相关,每种暴露出现桑迪飓风过后LRS的几率大约是两倍。我们发现报告的与桑迪飓风相关的暴露类型数量与桑迪飓风过后的LRS之间存在剂量反应关系。
本研究提供了证据表明飓风后的清理和重建暴露会增加LRS的风险。公共卫生干预应强调安全整治措施的重要性,并建议使用个人防护设备。(《灾难医学与公共卫生防范》。2018年;12:697 - 702)