Singh Ankura, Zeig-Owens Rachel, Webber Mayris P, Mueller Alexandra K, Prezant David J
Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, 9 Metrotech Center, Brooklyn, NY 11201, USA; Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center, 111 E 210(th) St., Bronx, NY 10467, USA.
Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, 9 Metrotech Center, Brooklyn, NY 11201, USA; Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center, 111 E 210(th) St., Bronx, NY 10467, USA; Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY 10461, USA.
Prev Med. 2025 Feb;191:108216. doi: 10.1016/j.ypmed.2024.108216. Epub 2024 Dec 29.
Greater World Trade Center (WTC) exposure levels have been associated with chronic rhinosinusitis (CRS) diagnoses and symptoms. We aimed to determine whether self-reported CRS is elevated in WTC-exposed Fire Department of the City of New York (FDNY) firefighters when compared with non-WTC-exposed/non-FDNY firefighters and with the general population.
The study included male WTC-exposed (N = 7840) and non-WTC-exposed (N = 2771) firefighters who were employed on 9/11/2001 and later completed a health survey. Self-reported CRS diagnoses and symptoms were evaluated. Multivariable logistic regression analyses estimated the odds of self-reported ever CRS diagnosis and current symptoms in WTC-exposed vs. non-WTC-exposed firefighters. Additional analyses compared self-reported current CRS diagnoses in firefighters vs. American males. Models were adjusted for demographics, smoking, and BMI.
Fifty-one percent of WTC-exposed firefighters reported ever having a CRS diagnosis vs. 20 % of non-WTC-exposed firefighters (adjusted-OR = 3.84, 95 % CI = 3.44-4.28). WTC-exposure was also associated with specific rhinosinusitis symptoms, including nasal/sinus congestion (adjusted-OR = 1.17, 95 % CI = 1.06-1.29), nose irritation (adjusted-OR = 1.48, 95 % CI = 1.24-1.76), and sinus pain/pressure (adjusted-OR = 1.42, 95 % CI = 1.26-1.60). Both WTC-exposed (adjusted-OR = 3.84, 95 % CI = 3.46-4.27) and non-WTC-exposed firefighters (adjusted-OR = 1.97, 95 % CI = 1.71-2.27) were more likely to report a current CRS diagnosis than similar adult males.
WTC-exposure was associated with self-reported CRS diagnoses and symptoms in firefighters. Higher CRS diagnosis prevalence in the WTC-exposed cohort could be a result of exposure to irritants present at the WTC site, and may also be explained, in part, by the enhanced surveillance and healthcare WTC-exposed firefighters receive via the WTC Health Program. Elevated levels of CRS in firefighters overall could be due to routine, non-WTC-related firefighting exposures.
世贸中心（WTC）更高的暴露水平与慢性鼻-鼻窦炎（CRS）的诊断及症状相关。我们旨在确定与未暴露于世贸中心的非纽约市消防局（FDNY）消防员以及普通人群相比，自我报告的CRS在暴露于世贸中心的纽约市消防局消防员中是否有所升高。
该研究纳入了2001年9月11日受雇且后来完成健康调查的男性世贸中心暴露组消防员（N = 7840）和非世贸中心暴露组消防员（N = 2771）。对自我报告的CRS诊断和症状进行评估。多变量逻辑回归分析估计了世贸中心暴露组与非世贸中心暴露组消防员自我报告的既往CRS诊断及当前症状的比值比。额外分析比较了消防员与美国男性中自我报告的当前CRS诊断情况。模型对人口统计学、吸烟和体重指数进行了校正。
51%的世贸中心暴露组消防员报告曾被诊断为CRS，而非世贸中心暴露组消防员这一比例为20%（校正比值比=3.84，95%置信区间=3.44 - 4.28）。世贸中心暴露还与特定的鼻-鼻窦炎症状相关，包括鼻/鼻窦充血（校正比值比=1.17，95%置信区间=1.06 - 1.29）、鼻刺激感（校正比值比=1.48，95%置信区间=1.24 - 1.76）以及鼻窦疼痛/压痛（校正比值比=1.42，95%置信区间=1.26 - 1.60）。与类似的成年男性相比，世贸中心暴露组消防员（校正比值比=3.84，95%置信区间=3.46 - 4.27）和非世贸中心暴露组消防员（校正比值比=1.97，95%置信区间=1.71 - 2.27）报告当前CRS诊断的可能性均更高。
世贸中心暴露与消防员自我报告的CRS诊断及症状相关。世贸中心暴露队列中较高的CRS诊断患病率可能是由于暴露于世贸中心现场存在的刺激物，部分原因也可能是世贸中心暴露组消防员通过世贸中心健康计划接受了强化的监测和医疗保健。消防员总体上CRS水平升高可能是由于常规的、与世贸中心无关的消防工作暴露。
