Categories: Emergency response, Respiratory health
September 8th, 2008 11:09 am ET -
By guest blogger Dr. David Prezant of the World Trade Center Medical Monitoring and Treatment Program and the Albert Einstein College of Medicine*
See the introduction to this blog entry by Dr. Christine Branche.
Can respirators be redesigned to “work” in this environment?
On September 11th, 2001, terrorist attacks led to the collapse of the World Trade Center. Approximately 70% of the buildings’ structural components were pulverized in the fiery collapse of these towers, including six million cubic feet of masonry, five million square feet of painted surfaces, seven million square feet of flooring, 600,000 cubic feet of window glass, 200 elevators, and all other items present in a modern office complex.1 It is estimated that hundreds of thousands of people were exposed, with the most highly exposed group being the rescue, recovery and cleanup workers.2,3 Pulverized building materials predominated in the initial period post-collapse, while combustion-derived pollutants increased as rescue, recovery and cleanup progressed.4 The fires at the site created toxic combustion products, such as polycyclic aromatic hydrocarbons (PAHs), dioxins, volatile organic compounds, and various other known carcinogenic compounds.1,4,5,6,7 Contaminants such as asbestos, hydrochloric acid, PCBs (Polychlorinated biphenyls), silica and heavy metals were found in the dust and ash resulting from the WTC collapse.1,4,5,6,7
The WTC Cough Syndrome (a chronic cough syndrome, thought to be a consequence of upper and lower respiratory disease typically including chronic asthmatic bronchitis, chronic rhinosinusitis, chronic gastroesophageal reflux, or any combination of the three) has been reported by a large percentage of the exposed.
10 Comments - Read more
Categories: Emergency response
September 8th, 2008 11:09 am ET -
Read the blog entry by Dr. David Prezant
This week marks seven years since the terrorist attacks on the World Trade Center. These events and the subsequent clean up efforts exposed rescue and recovery workers to unprecedented levels of risk for job-related injury, illness, and death, including exposure to silica dust, asbestos, and other dusts and gases; eye injury from blowing debris; and stress. The National Institute for Occupational Safety and Health (NIOSH) responded swiftly to address workers’ needs in the aftermath of the attacks. NIOSH quickly sent dozens of staff to Ground Zero who applied their technical expertise to help meet immediate worker protection needs including identifying hazards, assisting with the selection and use of appropriate sampling equipment and personal protective equipment, and developing cost-effective procedures for cleaning and sanitizing respirators on-site. Also, by helping workers and supervisors build their own safety and health capacity, NIOSH was able to enhance safety at the sprawling site.
Categories: Emergency response
September 8th, 2008 12:00 am ET -
- Lioy PJ, Weisel CP, Millette JR, Eisenreich S, Vallero D, Offenberg J, Buckley B, Turpin B, Zhong M, Cohen MD, Prophete C, Yang I, Stiles R, Chee G, Johnson W, Porcja R, Alimokhtari S, Hale RC, Weschler C, Chen LC. Characterization of the dust/smoke aerosol that settled east of the World Trade Center (WTC) in lower Manhattan after the collapse of the WTC 11 September 2001. Environ Health Perspect. 2002, 110(7):703-14.
- Prezant DJ, Levin S, Kelly K, and Aldrich TK. “Overview: Health Consequences of the World Trade Center Disaster” Mt. Sinai Medical Journal 2008; 75:89-100.
- Brackbill, R. Thorpe L, DiGrande L, Perrin M, Sapp J, Wu D., et al. “Surveillance for World Trade Center Heath Effects Among Survivors of Collapsed and Damaged Buildings” Morbidity and Mortality Weekly Report 2006 Apr 7;55(2):1-18.
- Banauch, G.I., Dhala, A., et al. “Pulmonary Disease in Rescue Workers at the World Trade Center Site” Current Opinion in Pulmonary Medicine 2005 Mar; 11(2):160-8.
- McGee JK, Chen LC, Cohen MD, Chee GR, Prophete CM, Haykal-Coates N, Wasson SJ, Conner TL, Costa DL, Gavett SH: Chemical analysis of World Trade Center fine particulate matter for use in toxicologic assessment. Environ Health Perspect. 2003, 111(7): 972-80.
- Gil L, Martinez V, Riquelme R, Ancic P, Gonzalez G, Rodriguez L, Adonis M. Occupational and environmental levels of mutagenic PAHs and respirable particulate matter associated with diesel exhaust in Santiago, Chile. J Occup Environ Med. 2003 Sep;45(9):984-92.
- Edelman P, Osterloh J, Pirkle J, Caudill SP, Grainger J, Jones R, Blount B, Calafat A, Turner W, Feldman D, Baron S, Bernard B, Lushniak BD, Kelly K, Prezant D. Biomonitoring of chemical exposure among New York City firefighters responding to the World Trade Center fire and collapse. Environ Health Perspect. 2003 Dec;111(16):1906-11.
- Banauch GI, McLaughlin M, Hirschhorn R, Corrigan M, Kelly KJ, Prezant DJ. Injuries and Illnesses among New York City Fire Department rescue workers after responding to the World Trade Center Attacks. MMWR 2002; 51:1-5.
- Centers for Disease Control and Prevention. Rapid assessment of injuries among survivors of the terrorist attack on the World Trade Center–New York City, September 2001. MMWR 2002; 51:1-5.
- Berríos-Torres SI, Greenko JA, Phillips M, Miller JR, Treadwell T, Ikeda RM. World Trade Center rescue worker injury and illness surveillance, New York, 2001. Am. J. Prev. Med. 2003; 25:79-87.
- Prezant DJ, Weiden M, Banauch GI, McGuinness G, Rom WN, Aldrich TK & Kelly KJ. Cough & bronchial responsiveness in firefighters at the World Trade Center site. N Eng J Med 2002;347:806-15.
- Kelly, KJ, Niles J, Corrigan M, McLaughlin MT, Carroll S, Al-Othman F, and Prezant DJ. FDNY WTC Health Effects – a six year assessment, FDNY 9/11/2007.
- Herbert, R, Moline, J, Skloot G, Metzger K, Baron S, Luft B, et al. “The World Trade Center Disaster and Health of Workers; Five Year Assessment of a Unique Medical Screening Program” Environmental Health Perspectives. 2006; 114:1853-8.
- Toren K, Brisman J, Hagberg S, Karlsson G. Improved nasal clearance among pulp-mill workers after the reduction of lime dust. Scand J Work Environ Health. 1996 Apr;22(2):102-7.
- Fireman EM, Lerman Y, Ganor E, Greif J, Fireman-Shoresh S, Lioy PJ, Banauch GI, Weiden M, Prezant DJ. Induced sputum assessment in New York City firefighters exposed to World Trade Center dust. Environ Health Perspect, 2004; 112: 1564-1569.
- Centers for Disease Control and Prevention. Physical Health Status of World Trade Center Rescue & Recovery Workers & Volunteers – New York City, July 2002 – August 2004. MMWR 2004;53:807-812.
- Salzman SH, Moosavy FM, Miskoff JA, Friedmann P, Fried G, Rosen MJ. Early respiratory abnormalities in emergency services police officers at the World Trade Center site. J Occup Environ Med. 2004;46:113-22.
- Buyantseva LV, Tulchinsky M, Kapalka GM, Chinchilli VM, Qian Z, Gillio R, Roberts A, Bascom R. Evolution of lower respiratory symptoms in New York police officers after 9/11: a prospective longitudinal study. J. Occup. Environ Med. 2007; 49: 310-317.
- Skloot G, Goldman M, Fischler D, Goldman C, Schechter C, Levin S, Teirstein A. Respiratory symptoms & physiologic assessment of ironworkers at the World Trade Center disaster site. Chest. 2004;25:1248-55.
- Physical and mental health symptoms among NYC Transit Workers seven and one half months after the WTC attacks. Tapp L, Baron S, etal. Am J. Ind. Med. 2005;47:475-483.
- Herbstman J, Schwab M, et al. Respiratory effects of inhalation exposure among workers during the clean-up effort at the WTC disaster site. Environ Res. 2005;99:85-92.
- Centers for Disease Control and Prevention. Self-Reported Increase in Asthma Severity After the September 11 Attacks on the World Trade Center — Manhattan, New York, 2001 MMWR 2002; 51:781-784.
- Reibman J. Respiratory health of residents near the former world trade center: the WTC Residents Respiratory Health Survey [Abstract]. Am J Respir Crit Care Med 2003;167: A335.
- Szema AM, Khedkar M, Maloney PF, Takach PA, Nickels MS, Patel H, Modugno F, Tso AY, Lin DH. Clinical deterioration in pediatric asthmatic patients after September 11, 2001. J Allergy Clin Immunol. 2004;113:420-6.
- Banauch GI, Alleyne D, Sanchez R, Olender K, Weiden M, Kelly KJ, & Prezant DJ. Persistent bronchial hyperreactivity in New York City firefighters & rescue workers following collapse of World Trade Center. Am. J. Resp. Crit. Care Med. 2003; 168:54-62.
- Feldman DM, Baron S, Mueller CA, Bernard BP, Lushniak BD, Kelly KJ, Prezant DJ. Initial symptoms, respiratory function & respirator use in New York City firefighters responding to the World Trade Center (WTC) disaster. Chest 2004;125:1256-64.
- Banauch GI, Dhala A, Alleyne D, Alva R, Santhyadka G, Krasko A, Weiden M, Kelly KJ, Prezant DJ. Bronchial hyperreactivity & other inhalation lung injuries in rescue/recovery workers after the World Trade Center collapse. Crit Care Med. 2005;33:S102-S106.
- Banauch GI, Dhala A, Prezant DJ. Airway dysfunction in rescue workers at the World Trade Center site. Curr Opin Pulm Med 2005; 11:160-8.
- Banauch GI, Hall C, Weiden M, Cohen HW, Aldrich TK, Christodoulou V, Arcentales N, Kelly KJ, & Prezant DJ. Pulmonary function loss after World Trade Center exposure in the New York City Fire Department. Am. J. Respir. Crit. Care Med. 2006; 174:312-319.
- Brooks SM, Weiss MA, Bernstein IL. Reactive airways dysfunction syndrome. Chest 1985, 88:376-84.
- American Thoracic Society. Guidelines for methacholine and exercise challenge testing – 1999. Am J Respir Crit Care Med, 2000; 161:309-29.
- Gavett S. Haykal-Coates N, Highfill J, Ledbettter A, Chi Chen L, Cohen M, et al. World Trade Center fine particulate matter causes respiratory tract hyperresponsiveness in mice. Environ Health Perspect. 2003; 111:981-991.
- Wheeler K, McKelvey, Thorpe L, Perrin M, Cone J, Kass D, Farfel M, Thomas P, and Brackbill R. Asthma diagnosed after September 11, 2001 among rescue and recovery workers: findings from the World Trade Center registry. Environ Health Perspect. On-line August 2007.
Categories: Mining, Respiratory health, Training
August 18th, 2008 9:47 am ET -
In the last decade, over 10,000 miners have died of coal workers’ pneumoconiosis, or what is commonly called black lung disease.1
Black lung disease, which is caused by inhaling coal mine dust, results in scarring of the lungs and emphysema, shortness of breath, disability, and premature death. While the prevalence of black lung disease had decreased by about 90% from 1969 to 1995 following the enactment of the Coal Mine Health and Safety Act, the downward trend of this disease in coal miners has stopped. Since 1995, the prevalence of black lung cases has more than doubled. Many current underground miners (some as young as in their 30s) are developing severe and advanced cases. Identification of advanced cases among miners under age 50 is of particular concern, as they were exposed to coal-mine dust in the years after implementation of the disease prevention measures mandated by the 1969 federal legislation. An increased risk of pneumoconiosis has also been associated with work in certain mining jobs, in smaller mines, in several geographic areas, and among contract miners.2
8 Comments - Read more