Respiratory Health and Lung Function in Children Exposed to the World Trade Center Disaster

Abstract

Objectives: To compare lung function in a representative sample of World Trade Center (WTC)-exposed children with matched comparisons, and examine relationships with reported exposures.

Study design: Study population consisted of 402 participants. Oscillometry, spirometry, and plethysmography were performed on WTC Health Registry (WTCHR) respondents who were ≤8 years of age on September 11, 2001 (n = 180) and a sociodemographically matched group of New York City residents (n = 222). We compared lung function by study arm (WTCHR and comparison group) as well as dust cloud (acute); home dust (subchronic); and other traumatic, nondust exposures.

Results: In multivariable models, post-9/11 risk of incident asthma was higher in the WTCHR participants than in the comparison group (OR 1.109, 95% CI 1.021, 1.206; P = .015). Comparing by exposure rather than by group, dust cloud (OR 1.223, 95% CI 1.095, 1.365; P < .001) and home dust (OR 1.123, 95% CI 1.029, 1.226; P = .009) exposures were also associated with a greater risk of incidence of post-9/11 asthma. No differences were identified for lung function measures.

Conclusions: Although we cannot exclude an alternative explanation to the null findings, these results may provide some measure of reassurance to exposed children and their families regarding long-term consequences. Further study with bronchodilation and/or methacholine challenge may be needed to identify and further evaluate effects of WTC exposure. Biomarker studies may also be more informative in delineating exposure-outcome relationships.

Trial registration: ClinicalTrials.gov: NCT02068183.

Keywords: asthma; dust cloud (acute) exposure; home dust (subchronic) exposure; traumatic nondust exposures.

Conflict of interest statement

The authors declare no conflicts of interest.

Copyright © 2018 Elsevier Inc. All rights reserved.

Figures

Figure 1.

Flow chart of recruitment of WTCHR and comparison group participants into the present study. DOB, date of birth; NYC, New York City.

Figure 2.

Incidence of post-9/11/01 asthma by WTCHR, dust cloud, home dust, and other traumatic exposures.

Figure 3.

Pulmonary function outcome comparison by WTCHR.

Figure 4.

Pulmonary function outcomes comparison by dust cloud exposure.

Figure 5.

Pulmonary function outcomes comparison by home dust exposure.

Figure 6.

Pulmonary function comparison by traumatic exposure.