Chest CT scan findings in World Trade Center workers

ABSTRACT

We examined the chest CT scans of 1,453 WTC responders using the International Classification of High-resolution CT for Occupational and Environmental Respiratory Diseases. Univariate and bivariate analyses of potential work-related pleural abnormalities were performed with pre-WTC and WTC-related occupational exposure data, spirometry, demographics and quantitative CT measurements. Logistic regression was used to evaluate occupational predictors of those abnormalities. Chest CT scans were performed first at a median of 6.8 years after 9/11/2001. Pleural abnormalities were the most frequent (21.1%) across all occupational groups In multivariable analyses, significant pre-WTC occupational asbestos exposure, and work as laborer/cleaner were predictive of pleural abnormalities, with prevalence being highest for the Polish subgroup (n = 237) of our population. Continued occupational lung disease surveillance is warranted in this cohort.

KEYWORDS:

• Occupational lung disease
• respiratory diseases
• asbestos
• workers
• occupational diseases
• lung diseases

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Acknowledgments

The authors would like to thank all participants in this study, and the staff of the WTC Health Program Clinical Center of Excellence at the Mount Sinai Selikoff Centers for Occupational Health, and the WTC Data Center at Mount Sinai. Dr. Yukinori Kusaka, (University of Fukui, Fukui, Japan), made available ICOERD references images to the authors, and Dr. Kurt G. Hering (Knappschaftskrankenhaus Dortmund, Dortmund, Germany) provided guidance on the use of the ICOERD classification system. We also acknowledge the able support of Lilliam Tirado and Raymond Mathews as research coordinators. Parts of this work were presented at the 2016 International Conference of the American Thoracic Society. Part of this work was presented to fulfill Jonathan Weber's requirements towards his Master of Public Health degree at the Icahn School of Medicine at Mount Sinai.

Author Contributions

Study conception and design: RED; Acquisition, analysis, and interpretation of data: all authors; Critical revision for important intellectual content: All authors; Statistical analysis: JW, JTD, RED, XL, and JCC; Obtained funding: RED; Administrative, technical, or material support: RED; Study supervision: RED. All authors approved the final version of the manuscript before submission.

Additional information

Funding

This work was supported by grant U01-OH010401 (PI, Rafael E. de la Hoz) from the CDCP/NIOSH. The contents of this article are the sole responsibility of the authors and do not necessarily represent the official views of the CDCP/NIOSH.