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World Trade Center Cough Syndrome and Its Treatment

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Abstract

To date, the main respiratory health consequence from the collapse of the World Trade Center (WTC) on September 11, 2001 has been the “WTC Cough Syndrome” (chronic rhinosinusitis, asthma, and/or bronchitis, often complicated by gastroesophageal reflux dysfunction). Syndrome incidence and severity have been linked to WTC dust exposure intensity. While it is too early to ascertain long-term effects of WTC dust exposure, effective treatment guidelines have been designed through a collaborative effort by the three established centers of excellence for WTC medical monitoring and treatment and the WTC Registry. These treatment recommendations are described here.

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References

  1. 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 (2002) 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 110:703–714

    Article  PubMed  CAS  Google Scholar 

  2. Prezant DJ, Levin S, Kelly K, and Aldrich TK (2007) Upper and Lower Respiratory Diseases after Occupational and Environmental Disasters Mt. Sinai Med J (in press)

  3. Brackbill R. Thorpe L, DiGrande L, Perrin M, Sapp JH 2nd, Wu D, Campolucci S, Walker DJ, Cone J, Pulliam P, Thalji L, Farfel MR, Thomas P (2006) Surveillance for World Trade Center heath effects among survivors of collapsed and damaged buildings. MMWR Surveill Summ 55:1–18

    Google Scholar 

  4. Banauch GI, Dhala A, Prezant DJ (2005) Pulmonary dsease in rescue workers at the World Trade Center site. Curr Opin Pulm Med 11:160–168

    Article  PubMed  CAS  Google Scholar 

  5. McGee JK, Chen LC, Cohen MD, Chee GR, Prophete CM, Haykal-Coates N, Wasson SJ, Conner TL, Costa DL, Gavett SH (2003) Chemical analysis of World Trade Center fine particulate matter for use in toxicologic assessment. Environ Health Perspect 111:972–980

    Article  PubMed  CAS  Google Scholar 

  6. Gil L, Martinez V, Riquelme R, Ancic P, Gonzalez G, Rodriguez L, Adonis M (2003) Occupational and environmental levels of mutagenic PAHs and respirable particulate matter associated with diesel exhaust in Santiago, Chile. J Occup Environ Med 45:984–992

    Article  PubMed  CAS  Google Scholar 

  7. 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 (2003) Biomonitoring of chemical exposure among New York City firefighters responding to the World Trade Center fire and collapse. Environ Health Perspect 111:1906–1911

    Article  PubMed  CAS  Google Scholar 

  8. Prezant DJ, Weiden M, Banauch GI, McGuiness G, Rom WN, Aldrich TK, Kelly KJ (2002) Cough and bronchial responsiveness in firefighters at the World Trade Center site. N Engl J Med 347:806–815

    Article  PubMed  Google Scholar 

  9. Kelly KJ, Niles J, McLaughlin MT, Carroll S, Corrigan M, Al-Othman F and Prezant DJ (2007) FDNY WTC Health Effects – a six year assessment, Fire Department of the City of New York, September 11, 2007

  10. Herbert R, Moline J, Skloot G, Metzger K, Baron S, Luft B, Markowitz S, Udasin I, Harrison D, Stein D, Todd A, Enright P, Stellman JM, landrigan PJ, Levin SM (2006) The World Trade Center disaster and health of workers; five year assessment of a unique medical screening program. Environ Health Perspect 114:1853–1858

    PubMed  Google Scholar 

  11. Toren K, Brisman J, Hagberg S, Karlsson G (1996) Improved nasal clearance among pulp-mill workers after the reduction of lime dust. Scand J Work Environ Health 22:102–107

    PubMed  CAS  Google Scholar 

  12. Fireman EM, Lerman Y, Ganor E, Greif J, Fireman-Shoresh S, Lioy PJ, Banauch GI, Weiden M, Kelly KJ, Prezant DJ (2004) Induced sputum assessment in New York City firefighters exposed to World Trade Center dust. Environ Health Perspect 112: 1564–1569

    Article  PubMed  CAS  Google Scholar 

  13. Centers for Disease Control, Prevention (2002) Injuries and illnesses among New York City Fire Department rescue workers after responding to the World Trade Center attacks. MMWR Morb Mortal Wkly Rep 51:1–5

    Google Scholar 

  14. Centers for Disease Control, Prevention (2002) Rapid assessment of injuries among survivors of the terrorist attack on the World Trade Center—New York City, September 2001. MMWR Morb Mortal Wkly Rep 51:1–5

    Google Scholar 

  15. Berríos-Torres SI, Greenko JA, Phillips M, Miller JR, Treadwell T, Ikeda RM (2003) World Trade Center rescue worker injury and illness surveillance, New York, 2001. Am J Prev Med 25:79–87

    Article  PubMed  Google Scholar 

  16. Centers for Disease Control, Prevention. (2004) Physical Health status of World Trade Center rescue and recovery workers and volunteers – New York City, July 2002–August 2004. MMWR Morb Mortal Wkly Rep. 53:807–812

    Google Scholar 

  17. Salzman SH, Moosavy FM, Miskoff JA, Friedman P, Fried G, Rosen MJ (2004) Early respiratory abnormalities in emergency services police officers at the World Trade Center site. J Occup Environ Med 46:113–122

    Article  PubMed  Google Scholar 

  18. Buyantseva LV, Tulchinsky M, Kapalka GM, Chinchilli VM, Qian Z, Gillio R, Roberts A, Bascom R (2007) Evolution of lower respiratory symptoms in New York police officers after 9/11: a prospective longitudinal study. J Occup Environ Med 49: 310–317

    Article  PubMed  Google Scholar 

  19. Skloot G, Goldman M, Fischler D, Goldman C, Schechter C, Levin S, Teirstein A (2004) Respiratory symptoms and physiologic assessment of ironworkers at the World Trade Center disaster site. Chest 25:1248–1255

    Article  Google Scholar 

  20. Tapp LC, Baron S, Bernard B, Driscoll R, Mueller C, Wallingford K (2005) Physical and mental health symptoms among NYC transit workers seven and one half months after the WTC attacks. Am J Ind Med 47:475–483

    Article  PubMed  Google Scholar 

  21. Herbstman JB, Frank R, Schwab M, Williams DL, Samet JM, Breysse PN, Geyh AS (2005) Respiratory effects of inhalation exposure among workers during the clean-up effort at the WTC disaster site. Environ Res 99:85–92

    Article  PubMed  CAS  Google Scholar 

  22. Centers for Disease Control, Prevention (2002) Self-reported increase in asthma severity after the September 11 attacks on the World Trade Center—Manhattan, New York, 2001. MMWR Morb Mortal Wkly Rep 51:781–784

    Google Scholar 

  23. Reibman J, Lin S, Hwang S, Gulati M, Bowers JA, Rogers L, Berger KI, Hoerning A, Gomez M, Fitzgerald EF (2005) The World Trade Center residents’ respiratory health study: new onset respiratory symptoms and pulmonary function. Environ Health Perspect 113:406–411

    PubMed  CAS  Google Scholar 

  24. Szema AM, Khedkar M, Maloney PF, Takach PA, Nickels MS, Patel H, Modugno F, Tso AY, Lin DH (2004) Clinical deterioration in pediatric asthmatic patients after September 11, 2001. J Allergy Clin Immunol 113:420–426

    Article  PubMed  Google Scholar 

  25. Pratter MR, Brightling CE, Boulet LP, Irwin RS (2006) An empiric integrative approach to the management of cough: ACCP evidence-based clinical practice guidelines. Chest 129(1 Suppl): 222S–231S

    Article  PubMed  Google Scholar 

  26. Friedman S, Cone J, Eros-Sarnyai M, Prezant D, Szeinuk J, Clark N, Milek D, Levin S, Gillio R (2006) Clinical guidelines for adults exposed to World Trade Center Disaster (Respiratory and Mental Health). City Health Information, NYC Department of Health and Mental Hygiene, September 2006

  27. Banauch GI, Alleyne D, Sanchez R, Oldender K, Cohen HW, Weiden M, Kelly KJ, Prezant DJ (2003) Persistent bronchial hyperreactivity in New York City firefighters and rescue workers following collapse of World Trade Center. Am J Respir Crit Care Med 168:54–62

    Article  PubMed  Google Scholar 

  28. Feldman DM, Baron S, Mueller CA, Bernard BP, Lushniak BD, Banauch GI, Arcentales N, Kelly KJ, Prezant DJ (2004) Symptoms, respirator use, and pulmonary function changes among New York City firefighters responding to the World Trade Center (WTC) disaster. Chest 125:1256–1264

    Article  PubMed  Google Scholar 

  29. Banauch GI, Dhala A, Alleyne D, Alva R, Santhyadka G, Krasko A, Weiden M, Kelly KJ, Prezant DJ (2005) Bronchial hyperreactivity and other inhalation lung injuries in rescue/recovery workers after the World Trade Center collapse. Crit Care Med 33:S102–S106

    Article  PubMed  Google Scholar 

  30. Banauch GI, Dhala A, Prezant DJ (2005) Pulmonary disease in rescue workers at the World Trade Center site. Curr Opin Pulm Med 11:160–168

    Article  PubMed  CAS  Google Scholar 

  31. Banauch GI, Hall C, Weiden M, Cohen HW, Aldreich TK, Christodoulou V, Arcentales N, Kelly KJ, Prezant DJ (2006) Pulmonary function after exposure to the World Trade Center collapse in the New York City Fire Department. Am J Respir Crit Care Med 174:312–319

    Article  PubMed  Google Scholar 

  32. Brooks SM, Weiss MA, Bernstein IL (1985) Reactive airways dysfunction syndrome. Chest 88:376–384

    Article  PubMed  CAS  Google Scholar 

  33. American Thoracic Society (2000) Guidelines for methacholine and exercise challenge testing – 1999. Am J Respir Crit Care Med 161:309–329

    Google Scholar 

  34. Gavett S. Haykal-Coates N, Highfill J, Ledbetter AD, Chen LC, Cohen MD, Harkema JR, Wagner JG, Costa DL (2003) World Trade Center fine particulate matter causes respiratory tract hyperresponsiveness in mice. Environ Health Perspect 111:981–991

    Article  Google Scholar 

  35. Wheeler K, McKelvey W, Thorpe L, Perrin M, Cone J, Kass D, Farfel M, Thomas P, and Brackbill R (2007) Asthma diagnosed after September 11, 2001 among rescue and recovery workers: findings from the World Trade Center registry. Environ Health Perspect 115:1584–1590

    Article  PubMed  Google Scholar 

  36. Reed CE (2006) The natural history of asthma. J Allergy Clin Immunol 118:543–548

    Article  PubMed  Google Scholar 

  37. Wagner VL, Radigan MS, Roohan PJ, Anarella JP, Gesten FC (2005) Asthma in Medicaid managed care enrollees residing in New York City: results from a post-World Trade Center disaster survey. J Urban Health 82:76–89

    PubMed  Google Scholar 

  38. Izbicki G, Chavko R, Banauch GI, Weiden MD, Berger KI, Aldrich TK, Hall C, Kelly KJ, Prezant DJ (2007) World Trade Center “sarcoid-like” granulomatous pulmonary disease in New York City Fire Department rescue workers. Chest 131:1414–1423

    Article  PubMed  Google Scholar 

  39. Culver DA, Newman LS, Kavuru MS (2007) Gene–environment interactions in sarcoidosis: challenge and opportunity. Clin Dermatol 25:267–275

    Article  PubMed  Google Scholar 

  40. Prezant D, Dhala A, Goldstein A, Janus D, Ortiz F, Aldrich TK, Kelly KJ (1999) The incidence, prevalence and severity of sarcoidosis in New York City firefighters. Chest 116:1183–1193

    Article  PubMed  CAS  Google Scholar 

  41. Rom WN, Weiden M, Garcia R, Yie TA, Vathesatogkit P, Tse DB, McGuinness G, Roggli V, Prezant D (2002) Acute eosinophilic pneumonia in a New York City firefighter exposed to World Trade center dust. Am J Respir Crit Care Med 166:797–800

    Article  PubMed  Google Scholar 

  42. Mann JM, Sha KK, Kline G, Breuer FU, Miller A (2005) World Trade Center dyspnea: bronchioloitis obliterans with functional improvement: case report. Am J Ind Med 48:225–229

    Article  PubMed  Google Scholar 

  43. Safirstein BH, Klukowitcz A, Miller R, Teirstein A (2003) Granulomatous pneumonitis following exposure to the World Trade Center collapse. Chest 123:301–304

    Article  PubMed  Google Scholar 

  44. DePalma A (2006) Medical views of 9/11 dust shows big gaps. The New York Times, October 26, 2006, pp 1

  45. Mulshine J, Sullivan D (2005) Lung cancer screening. New Engl J Med 352:2714–2720

    Article  PubMed  CAS  Google Scholar 

  46. Gwaltney JM Jr, Jones JG, Kennedy DW (1995) Medical management of sinusitis: educational goals and management guidelines. The International Conference on sinus Disease. Ann Otol Rhinol Laryngol Suppl 167:22–30

    PubMed  Google Scholar 

  47. DeVault KR, Castell DO, American College of Gastroenterology (2005) Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol 100:190–200

    Article  PubMed  Google Scholar 

  48. Irwin RS, Madison JM (2000) Diagnosis and treatment of chronic cough due to gastroesophageal reflux disease and postnasal drip syndrome. Pulm Pharmacol Ther 15:261–266

    Article  CAS  Google Scholar 

  49. Bars MP, Banauch GI, Appel DW, Andreaci M, Mouren P, Kelly KJ, Prezant DJ (2006) “Tobacco Free with FDNY” – The New York City Fire Department World Trade Center Tobacco Cessation Study. Chest 129:979–987

    Article  PubMed  Google Scholar 

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  1. Office of Medical Affairs, Fire Department of City of New York (FDNY), FDNY World Trade Center Monitoring and Treatment Program, 9 Metrotech Center; Room 4w-1, Brooklyn, New York, 11201, USA

    David J. Prezant

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  1. David J. Prezant
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Correspondence to David J. Prezant.

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Prezant, D.J. World Trade Center Cough Syndrome and Its Treatment. Lung 186 (Suppl 1), 94–102 (2008). https://doi.org/10.1007/s00408-007-9051-9

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