Occupational
Self-reported chronic rhinosinusitis diagnoses and symptoms in WTC-exposed and non-WTC-exposed firefighters Ankura Singh* Ankura Singh Rachel Zeig-Owens Mayris P. Webber Alexandra Mueller David J. Prezant
Background
Studies conducted within World Trade Center (WTC)-exposed populations have shown that greater WTC exposure is associated with chronic rhinosinusitis (CRS) diagnoses and symptoms. We aimed to determine whether self-reported CRS diagnoses and related symptoms are elevated in WTC-exposed Fire Department of the City of New York (FDNY) firefighters when compared with non-WTC-exposed non-FDNY firefighters.
Methods
The study population included 9964 WTC-exposed and 2771 non-WTC-exposed firefighters who were actively employed on 9/11/01 and later completed a health survey. Participants indicated whether they had ever been diagnosed with CRS. Logistic regression analyses estimated the odds of self-reported CRS diagnoses in WTC-exposed vs non-WTC-exposed firefighters. Secondary analyses within the non-WTC-exposed group and a subset of WTC-exposed firefighters (N=7840) who completed the health survey during the same recent time period assessed associations between WTC exposure and current CRS-related symptoms. Models adjusted for age, race, smoking and BMI.
Results
More WTC-exposed firefighters (4681/9964, 47%) reported a CRS diagnosis than did non-WTC-exposed firefighters (544/2771, 20%; adjusted OR=3.25, 95% CI=2.92-3.61). Secondary analyses showed that WTC exposure was associated with CRS-related symptoms in the past 12 months, i.e. nasal/sinus congestion (OR=1.17, 95% CI=1.06-1.28), nose irritation (OR=1.48, 95% CI=1.24-1.76) and sinus pain/pressure (OR=1.41, 95% CI=1.26-1.59).
Conclusion
WTC exposure was associated with self-reported CRS diagnoses and recent CRS symptoms in firefighters. Elevated CRS in the WTC-exposed cohort could be a result of exposure to irritants at the WTC site. However, given the attenuated association between WTC exposure and recent CRS symptoms, the association between WTC-exposure and CRS diagnosis may be explained, in part, by enhanced surveillance and comprehensive healthcare provided to WTC-exposed firefighters via the WTC Health Program.
