Respiratory effects of inhalation exposure among workers during the clean-up effort at the World Trade Center disaster site

During December 2001 we conducted a field study of 183 clean-up and recovery workers at the World Trade Center (WTC) disaster site to assess respiratory health effects potentially resulting from their work at the site. On site, we administered a respiratory health questionnaire designed to assess upper respiratory symptoms and lower respiratory symptoms, including cough, phlegm, and wheeze, as well as indices of exposure, including number of days worked at the site and job category. Spirometry was conducted for 175 workers. Sixty-five percent of the workers surveyed arrived at the site without lower respiratory symptoms. Of this group, 34% developed cough, 24% developed phlegm, and 19% developed wheeze. Prevalence rates of these symptoms were related to the number of days spent working at the WTC, but not job category. The mean percentage predicted FEV₁ and FVC were 6% and 5% lower, respectively, for workers who developed new lower respiratory symptoms compared to those who remained symptom free. While the development of new wheeze suggested the presence of airway obstruction, the near-normal distribution of age-adjusted FEV₁/FVC ratios suggested that the degree of obstruction was mild. The prevalence rates of upper airway symptoms (nasal congestion, sore throat, hoarse throat) exceeded those of lower respiratory symptoms, however, it was not determined whether symptoms pre-dated arrival at the WTC site.