Odor identification ability and self-reported upper respiratory symptoms in workers at the post-9/11 World Trade Center site

  • Kenneth W. Altman
  • Shaun C. Desai
  • Jacqueline Moline
  • Rafael E. de la Hoz
  • Robin Herbert
  • Patrick J. Gannon
  • Richard L. Doty
Original Article


Following the World Trade Center (WTC) collapse on September 11, 2001, more than 40,000 people were exposed to a complex mixture of inhalable nanoparticles and toxic chemicals. While many developed chronic respiratory symptoms, to what degree olfaction was compromised is unclear. A previous WTC Medical Monitoring and Treatment Program study found that olfactory and nasal trigeminal thresholds were altered by the toxic exposure, but not scores on a 20-odor smell identification test.


To employ a well-validated 40-item smell identification test to definitively establish whether the ability to identify odors is compromised in a cohort of WTC-exposed individuals and, if so, whether the degree of compromise is associated with self-reported severity of rhinitic symptoms.


The University of Pennsylvania Smell Identification Test (UPSIT) was administered to 99 WTC-exposed persons and 99 matched normal controls. The Sino-Nasal Outcomes Test (SNOT-20) was administered to the 99 WTC-exposed persons and compared to the UPSIT scores.


The mean (SD) UPSIT scores were lower in the WTC-exposed group than in age-, sex-, and smoking history-matched controls [respective scores: 30.05 (5.08) vs 35.94 (3.76); p = 0.003], an effect present in a subgroup of 19 subjects additionally matched on occupation (p < 0.001). Fifteen percent of the exposed subjects had severe microsmia, but only 3% anosmia. SNOT-20 scores were unrelated to UPSIT scores (r = 0.20; p = 0.11).


Exposure to WTC air pollution was associated with a decrement in the ability to identify odors, implying that such exposure had a greater influence on smell function than previously realized.


Anosmia Hyposmia Rhinosinusitis World Trade Center SNOT-20 UPSIT Smell Rhinology Occupational medicine 


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Kenneth W. Altman
    • 1
  • Shaun C. Desai
    • 1
  • Jacqueline Moline
    • 2
  • Rafael E. de la Hoz
    • 2
    • 3
  • Robin Herbert
    • 2
  • Patrick J. Gannon
    • 4
  • Richard L. Doty
    • 5
  1. 1.Department of Otolaryngology-Head and Neck SurgeryMount Sinai School of MedicineNew YorkUSA
  2. 2.Department of Community and Preventive MedicineMount Sinai School of MedicineNew YorkUSA
  3. 3.Department of MedicineMount Sinai School of MedicineNew YorkUSA
  4. 4.Touro University College of MedicineHackensackUSA
  5. 5.Smell and Taste Center and Department of Otorhinolaryngology: Head and Neck Surgery, School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA

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