Occupational Rhinosinusitis and Upper Airway Disease: The World Trade Center Experience
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The World Trade Center disaster and its recovery work involved a range of hazardous occupational exposures that have not been fully characterized but that can be reasonably assumed to have the potential to cause mucosal inflammation, preferentially (but not exclusively) in the upper airway. A high prevalence of rhinosinusitis and upper airway disease (UAD) symptoms was reported by several early surveys. Clinical studies demonstrated objective, clinically significant, and persistent chronic perennial rhinosinusitis and UAD—with or without seasonal exacerbation—in a large proportion of patients. Demonstration of an association between UAD and available exposure indicators has been limited. Atopy seemed to be associated with increased UAD symptom severity and to be a risk factor for upper, but not lower, airway disease. World Trade Center-related UAD is considered an irritant-induced disease but not, in many cases, of acute onset. No data thus far suggest an increased upper airway cancer incidence.
KeywordsOccupational medicine Rhinitis Sinusitis Inhalation injury Atopy Allergy Pharyngitis Laryngitis Reflux disease
The publication of this work was made possible by the Centers for Disease Control and Prevention and the National Institute for Occupational Safety and Health (CDC/NIOSH) cooperative agreement no. U10 OH008225. The contents of this article are the sole responsibility of the authors and do not necessarily represent the official views of the CDC/NIOSH. The work described in this article was done before October 2006, when the WTC HETP had been funded by the following philanthropic organizations: the American Red Cross, the September 11 Fund, the Robin Hood Foundation, and the Bear Stearns Charitable Foundation.
No potential conflicts of interest relevant to this article were reported.
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