Occupational toxicant inhalation injury: the World Trade Center (WTC) experience

  • Rafael E. de la Hoz
  • Michael R. Shohet
  • Rachel Chasan
  • Laura A. Bienenfeld
  • Aboaba A. Afilaka
  • Stephen M. Levin
  • Robin Herbert
Original Article


Objective and methods

Clinical descriptive data is presented on a group of 554 former workers and volunteers (with more than 90 different occupations) at the World Trade Center (WTC) disaster site. A subsample of 168 workers (30% of the group) was selected to examine lower airway disease risk in relation to smoking and WTC exposure variables.


Five diagnostic categories clearly predominate: upper airway disease (78.5%), gastroesophageal reflux disease (57.6%), lower airway disease (48.9%), psychological (41.9%) and chronic musculoskeletal illnesses (17.8%). The most frequent pattern of presentation was a combination of the first three of those categories (29.8%). Associations were found between arrival at the WTC site within the first 48 h of the terrorist attack and lower airway and gastroesophageal reflux disease, and between past or present cigarette smoking and lower airway disease.


Occupational exposures at the WTC remain consistently associated with a disease profile, which includes five major diagnostic categories. These conditions often coexist in different combinations, which (as expected) mutually enhances their clinical expression, complicates medical management, and slows recovery. Cigarette smoking and early arrival at the WTC site appear to be risk factors for lower airway disease diagnosis.


Occupational medicine Inhalation injury Asthma Respiratory diseases Irritant exposures 


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Rafael E. de la Hoz
    • 1
  • Michael R. Shohet
    • 3
  • Rachel Chasan
    • 4
  • Laura A. Bienenfeld
    • 1
  • Aboaba A. Afilaka
    • 2
  • Stephen M. Levin
    • 2
  • Robin Herbert
    • 2
  1. 1.Department of Community and Preventive Medicine, and MedicineThe Mount Sinai School of Medicine, WTC Health Effects Treatment ProgramNew YorkUSA
  2. 2.Department of Community and Preventive MedicineThe Mount Sinai School of Medicine, WTC Health Effects Treatment ProgramNew YorkUSA
  3. 3.Department of Otolaryngology and Head and Neck SurgeryThe Mount Sinai School of MedicineNew YorkUSA
  4. 4.Department of MedicineThe Mount Sinai School of MedicineNew YorkUSA

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