Respiratory Health and Lung Function in Children Exposed to the World Trade Center Disaster

J Pediatr. 2018 Oct:201:134-140.e6. doi: 10.1016/j.jpeds.2018.06.009. Epub 2018 Jul 18.

Abstract

Objectives: To compare lung function in a representative sample of World Trade Center (WTC)-exposed children with matched comparisons, and examine relationships with reported exposures.

Study design: Study population consisted of 402 participants. Oscillometry, spirometry, and plethysmography were performed on WTC Health Registry (WTCHR) respondents who were ≤8 years of age on September 11, 2001 (n = 180) and a sociodemographically matched group of New York City residents (n = 222). We compared lung function by study arm (WTCHR and comparison group) as well as dust cloud (acute); home dust (subchronic); and other traumatic, nondust exposures.

Results: In multivariable models, post-9/11 risk of incident asthma was higher in the WTCHR participants than in the comparison group (OR 1.109, 95% CI 1.021, 1.206; P = .015). Comparing by exposure rather than by group, dust cloud (OR 1.223, 95% CI 1.095, 1.365; P < .001) and home dust (OR 1.123, 95% CI 1.029, 1.226; P = .009) exposures were also associated with a greater risk of incidence of post-9/11 asthma. No differences were identified for lung function measures.

Conclusions: Although we cannot exclude an alternative explanation to the null findings, these results may provide some measure of reassurance to exposed children and their families regarding long-term consequences. Further study with bronchodilation and/or methacholine challenge may be needed to identify and further evaluate effects of WTC exposure. Biomarker studies may also be more informative in delineating exposure-outcome relationships.

Trial registration: ClinicalTrials.gov: NCT02068183.

Keywords: asthma; dust cloud (acute) exposure; home dust (subchronic) exposure; traumatic nondust exposures.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Air Pollutants / adverse effects*
  • Child
  • Child, Preschool
  • Disasters*
  • Dust
  • Environmental Exposure / adverse effects*
  • Female
  • Health Status*
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • New York City / epidemiology
  • Registries*
  • Respiratory Physiological Phenomena*
  • Retrospective Studies
  • Stress Disorders, Post-Traumatic / epidemiology*
  • Stress Disorders, Post-Traumatic / physiopathology

Substances

  • Air Pollutants
  • Dust

Associated data

  • ClinicalTrials.gov/NCT02068183