The World Trade Center disaster and the health of workers: Five-year assessment of a unique medical screening program
The World Trade Center disaster and the health of workers: Five-year assessment of a unique medical screening program
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DOI：
10.1289/ehp.9592
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发表时间：
2006-12-01
影响因子：
10.4
通讯作者：
Levin, Stephen M.
中科院分区：
文献类型：
--
作者：
Herbert, Robin;Moline, Jacqueline;Levin, Stephen M.
背景技术背景：在2001年9月11日世界贸易中心（世贸中心）遭受袭击后，大约有40 000名救援和恢复工作人员暴露在腐蚀性粉尘和有毒污染物中。这些工人包括传统的第一反应，如消防队员和警察，和不同的人口建设，公用事业，和公共部门workers.METHODS：为了表征世贸组织相关的健康影响，世贸组织工作人员和志愿者的医疗筛查计划成立。这个多中心的临床项目为反应者提供免费的标准化检查。检查包括医疗，心理健康和暴露评估问卷，体检，肺功能测定，和胸部X射线。结果：9,442应答者检查2002年7月至2004年4月，69%的报告新的或恶化的呼吸道症状，而执行世卫组织的工作。这些工人中有59%的症状持续到检查时。在9月11日之前无症状的人中，61%在进行WTC工作时出现呼吸道症状。28%的患者肺功能异常; 21%的患者用力肺活量（FVC）较低; 5%的患者存在阻塞。在非吸烟者中，27%的人有肺功能异常，而在美国普通人群中这一比例为13%。非吸烟人群中FVC低的患病率是美国人群的5倍（20% vs. 4%）。呼吸系统症状和肺功能异常显着相关的早期到达在situ.CONCLUSION：世贸中心反应者有呼吸系统症状和肺功能测试异常，持续到2.5年后的攻击与呼吸相关的增加。需要进行长期的医学监测，以跟踪这些异常的持续性，并确定迟发效应，包括可能的恶性肿瘤。所吸取的经验教训应指导今后应对国内灾害的工作。
BACKGROUND: Approximately 40,000 rescue and recovery workers were exposed to caustic dust and toxic pollutants following the 11 September 2001 attacks on the World Trade Center (WTC). These workers included traditional first responders, such as firefighters and police, and a diverse population of construction, utility, and public sector workers.METHODS: To characterize WTC-related health effects, the, WTC Worker and Volunteer Medical Screening Program was established. This multicenter clinical program provides free standardized examinations to responders. Examinations include medical, mental health, and exposure assessment questionnaires; physical examinations; spirometry; and chest X rays.RESULTS: Of 9,442 responders examined between July 2002 and April 2004, 69% reported new or worsened respiratory symptoms while performing WTC work. Symptoms persisted to the time of examination in 59% of these workers. Among those who had been asymptomatic before September 11, 61% developed respiratory symptoms while performing WTC work. Twenty-eight percent had abnormal spirometry; forced vital capacity (FVC) was low in 21%; and obstruction was present in 5%. Among nonsmokers, 27% had abnormal spirometry compared with 13% in the general U.S. population. Prevalence of low FVC among nonsmokers was 5-fold greater than in the U.S. population (20% vs. 4%). Respiratory symptoms and spirometry abnormalities were significantly associated with early arrival at the site.CONCLUSION: WTC responders had exposure-related increases in respiratory symptoms and pulmonary function test abnormalities that persisted up to 2.5 years after the attacks. Long-term medical monitoring is required to track persistence of these abnormalities and identify late effects, including possible malignancies. Lessons learned should guide future responses to civil disasters.