Pulmonary Diseases in WTC Workers: Symptoms, Function, and Chest CT Correlates

世贸中心工作人员的肺部疾病：症状、功能和胸部 CT 相关性

• 批准号: 10678696
• 负责人: Rafael E. de la Hoz
• 金额: $ 59.92万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10678696
• 关键词: Pulmonary; Diseases; WTC; Workers; Symptoms

Project Summary Our long-term goal has been to characterize the heterogeneous group of chronic lower airway diseases (LAD) observed in World Trade Center (WTC) workers and volunteers, uncover their risk factors and comorbidities, identify subgroups with adverse and favorable lung function trajectories and outcomes, and develop and deploy novel imaging approaches to the investigation of the lung injury underlying them. Such goal will in turn translate into better understanding of disease pathophysiology, more targeted, personalized, and perhaps disease modifying treatment approaches, and improved surveillance and prevention strategies. Our previous studies established valid clinical diagnoses and have demonstrated markedly diverging longitudinal lung function trajectories in the largest and most diverse WTC occupational cohort. Besides our expertise with longitudinal lung function analyses, we were uniquely able to demonstrate associated quantitative chest computer tomography (QCT) metrics that have helped validate and characterize the disease processes that have been associated with WTC occupational exposures. QCT has revolutionized respiratory research, and has contributed important and novel information on interstitial, proximal and distal airway, and vascular changes that underlie the process of inflammatory remodeling and disease progression. Our observations in this cohort have also identified a subgroup who has experienced unexpected and significant lung function gain in adult life, suggesting a process of resolution in need of improved understanding. Our studies have been on the forefront of occupational respiratory research. We propose three specific aims to deploy novel QCT and spirometric markers to investigate early interstitial and airway injury and remodeling in subjects who have experienced accelerated lung function decline or developed chronic obstructive pulmonary disease while on longitudinal and clinical surveillance.

项目摘要 我们的长期目标是表征异质的慢性下气道 在世界贸易中心（WTC）工人和志愿者中观察到的疾病（LAD），发现其风险因素和 合并症，确定具有不良和有利肺功能轨迹和结果的亚组，以及 开发和部署新颖的成像方法，以调查其肺部损伤。这样的 目标反过来将转化为对疾病病理生理学的更好理解，更有针对性， 个性化的，也许可以改变治疗方法，并改善监视和 预防策略。 我们以前的研究建立了有效的临床诊断，并证明了显着分歧 纵向肺功能轨迹是最大，最多样化的WTC职业队列。除了我们 通过纵向肺功能分析的专业知识，我们独特地证明了相关的 定量胸部计算机断层扫描（QCT）指标，这些指标有助于验证和表征 与WTC职业暴露有关的疾病过程。 QCT发生了革新 呼吸研究，并为间隙，近端和 远端气道和血管变化是炎症重塑和疾病过程的基础 进展。我们在该队列中的观察也确定了经历过的子组 成人生活中意外且明显的肺功能增长，这表明需要解决的过程 改善理解。我们的研究一直处于职业呼吸研究的最前沿。 我们提出了三个特定的目标，以部署新型QCT和肺活量标记以提早研究 在经历了加速肺功能的受试者中的间隙和气道损伤和重塑 在纵向和临床监测时，下降或发展了慢性阻塞性肺部疾病。

项目成果

World Trade Center Health Program best practices for diagnosing and treating chronic rhinosinusitis.

世界贸易中心健康计划诊断和治疗慢性鼻窦炎的最佳实践。

• DOI: 10.1080/19338244.2023.2169655
• 发表时间: 2023
• 期刊: Archives of environmental & occupational health
• 影响因子: 1.8
• 作者: delaHoz,RafaelE;Shohet,MichaelR
• 通讯作者: Shohet,MichaelR

Association of low FVC spirometric pattern with WTC occupational exposures.

• DOI: 10.1016/j.rmed.2020.106058
• 发表时间: 2020-08
• 期刊: Respiratory medicine
• 影响因子: 4.3
• 作者: de la Hoz RE;Shapiro M;Nolan A;Celedón JC;Szeinuk J;Lucchini RG
• 通讯作者: Lucchini RG

Self-management behaviors in World Trade Center rescue and recovery workers with asthma.

世贸中心哮喘救援人员的自我管理行为。

• DOI: 10.1080/02770903.2018.1462377
• 发表时间: 2019-04
• 期刊: The Journal of asthma : official journal of the Association for the Care of Asthma
• 作者: Rojano B;West E;Goodman E;Weiss JJ;de la Hoz RE;Crane M;Crowley L;Harrison D;Markowitz S;Wisnivesky JP
• 通讯作者: Wisnivesky JP

World Trade Center Health Program best practices for the diagnosis and treatment of fibrosing interstitial lung diseases.

世界贸易中心健康计划诊断和治疗纤维化间质性肺疾病的最佳实践。

• DOI: 10.1080/19338244.2023.2166007
• 发表时间: 2023
• 期刊: Archives of environmental & occupational health
• 影响因子: 1.8
• 作者: delaHoz,RafaelE;Johannson,KerriA
• 通讯作者: Johannson,KerriA

Chest CT scan findings in World Trade Center workers.

• DOI: 10.1080/19338244.2018.1452712
• 发表时间: 2019
• 期刊: Archives of environmental & occupational health
• 影响因子: 1.8
• 作者: de la Hoz RE;Weber J;Xu D;Doucette JT;Liu X;Carson DA;Celedón JC
• 通讯作者: Celedón JC