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

描述（由申请人提供）：本提案的总体目标是确定WTC工作人员和志愿者中肺部疾病的早期表现，并调查其风险因素。为了实现这一目标，我们将对2003年1月以来在西奈山医疗中心对这些工人进行的所有胸部CT扫描进行标准化和计算机辅助读数，以系统的方式评估结果，评估结果与临床、功能和暴露指标的相关性，并制定一项对该队列进行持续放射学监测的方案。为了验证胸部CT扫描的结果 从2002-2011年获得的数据（1710名工作人员中的2870项研究），我们将前瞻性地对一组800名参与者进行配对的吸气-呼气、低剂量、门控CT扫描和肺活量测定，以确定肺癌、肺气肿、纤维化和间质性肺病、小气道疾病（包括空气潴留）的患病率。我们将选择没有临床适应症的个体来检验一些次要假设，更新先前的研究，并允许对回顾性病例进行病例对照研究（其中大多数患者有呼吸道症状、肺功能异常或胸部放射学异常，或其任何组合）。

DESCRIPTION (provided by applicant): The overall goals of this proposal are to identify the early manifestations of lung disease among the WTC workers and volunteers, as well as investigate their risk factors. To accomplish this, we will perform standardized and computer-assisted readings of all the chest CT scans performed at Mount Sinai Medical Center on these workers since January 2003, assess the findings in a systematic way, evaluate the correlation of findings with clinical, functional, and exposure indicators, and develop a protocol for continued radiological surveillance of this cohort. In order to validate the findings from the chest CT scans obtained from 2002-2011 (2870 studies in 1710 workers), we will prospectively perform paired inspiratory-expiratory, low- dose, gated CT scans and spirometry on a set of 800 participants over the 4 years of the grant, to determine the prevalence of lung cancer, emphysema, fibrotic and Interstitial lung disease, small airways disease (including air trapping). We will select individuals for whom there would not be a clinical indication to test some of the secondary hypotheses, to update a previous study, and to allow case-control studies with the retrospective cases (most of whom had respiratory symptoms, spirometric abnormalities, or chest radiographic abnormalities, or any combination thereof).