Complex WTC Exposures Impacting Persistent Large and Small Airflow Limitation and Vulnerable Subgroups in the WTC Survivor Population

项目摘要 今天，在9·11恐怖袭击20多年后的今天，许多暴露的社区成员继续 有持续的下呼吸道症状，并有指示的大和/或小气道功能异常 通过测量气流的肺活量和/或测量呼吸道的异质性。先前的研究和 知识一直集中在世界贸易中心(WTC)暴露对健康的平均影响 然而，肺功能谱或离散的肺功能模式，对重症患者的系统研究 该病的病谱有限。支气管扩张剂(BD)后的测量可确定持续性肺损伤 因为残留气流受限会导致严重的发病率和生活质量下降，因此是重要的 临床相关参数的研究。此外，研究空气污染对公众健康亦有重要意义。 灾难对健康的不同影响以及各亚组在医疗保健和福祉方面的差异。在……里面 在这个项目中，我们建议解决与WTC呼吸系统疾病相关的重要科学问题 幸存者群体和弱势群体，通过以下目标：目标1：评价 BD术后气道功能横断面测量的极端分位数，包括大的和小的 呼吸道指标，以及它们与WTC暴露和并存的关系。目标2：纵向引导 分位数分析调查WTC暴露和其他风险因素作为决定因素的轨迹 BD后大、小气道指标的极端分位数。目标3：确定和评估易受攻击的群体 对WTC暴露表现出不同易感性的亚组。工程完成后，建议的 该项目将扩大我们对与9/11有关的严重呼吸系统疾病的健康影响的了解 恐怖袭击，帮助应对身心健康并存的复杂相互作用，并适用于 灾难事件管理的经验教训。

Project Abstract Today, more than 20 years after the 9/11 terrorist attacks, many exposed community members continue to have persistent lower airway symptoms with functional abnormalities in large and/or small airways as indicated by spirometry measures of airflow and/or oscillometry measures of airway heterogeneity. Prior studies and knowledges have been focused on the health effects of World Trade Center (WTC) exposures on the average lung function profiles or discrete lung function patterns, however, systematic investigations on the severe spectrum of the disease are limited. Post-bronchodilator (BD) measurements may identify persistent lung injury as residual airflow limitation with significant morbidity and reduced quality of life, and thus are important and clinically relevant parameters to investigate. Moreover, it is of key public health importance to study the heterogeneous health impacts of the disaster and disparities in healthcare and wellbeing within subgroups. In this project, we propose to address the important scientific questions related to respiratory disease in WTC Survivor population and within vulnerable subgroups, through the following aims: Aim 1: Evaluate the extreme quantiles of cross-sectional measurements of post-BD airway function, including large and small airway metrics, and their association with WTC exposures and comorbidities. Aim 2: Conduct longitudinal quantile analysis to investigate WTC exposures and other risk factors as determinants of the trajectory of extreme quantiles of post-BD large and small airway metrics. Aim 3: Identify and evaluate vulnerable subgroups who show heterogeneous susceptibilities to WTC exposures. Upon its completion, the proposed project will expand our knowledge about health effects on severe respiratory diseases related to the 9/11 terrorist attacks, help to answer complex interplays of physical and mental health comorbidities, and apply lessons to the management of disaster events.