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Open AccessArticle

9/11 Residential Exposures: The Impact of World Trade Center Dust on Respiratory Outcomes of Lower Manhattan Residents

Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registries, 4770 Buford Highway NE, Mail Stop F-58, Atlanta, GA 30341, USA
Center for the Advancement of Value in Musculoskeletal Care, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA
Department of Health and Mental Hygiene, World Trade Center Health Registry, 125 Worth St, New York, NY 10013, USA
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(5), 798;
Received: 4 February 2019 / Revised: 25 February 2019 / Accepted: 28 February 2019 / Published: 5 March 2019
(This article belongs to the Special Issue Long-Term Health Effects of the 9/11 Disaster)
Thousands of lower Manhattan residents sustained damage to their homes following the collapse of the Twin Towers on 11 September 2001. Respiratory outcomes have been reported in this population. We sought to describe patterns of home damage and cleaning practices in lower Manhattan and their impacts on respiratory outcomes among World Trade Center Health Registry (WTCHR) respondents. Data were derived from WTCHR Wave 1 (W1) (9/2003–11/2004) and Wave 2 (W2) (11/2006–12/2007) surveys. Outcomes of interest were respiratory symptoms (shortness of breath (SoB), wheezing, persistent chronic cough, upper respiratory symptoms (URS)) first occurring or worsening after 9/11 W1 and still present at W2 and respiratory diseases (asthma and chronic obstructive pulmonary disease (COPD)) first diagnosed after 9/11 W1 and present at W2. We performed descriptive statistics, multivariate logistic regression and geospatial analyses, controlling for demographics and other exposure variables. A total of 6447 residents were included. Mean age on 9/11 was 45.1 years (±15.1 years), 42% were male, 45% had ever smoked cigarettes, and 44% reported some or intense dust cloud exposure on 9/11. The presence of debris was associated with chronic cough (adjusted OR (aOR) = 1.56, CI: 1.12–2.17), and upper respiratory symptoms (aOR = 1.56, CI: 1.24–1.95). A heavy coating of dust was associated with increased shortness of breath (aOR = 1.65, CI: 1.24–2.18), wheezing (aOR = 1.43, CI: 1.03–1.97), and chronic cough (aOR = 1.59, CI: 1.09–2.28). Dusting or sweeping without water was the cleaning behavior associated with the largest number of respiratory outcomes, such as shortness of breath, wheezing, and URS. Lower Manhattan residents who suffered home damage following the 9/11 attacks were more likely to report respiratory symptoms and diseases compared to those who did not report home damage. View Full-Text
Keywords: WTC attack; respiratory symptoms; lower Manhattan residents; cleaning practices WTC attack; respiratory symptoms; lower Manhattan residents; cleaning practices
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Antao, V.C.; Pallos, L.L.; Graham, S.L.; Shim, Y.K.; Sapp, J.H.; Lewis, B.; Bullard, S.; Alper, H.E.; Cone, J.E.; Farfel, M.R.; Brackbill, R.M. 9/11 Residential Exposures: The Impact of World Trade Center Dust on Respiratory Outcomes of Lower Manhattan Residents. Int. J. Environ. Res. Public Health 2019, 16, 798.

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