Elevated Peripheral Eosinophils Are Associated with New-onset and Persistent Wheeze and Airflow Obstruction in World Trade Center-exposed Individuals

Overview

Journal J Asthma

Publisher Informa Healthcare

Specialties Allergy & Immunology
Pulmonary Medicine

Date 2012 Dec 12

PMID 23227974

Citations 20

Authors

Angeliki Kazeros

Ming-Tyh Maa

Paru Patrawalla

Mengling Liu

Yongzhao Shao

Meng Qian

Meredith Turetz

Sam Parsia

Caralee Caplan-Shaw

Kenneth I Berger

Roberta Goldring

Linda Rogers

Joan Reibman

Affiliations

Soon will be listed here.

Abstract

Background: Exposure to World Trade Center (WTC) dust and fumes is associated with the onset of asthma-like respiratory symptoms in rescue and recovery workers and exposed community members. Eosinophilic inflammation with increased lung and peripheral eosinophils has been described in subpopulations with asthma. We hypothesized that persistent asthma-like symptoms in WTC-exposed individuals would be associated with systemic inflammation characterized by peripheral eosinophils.

Methods: The WTC Environmental Health Center (WTC EHC) is a treatment program for local residents, local workers, and cleanup workers with presumed WTC-related symptoms. Patients undergo a standardized evaluation including questionnaires and complete blood count. Between September 2005 and March 2009, 2462 individuals enrolled in the program and were available for analysis. Individuals with preexisting respiratory symptoms or lung disease diagnoses prior to September 2001 and current or significant tobacco use were excluded,

Results: One thousand five hundred and seventeen individuals met the inclusion criteria. Patients had a mean age of 47 years, were mostly female (51%), and had a diverse race/ethnicity. Respiratory symptoms that developed after WTC dust/fume exposure and remained persistent included dyspnea on exertion (68%), cough (57%), chest tightness (47%), and wheeze (33%). A larger percentage of patients with wheeze had elevated peripheral eosinophils compared with those without wheeze (21% vs. 13%, p < .0001). Individuals with elevated peripheral eosinophils were more likely to have airflow obstruction on spirometry (16% vs. 7%, p = .0003).

Conclusion: Peripheral eosinophils were associated with wheeze and airflow obstruction in a diverse WTC-exposed population. These data suggest that eosinophils may participate in lung inflammation in this population with symptoms consistent with WTC-related asthma.

Citing Articles

Posttraumatic Stress Disorder Mediates the Association between Traumatic World Trade Center Dust Cloud Exposure and Ongoing Systemic Inflammation in Community Members.

Zhang Y, Rosen R, Reibman J, Shao Y Int J Environ Res Public Health. 2022; 19(14).

PMID: 35886474 PMC: 9322679. DOI: 10.3390/ijerph19148622.

Health effects following exposure to dust from the World Trade Center disaster: An update.

Mears M, Aslaner D, Barson C, Cohen M, Gorr M, Wold L Life Sci. 2021; 289:120147.

PMID: 34785191 PMC: 8791014. DOI: 10.1016/j.lfs.2021.120147.

Serum Th-2 cytokines and FEV decline in WTC-exposed firefighters: A 19-year longitudinal study.

Weiden M, Singh A, Goldfarb D, Putman B, Zeig-Owens R, Schwartz T Am J Ind Med. 2021; 64(10):845-852.

PMID: 34288008 PMC: 9290799. DOI: 10.1002/ajim.23276.

Lung function decline before and after treatment of World Trade Center associated obstructive airways disease with inhaled corticosteroids and long-acting beta agonists.

Goldfarb D, Putman B, Lahousse L, Zeig-Owens R, Vaeth B, Schwartz T Am J Ind Med. 2021; 64(10):853-860.

PMID: 34254700 PMC: 9292780. DOI: 10.1002/ajim.23272.

Lung Cancer Characteristics in the World Trade Center Environmental Health Center.

Durmus N, Pehlivan S, Zhang Y, Shao Y, Arslan A, Corona R Int J Environ Res Public Health. 2021; 18(5).

PMID: 33800009 PMC: 7967411. DOI: 10.3390/ijerph18052689.

References

Gautrin D, Boulet L, Boutet M, Dugas M, Bherer L, Larcheveque J . Is reactive airways dysfunction syndrome a variant of occupational asthma?. J Allergy Clin Immunol. 1994; 93(1 Pt 1):12-22. DOI: 10.1016/0091-6749(94)90228-3. View

Meijer R, Postma D, Kauffman H, Arends L, Koeter G, Kerstjens H . Accuracy of eosinophils and eosinophil cationic protein to predict steroid improvement in asthma. Clin Exp Allergy. 2002; 32(7):1096-103. DOI: 10.1046/j.1365-2222.2002.01412.x. View

Takeda N, Maghni K, Daigle S, LArcheveque J, Castellanos L, Al-Ramli W . Long-term pathologic consequences of acute irritant-induced asthma. J Allergy Clin Immunol. 2009; 124(5):975-81.e1. DOI: 10.1016/j.jaci.2009.08.008. View

Petsky H, Kynaston J, Turner C, Li A, Cates C, Lasserson T . Tailored interventions based on sputum eosinophils versus clinical symptoms for asthma in children and adults. Cochrane Database Syst Rev. 2007; (2):CD005603. DOI: 10.1002/14651858.CD005603.pub2. View

Brackbill R, Thorpe L, DiGrande L, Perrin M, Sapp 2nd J, Wu D . Surveillance for World Trade Center disaster health effects among survivors of collapsed and damaged buildings. MMWR Surveill Summ. 2006; 55(2):1-18. View

Prezant D, Weiden M, Banauch G, McGuinness G, Rom W, Aldrich T . Cough and bronchial responsiveness in firefighters at the World Trade Center site. N Engl J Med. 2002; 347(11):806-15. DOI: 10.1056/NEJMoa021300. View

Brooks S . Occupational asthma. Toxicol Lett. 1995; 82-83:39-45. DOI: 10.1016/0378-4274(95)03466-8. View

Friedman S, Maslow C, Reibman J, Pillai P, Goldring R, Farfel M . Case-control study of lung function in World Trade Center Health Registry area residents and workers. Am J Respir Crit Care Med. 2011; 184(5):582-9. DOI: 10.1164/rccm.201011-1909OC. View

Brooks S, Weiss M, Bernstein I . Reactive airways dysfunction syndrome (RADS). Persistent asthma syndrome after high level irritant exposures. Chest. 1985; 88(3):376-84. DOI: 10.1378/chest.88.3.376. View

10.

Ward C, Pais M, Bish R, Reid D, Feltis B, Johns D . Airway inflammation, basement membrane thickening and bronchial hyperresponsiveness in asthma. Thorax. 2002; 57(4):309-16. PMC: 1746305. DOI: 10.1136/thorax.57.4.309. View

11.

Lin S, Reibman J, Bowers J, Hwang S, Hoerning A, Gomez M . Upper respiratory symptoms and other health effects among residents living near the World Trade Center site after September 11, 2001. Am J Epidemiol. 2005; 162(6):499-507. DOI: 10.1093/aje/kwi233. View

12.

Gibson P, Saltos N, Borgas T . Airway mast cells and eosinophils correlate with clinical severity and airway hyperresponsiveness in corticosteroid-treated asthma. J Allergy Clin Immunol. 2000; 105(4):752-9. DOI: 10.1067/mai.2000.105319. View

13.

Brooks S, Weiss M, Bernstein I . Reactive airways dysfunction syndrome. Case reports of persistent airways hyperreactivity following high-level irritant exposures. J Occup Med. 1985; 27(7):473-6. View

14.

Lam S, Kennedy S, Frew A . Persistent asthma after repeated exposure to high concentrations of gases in pulpmills. Am J Respir Crit Care Med. 1994; 149(6):1676-80. DOI: 10.1164/ajrccm.149.6.8004329. View

15.

Buyantseva L, Tulchinsky M, Kapalka G, Chinchilli V, Qian Z, Gillio R . Evolution of lower respiratory symptoms in New York police officers after 9/11: a prospective longitudinal study. J Occup Environ Med. 2007; 49(3):310-7. DOI: 10.1097/JOM.0b013e318032256e. View

16.

Bradding P, Green R . Subclinical phenotypes of asthma. Curr Opin Allergy Clin Immunol. 2009; 10(1):54-9. DOI: 10.1097/ACI.0b013e32833489a9. View

17.

Lemiere C, Efthimiadis A, Hargreave F . Occupational eosinophilic bronchitis without asthma: an unknown occupational airway disease. J Allergy Clin Immunol. 1998; 100(6 Pt 1):852-3. DOI: 10.1016/s0091-6749(97)70286-0. View

18.

Mauer M, Cummings K, Hoen R . Long-term respiratory symptoms in World Trade Center responders. Occup Med (Lond). 2009; 60(2):145-51. DOI: 10.1093/occmed/kqp176. View

19.

Djukanovic R, Wilson J, Britten K, Wilson S, Walls A, Roche W . Effect of an inhaled corticosteroid on airway inflammation and symptoms in asthma. Am Rev Respir Dis. 1992; 145(3):669-74. DOI: 10.1164/ajrccm/145.3.669. View

20.

Brackbill R, Hadler J, DiGrande L, Ekenga C, Farfel M, Friedman S . Asthma and posttraumatic stress symptoms 5 to 6 years following exposure to the World Trade Center terrorist attack. JAMA. 2009; 302(5):502-16. DOI: 10.1001/jama.2009.1121. View