World Trade Center Workers Twice as Likely to Have Asthma

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This study is different in that it measures not new diagnoses, but actual asthma attacks.

One drawback to the new study is that the group of patients who were followed wasn't static. Because people can drop in and out of the monitoring program, those who came for their initial evaluation years after the attacks may have been more likely to be among those whose health wasn't improving.

"The question is, are the people who stay in and keep being seen the sicker ones while the healthier ones drop out? If so, that may explain the reason for the rise in asthma over time," Thorpe said.

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Furthermore, she added, it would be interesting to know the mental state of those who continue to experiencing asthma attacks. Coughing and wheezing due to asthma could bring back memories of the horror, triggering emotional stress that in turn could make asthma attacks worse.

"The physical health conditions and the mental health conditions are highly overlapping," Thorpe said.

Dr. Norman H. Edelman, chief medical officer for the American Lung Association, said it was important to continue to follow responders and their asthma rates.

Typically, asthma comes on quickly after the lungs are exposed to the toxic pollutants or caustic dust that resulted from the blasts, then declines as the lungs heal.

"Ordinarily, when people get exposed to toxic stuff, you get an immediate reaction. We don't expect a delayed effect," Edelman said. "We saw 9/11 responders who got sick pretty quickly. Some got better. Some did not. What we haven't seen are people who present with asthma two or three years later related to 9/11."

Diseases of the spongy part of the lungs, such as mesotheliomia from asbestos exposure, may take years or decades to develop. But asthma is a disease of the airways, which is typically apparent right away.

Researchers said there was no evidence that asthma rates continued to rise after 2005.

"However, the majority of those who developed asthma during or after their World Trade Center exposures have continued to have asthma attacks many years later," Enright said. "Their asthma did not spontaneously resolve within a few months after their WTC exposure ceased."

More information

The American Lung Association has more on asthma.

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