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Int J Environ Res Public Health. 2019 May 16;16(10). pii: E1727. doi: 10.3390/ijerph16101727.

Post-9/11 Peripheral Neuropathy Symptoms among World Trade Center-Exposed Firefighters and Emergency Medical Service Workers.

Author information

1
Fire Department of the City of New York, Bureau of Health Services, 9 Metrotech Center, Brooklyn, NY 11201, USA. Hilary.Colbeth@fdny.nyc.gov.
2
Department of Medicine, Pulmonology Division, Montefiore Medical Center, Bronx, NY 10467, USA. Hilary.Colbeth@fdny.nyc.gov.
3
Fire Department of the City of New York, Bureau of Health Services, 9 Metrotech Center, Brooklyn, NY 11201, USA. rachel.zeig-owens@fdny.nyc.gov.
4
Department of Medicine, Pulmonology Division, Montefiore Medical Center, Bronx, NY 10467, USA. rachel.zeig-owens@fdny.nyc.gov.
5
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA. rachel.zeig-owens@fdny.nyc.gov.
6
Fire Department of the City of New York, Bureau of Health Services, 9 Metrotech Center, Brooklyn, NY 11201, USA. Mayris.Webber@fdny.nyc.gov.
7
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA. Mayris.Webber@fdny.nyc.gov.
8
Department of Epidemiology and Population Health, Montefiore Medical Center, Department of Epidemiology and Population Health, Bronx, New York, NY 10467, USA. Mayris.Webber@fdny.nyc.gov.
9
Fire Department of the City of New York, Bureau of Health Services, 9 Metrotech Center, Brooklyn, NY 11201, USA. David.Goldfarb@fdny.nyc.gov.
10
Department of Medicine, Pulmonology Division, Montefiore Medical Center, Bronx, NY 10467, USA. David.Goldfarb@fdny.nyc.gov.
11
Fire Department of the City of New York, Bureau of Health Services, 9 Metrotech Center, Brooklyn, NY 11201, USA. Theresa.Schwartz@fdny.nyc.gov.
12
Department of Medicine, Pulmonology Division, Montefiore Medical Center, Bronx, NY 10467, USA. Theresa.Schwartz@fdny.nyc.gov.
13
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA. charles.hall@einstein.yu.edu.
14
Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 10461, USA. charles.hall@einstein.yu.edu.
15
Fire Department of the City of New York, Bureau of Health Services, 9 Metrotech Center, Brooklyn, NY 11201, USA. David.Prezant@fdny.nyc.gov.
16
Department of Medicine, Pulmonology Division, Albert Einstein College of Medicine, Bronx, NY 10461, USA. David.Prezant@fdny.nyc.gov.

Abstract

Peripheral neuropathy can result from numerous conditions including metabolic disorders, inflammatory disease, or exposure to environmental or biological toxins. We analyzed questionnaire data from 9239 Fire Department of the City of New York (FDNY) World Trade Center (WTC)-exposed firefighters and emergency medical service workers (EMS) to evaluate the association between work at the WTC site and subsequent peripheral neuropathy symptoms using the validated Diabetic Neuropathy Symptom (DNS) score. We grouped the population into an "Indicated" group with conditions known to be associated with paresthesia (N = 2059) and a "Non-Indicated" group without conditions known to be associated (N = 7180). The level of WTC exposure was categorized by time of arrival to the WTC. Overall, 25% of workers aged 40 and older reported peripheral neuropathy symptoms: 30.6% in the Indicated and 23.8% in the Non-Indicated groups, respectively. Multivariable logistic models performed on the Non-Indicated group, and on the Non-Indicated in comparison with non-WTC exposed National Health and Nutrition Examination Survey (NHANES), found that the highest level of WTC-exposure was significantly associated with DNS positive outcomes, after controlling for potential confounders. In conclusion, this study suggests that symptoms of peripheral neuropathy and paresthesias are common and are associated with WTC-exposure intensity.

KEYWORDS:

World Trade Center; occupational exposure; peripheral neuropathy; prevalence; rescue/recovery workers

PMID:
31100846
DOI:
10.3390/ijerph16101727
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