Obstructive sleep apnea and World Trade Center exposure

J Occup Environ Med. 2014 Oct:56 Suppl 10:S30-4. doi: 10.1097/JOM.0000000000000283.

Abstract

Objectives: To describe the proportion of at-risk World Trade Center (WTC)-exposed rescue/recovery workers with polysomnogram-confirmed obstructive sleep apnea (OSA) and examine the relationship between WTC exposure, physician-diagnosed gastroesophageal reflux disease (GERD), and rhinosinusitis and OSA.

Methods: A total of 636 male participants completed polysomnography from September 24, 2010, to September 23, 2012. Obstructive sleep apnea was classified as mild, moderate, or severe. Associations were tested using nominal polytomous logistic regression.

Results: Eighty-one percent of workers were diagnosed with OSA. Using logistic regression models, severe OSA was associated with WTC exposure on September 11, 2001 (odds ratio, 1.91; 95% confidence interval, 1.15 to 3.17), GERD (odds ratio, 2.75; 95% confidence interval, 1.33 to 5.70), and comorbid GERD/rhinosinusitis (odds ratio, 2.31; 95% confidence interval, 1.22 to 4.40).

Conclusions: We found significant associations between severe OSA and WTC exposure, and with diseases prevalent in this population. Accordingly, we recommend clinical evaluation, including polysomnography, for patients with high WTC exposure, other OSA risk factors, and a physician diagnosis of GERD or comorbid GERD and rhinosinusitis.

MeSH terms

  • Adult
  • Comorbidity
  • Cross-Sectional Studies
  • Emergency Responders* / statistics & numerical data
  • Gastroesophageal Reflux / diagnosis
  • Gastroesophageal Reflux / epidemiology
  • Gastroesophageal Reflux / etiology
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • New York City
  • Occupational Exposure / adverse effects*
  • Polysomnography
  • Rescue Work*
  • September 11 Terrorist Attacks*
  • Sinusitis / diagnosis
  • Sinusitis / epidemiology
  • Sinusitis / etiology
  • Sleep Apnea, Obstructive / diagnosis
  • Sleep Apnea, Obstructive / epidemiology
  • Sleep Apnea, Obstructive / etiology*