Obstructive sleep apnea and World Trade Center exposure

Area of Science:

• Occupational Health
• Sleep Medicine
• Environmental Health

Background:

• World Trade Center (WTC) exposure has been linked to various health issues in rescue and recovery workers.
• Obstructive sleep apnea (OSA) is a common sleep disorder with significant health implications.
• Gastroesophageal reflux disease (GERD) and rhinosinusitis are prevalent comorbidities in WTC-exposed populations.

Purpose of the Study:

• To determine the prevalence of polysomnogram-confirmed obstructive sleep apnea (OSA) among at-risk WTC-exposed workers.
• To investigate the association between WTC exposure, GERD, rhinosinusitis, and the presence and severity of OSA.

Main Methods:

• A cohort of 636 male WTC-exposed rescue/recovery workers underwent polysomnography between 2010 and 2012.
• Obstructive sleep apnea was categorized as mild, moderate, or severe based on polysomnography results.
• Nominal polytomous logistic regression was employed to analyze associations between WTC exposure, GERD, rhinosinusitis, and OSA severity.

Main Results:

• Eighty-one percent of the studied workers were diagnosed with OSA.
• Severe OSA showed significant associations with WTC exposure on September 11, 2001 (OR, 1.91).
• Severe OSA was also associated with physician-diagnosed GERD (OR, 2.75) and comorbid GERD/rhinosinusitis (OR, 2.31).

Conclusions:

• Significant associations exist between severe OSA and WTC exposure, GERD, and rhinosinusitis in this population.
• Clinical assessment, including polysomnography, is advised for WTC-exposed individuals with risk factors for OSA, particularly those with GERD or rhinosinusitis.
• These findings highlight the importance of screening for sleep-disordered breathing in WTC-exposed populations with specific comorbidities.