Michelle S Glaser1, Neomi Shah, Mayris P Webber, Rachel Zeig-Owens, Nadia Jaber, David W Appel, Charles B Hall, Jessica Weakley, Hillel W Cohen, Lawrence Shulman, Kerry Kelly, David Prezant. 1. From the Department of Medicine (Ms Glaser, Dr Shah, Ms Zeig-Owens, Dr Appel, and Ms Weakley), Montefiore Medical Center, Bronx, NY; Bureau of Health Services (Ms Glaser, Ms Zeig-Owens, Ms Jaber, Ms Weakley, Dr Kelly, and Dr Prezant), Fire Department of the City of New York, Brooklyn, NY; Department of Epidemiology and Population Health (Drs Webber, Hall, and Cohen), Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY; Department of Pulmonary Medicine (Drs Shah, Appel, and Prezant), Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY; and Pulmonary, Critical Care, and Sleep Medicine Department (Dr Shulman), ProHEALTH Care Associates, LLP, Lake Success, NY.
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.
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.
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