Chronic Rhinosinusitis Is an Independent Risk Factor for OSA in World Trade Center Responders
Open accessAbstract
BACKGROUND: Many respiratory conditions have been attributed to toxic dust and fume exposure in World Trade Center (WTC) rescue and recovery workers, who frequently report symptoms of OSA. We examined the prevalence of new‐onset OSA and tested if the prevalence and severity of OSA are related to the presence of chronic rhinosinusitis (CRS). METHODS: A total of 601 subjects (83% men; age, 33‐87 years; BMI, 29.9 ± 5.5 kg/m2) enrolled in the WTC Health Program, excluding those with significant pre‐September 11, 2001, snoring or prior CRS, underwent two nights of home sleep testing. OSA was defined as Apnea Hypopnea Index 4% ≥ 5 events/h or respiratory disturbance index of ≥ 15 events/h. CRS was assessed using nasal symptom questionnaires. RESULTS: The prevalence of OSA was 75% (25% no OSA, 46% mild OSA, 19% moderate OSA, and 10% severe OSA), and the prevalence of CRS was 43.5%. Compared with no CRS, new and worsening CRS was a significant risk factor for OSA with an OR of 1.80 (95% CI, 1.18‐2.73; P = .006) unadjusted and 1.76 (95% CI, 1.08‐2.88; P = .02) after adjustment for age, BMI, sex, gastroesophageal reflux disorder, and alcohol use. CONCLUSIONS: The high prevalence of OSA in WTC responders was not explained fully by obesity and sex. Possible mechanisms for the elevated risk of OSA in subjects with CRS include increased upper airway inflammation and/or elevated nasal/upper airway resistance, but these need confirmation.
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Among World Trade Center responders, chronic rhinosinusitis independently predicts obstructive sleep apnea.
“Among World Trade Center responders, CRS was an independent risk factor for OSA.917”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [917]
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- Authors
- Sunderram, J., Weintraub, M., Black, K., Alimokhtari, S., Twumasi, A., Sanders, H., Udasin, I., Harrison, D., Chitkara, N., de la Hoz, R. E., Lu, S.-E., Rapoport, D. M., & Ayappa, I.
- Affiliations
- Rutgers, The State University of New Jersey (US)
- Environmental and Occupational Health Sciences Institute (US)
- Icahn School of Medicine at Mount Sinai (US)
- New York University (US)
- Rutgers Health (US)
- Corresponding author
- Sunderram, Jag
- ORCID
- Venue
- Chest
- Publisher
- Elsevier BV
- Published
- 2019-02
- Volume
- 155
- Issue
- 2
- Pages
- 375-383
- ISSN
- 0012-3692 (ISSN-L)
- PMC
- PMC6688979
- OpenAlex
- W2898507381
- Semantic Scholar
- 76b120610352151f50372bb4e2b561ab951d90ed
- Cited by
- 38
- References
- 34
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 8 · 2023: 5 · 2022: 5 · 2021: 5 · 2020: 2 · 2019: 1
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- CHEST Journal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centers for Disease Control and Prevention (U10OH008232, 200-2011-39385, U01OH010415, 200-2011-39384)
- Canadian Dairy Commission
- National Institute for Occupational Safety and Health
- National Institutes of Health (HL109156)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Keywords
- chronic rhinosinusitis, obstructive sleep apnea, World Trade Center responders, September 11 attacks, occupational respiratory disease, OSA risk factors, upper airway inflammation, nasal obstruction, OSA prevalence
- MeSH terms
- Adult, Aged, Aged, 80 and over, Chronic Disease, Female, Humans, Male, Middle Aged, New York City, Occupational Diseases, Rhinitis, Risk Factors, Sinusitis, Prevalence, Occupational Exposure, Sleep Apnea, Obstructive, September 11 Terrorist Attacks, Emergency Responders
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