{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T23:08:42Z","timestamp":1769123322571,"version":"3.49.0"},"reference-count":39,"publisher":"BMJ","issue":"11","funder":[{"name":"WTC Health Program General Responder Data Center at Mount Sinai","award":["75D30122C15187"],"award-info":[{"award-number":["75D30122C15187"]}]},{"name":"Clinical and Translational Science Awards","award":["UL1TR004419"],"award-info":[{"award-number":["UL1TR004419"]}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"crossref","award":["TL1TR004420"],"award-info":[{"award-number":["TL1TR004420"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2025,11,8]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We assessed upper-aero digestive tract disorders in World Trade Center (WTC) patients seen in the Otolaryngology \u2013 Head and Neck Surgery Department of a large New York City hospital system and the association between WTC exposure and sinonasal surgery for chronic rhinosinusitis (CRS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective review of medical records of all WTC patients seen between July 2002 and December 2023. Primary exposure was measured by arrival date and exposure length to the disaster site. Primary outcomes were upper-aero digestive tract disorders and sinonasal surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>3118 WTC patients were reviewed. Of these, 1162 (37.3%) had CRS. CRS patients were more likely female (p=0.03) and had higher proportion of comorbid obstructive sleep apnoea (OSA) (p&lt;0.0001), allergic rhinitis (p&lt;0.0001) and gastro-oesophageal reflux disease (p&lt;0.0001). 355 (31.0%) CRS patients underwent sinonasal surgery. Relative to the medically managed patients, surgical CRS patients were younger at time of 9\/11 (p=0.006), had a higher proportion of comorbid OSA (p=0.02) and earlier exposure (arrival date 11 September\u201313 September prior to rainfall) (p=0.001). CRS patients with early exposure demonstrated significantly greater odds of undergoing sinonasal surgery compared with those with late exposure (adjusted OR 1.61; 95% CI 1.2 to 2.3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Earlier arrival at WTC site increased the risk of needing surgery for responders with CRS. Higher levels of irritant exposure prior to rainfall on 14 September 2001 may have caused significant epithelial injury to the sinonasal mucosa of WTC patients, leading to an elevated prevalence of CRS requiring surgical intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/oemed-2025-110133","type":"journal-article","created":{"date-parts":[[2025,11,30]],"date-time":"2025-11-30T18:20:27Z","timestamp":1764526827000},"page":"534-539","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of World Trade Center dust exposure on upper-aero digestive tract disorders and sinonasal surgery: findings from patients seen in the Department of Otolaryngology \u2013 Head and Neck Surgery at Mount Sinai Hospital"],"prefix":"10.1136","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2406-9865","authenticated-orcid":false,"given":"Horacio M","family":"Romero Castillo","sequence":"first","affiliation":[{"name":"Icahn School of Medicine, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9312-7899","authenticated-orcid":false,"given":"Alicia","family":"Yang","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalena","family":"Liu","sequence":"additional","affiliation":[{"name":"CUNY School of Medicine at The City College of New York, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madeleine","family":"Schaberg","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathilda","family":"Monaghan","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0568-7388","authenticated-orcid":false,"given":"Maaike","family":"van Gerwen","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine, New York City, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,30]]},"reference":[{"key":"2026012122551545000_82.11.534.1","doi-asserted-by":"publisher","DOI":"10.1289\/EHP.9592"},{"key":"2026012122551545000_82.11.534.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.15.1811"},{"key":"2026012122551545000_82.11.534.3","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.6702"},{"key":"2026012122551545000_82.11.534.4","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.02110703"},{"key":"2026012122551545000_82.11.534.5","unstructured":"U.S. Environmental Protection Agency . EPA\u2019s response to the world trade center collapse: challenges, successes, and areas for improvement. report no. 2003-p-00012. U.S. Environmental Protection Agency; 2003."},{"key":"2026012122551545000_82.11.534.6","doi-asserted-by":"crossref","first-page":"s37","DOI":"10.1016\/S0140-6736(02)11814-9","article-title":"World Trade Center cough","volume":"360","author":"Chen","year":"2002","journal-title":"Lancet"},{"key":"2026012122551545000_82.11.534.7","doi-asserted-by":"crossref","unstructured":"Clark R . Environmental studies of the world trade center area after the september 11, 2001 attack. 2001. Available: https:\/\/pubs.usgs.gov\/of\/2001\/ofr-01-0429\/ [Accessed 15 May 2024].","DOI":"10.3133\/fs05002"},{"key":"2026012122551545000_82.11.534.8","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1289\/ehp.5930","article-title":"Chemical analysis of World Trade Center fine particulate matter for use in toxicologic assessment","volume":"111","author":"McGee","year":"2003","journal-title":"Environ Health Perspect"},{"key":"2026012122551545000_82.11.534.9","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1002\/ajim.22109","article-title":"Potential carcinogenic effects of world trade center dust after intratracheal instillation to Sprague-Dawley rats: first observation","volume":"56","author":"Soffritti","year":"2013","journal-title":"Am J Ind Med"},{"key":"2026012122551545000_82.11.534.10","doi-asserted-by":"publisher","DOI":"10.1097\/01.jom.0000111612.68916.d0"},{"key":"2026012122551545000_82.11.534.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021300"},{"key":"2026012122551545000_82.11.534.12","first-page":"807","article-title":"Physical health status of World Trade Center rescue and recovery workers and volunteers - New York City, July 2002-August 2004","volume":"53","year":"2002","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2026012122551545000_82.11.534.13","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.0800291"},{"key":"2026012122551545000_82.11.534.14","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-007-0240-x"},{"key":"2026012122551545000_82.11.534.15","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61180-X"},{"key":"2026012122551545000_82.11.534.16","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.chest.2018.10.015","article-title":"Chronic Rhinosinusitis Is an Independent Risk Factor for OSA in World Trade Center Responders","volume":"155","author":"Sunderram","year":"2019","journal-title":"Chest"},{"key":"2026012122551545000_82.11.534.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.06.726"},{"key":"2026012122551545000_82.11.534.18","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/S2213-2600(21)00457-4","article-title":"Endoscopic sinus surgery with medical therapy versus medical therapy for chronic rhinosinusitis with nasal polyps: a multicentre, randomised, controlled trial","volume":"10","author":"Lourijsen","year":"2022","journal-title":"Lancet Respir Med"},{"key":"2026012122551545000_82.11.534.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2010.07.014"},{"key":"2026012122551545000_82.11.534.20","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1513\/AnnalsATS.201511-742OC","article-title":"Blood Eosinophils and World Trade Center Exposure Predict Surgery in Chronic Rhinosinusitis. 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