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Peer-reviewedCC BY-NCERJ open research

Respiratory oscillometry findings in World Trade Center-exposed rescue/recovery workers

  • Krystal L Cleven1
  • Rachel Zeig-Owens1,2,3
  • David G Goldfarb1,2,3
  • Brandon M Vaeth1,2
  • Jack Galfund4
  • Michael D Weiden5
  • Kenneth I Berger6
  • David J Prezant1,2,3
6 affiliations
  1. 1Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
  2. 2The Bureau of Health Services and the FDNY World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY, USA.
  3. 3Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
  4. 4Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
  5. 5Pulmonary Medicine Division, Department of Medicine, New York University, New York, NY, USA.
  6. 6Sanofi, Morristown, NJ, USA.
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Abstract

Background

Persistent respiratory symptoms are common in Fire Department of the City of New York (FDNY) rescue/recovery workers following the World Trade Center (WTC) collapse on 11 September 2001 and some continue to experience symptoms despite normal spirometry without bronchodilator response. Respiratory oscillometry is a sensitive method for detecting small airways dysfunction and identifies abnormalities undetected by spirometry. This study evaluated whether respiratory oscillometry is associated with respiratory symptoms among workers with normal spirometry, and qualitatively assessed this association stratified by serum eosinophilia.Methods

We analysed a cohort of FDNY WTC-exposed rescue/recovery workers who completed same-day respiratory oscillometry, spirometry and symptom questionnaires. We included only those with normal spirometry without obstruction, defined as forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC) and FEV₁/FVC greater than the lower limit of normal and no bronchodilator response. Logistic regression estimated associations between oscillometry z-scores (as continuous variables in separate models) and symptom burden. Models were adjusted for age, race, WTC arrival time, smoking status and body mass index. Analyses were also stratified by eosinophilia status.Results

Resistance at 5 Hz (R5) was associated with persistently high symptom count (odds ratio (OR) 1.36, 95% CI 1.11-1.66) and high symptom severity (OR 1.32, 95% CI 1.05-1.67). Frequency dependence of resistance (the difference between resistance at 5 Hz and resistance at 20 Hz (R5-R20)) was also associated with persistently high symptom count (OR 1.31, 95% CI 1.11-1.56). Associations for R5 and R5-R20 were greatest in those with eosinophilia (≥300 cells·μL⁻¹).Conclusion

In symptomatic individuals with normal spirometry, oscillometry is sensitive for detecting airways dysfunction, supporting our hypothesis that persistent, severe symptoms are attributable to disease in the small airways. Larger associations with eosinophilia identify a phenotype that may inform early intervention and treatment.

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Cite

BibTeXRIS
BibTeX
@article{cleven2026respiratory,
  title = {{Respiratory oscillometry findings in World Trade Center-exposed rescue/recovery workers}},
  author = {Krystal L Cleven and Rachel Zeig-Owens and David G Goldfarb and Brandon M Vaeth and Jack Galfund and Michael D Weiden and Kenneth I Berger and David J Prezant},
  journal = {ERJ open research},
  year = {2026},
  month = nov,
  doi = {10.1183/23120541.00598-2026},
  url = {https://europepmc.org/article/PMC/PMC13725835},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Respiratory oscillometry findings in World Trade Center-exposed rescue/recovery workers
AU  - Krystal L Cleven
AU  - Rachel Zeig-Owens
AU  - David G Goldfarb
AU  - Brandon M Vaeth
AU  - Jack Galfund
AU  - Michael D Weiden
AU  - Kenneth I Berger
AU  - David J Prezant
PY  - 2026
DA  - 2026/11/01
JO  - ERJ open research
DO  - 10.1183/23120541.00598-2026
UR  - https://europepmc.org/article/PMC/PMC13725835
AB  - Background  Persistent respiratory symptoms are common in Fire Department of the City of New York (FDNY) rescue/recovery workers following the World Trade Center (WTC) collapse on 11 September 2001 and some continue to experience symptoms despite normal spirometry without bronchodilator response. Respiratory oscillometry is a sensitive method for detecting small airways dysfunction and identifies abnormalities undetected by spirometry. This study evaluated whether respiratory oscillometry is associated with respiratory symptoms among workers with normal spirometry, and qualitatively assessed this association stratified by serum eosinophilia.Methods  We analysed a cohort of FDNY WTC-exposed rescue/recovery workers who completed same-day respiratory oscillometry, spirometry and symptom questionnaires. We included only those with normal spirometry without obstruction, defined as forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC) and FEV₁/FVC greater than the lower limit of normal and no bronchodilator response. Logistic regression estimated associations between oscillometry z-scores (as continuous variables in separate models) and symptom burden. Models were adjusted for age, race, WTC arrival time, smoking status and body mass index. Analyses were also stratified by eosinophilia status.Results  Resistance at 5 Hz (R5) was associated with persistently high symptom count (odds ratio (OR) 1.36, 95% CI 1.11-1.66) and high symptom severity (OR 1.32, 95% CI 1.05-1.67). Frequency dependence of resistance (the difference between resistance at 5 Hz and resistance at 20 Hz (R5-R20)) was also associated with persistently high symptom count (OR 1.31, 95% CI 1.11-1.56). Associations for R5 and R5-R20 were greatest in those with eosinophilia (≥300 cells·μL⁻¹).Conclusion  In symptomatic individuals with normal spirometry, oscillometry is sensitive for detecting airways dysfunction, supporting our hypothesis that persistent, severe symptoms are attributable to disease in the small airways. Larger associations with eosinophilia identify a phenotype that may inform early intervention and treatment.
SN  - 2312-0541
ER  -