Lack of association of impaired upper airway sensation with the presence or absence of obstructive sleep apnoea or chronic rhinosinusitis in World Trade Center responders

• Published in: Occupational and environmental medicine (London, England) England), 2024-06, Vol.81 (6), p.302-307
• Main Authors: Sunderram, Jag, Legard, Alicia, De Resende, Adriana, Black, Kathleen, Udasin, Iris G, Lu, Shou-en, Romero Castillo, Horacio, Ravi, Sri Saranya, Mullins, Anna E, de la Hoz, Rafael E, Rapoport, David M, Ayappa, Indu
• Format: Article
• Language: English
• Subjects: Adult; Apnea; Body mass index; Body size; Chronic Disease; Chronic illnesses; Clinical medicine; Dependent variables; Dust; Emergency Responders - statistics & numerical data; Environmental Exposure; Environmental Pollution; Exposure assessment; Female; Firefighters; Humans; Independent variables; Male; Middle Aged; Occupational Diseases - epidemiology; Occupational Diseases - etiology; Occupational Diseases - physiopathology; Particulate Matter; Regression analysis; Respiratory tract; Rhinitis; Rhinitis - complications; Rhinitis - physiopathology; Rhinosinusitis; Sensation; Sensory evaluation; Sensory Thresholds - physiology; September 11 Terrorist Attacks; September 11 terrorist attacks-2001; Sinusitis; Sinusitis - complications; Sinusitis - physiopathology; Sleep; Sleep apnea; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - physiopathology; Sleep disorders; Statistical analysis; Statistical models; Vibration analysis
• ISSN: 1351-0711; 1470-7926; 1470-7926
• DOI: 10.1136/oemed-2023-109262

ObjectiveExamine sensory function of the upper airway in four groups of subjects recruited from the World Trade Centre General Responder Cohort (WTCGRC), with/without obstructive sleep apnoea (OSA), and with/without chronic rhinosinusitis (CRS).MethodsUpper airway sensory function was determined using 2-point discrimination (2-PD) and vibration threshold (VT) in 163 WTCGRC subjects with both OSA and CRS (cases), OSA or CRS alone and without OSA or CRS (controls). Presence of OSA was determined from clinical sleep studies or home sleep testing. Presence of CRS was determined by nasal symptom questionnaire. The relationship between the presence of OSA and CRS and upper airway sensory impairment was assessed using linear regression analysis with each of 2PD and VT sensory threshold values as the dependent variable; OSA, CRS and their interaction were the independent variables. Age, gender and body mass index were covariates in the statistical model. The primary analysis was comparison of OSA+CRS versus controls (no OSA and no CRS) evaluated by linear contrasts.ResultsThere were no differences in 2-PD or VT in those with OSA+CRS, OSA and CRS alone or controls. However, both 2-PD and VT were significantly higher in the WTCGRC controls compared with values seen in historical controls using the same methodology (median 2-PD 13.0; CI (11.0 to 13.5) vs 10.5; CI (8 to 11); VT: mean±SEM (9.3±0.6 vs 2.2±0.1)).ConclusionWhile no differences were found in upper airway sensation between cases of OSA and CRS versus controls in the WTGRC population, there was evidence of impaired upper airway sensation in the WTGRC overall.