The upper respiratory pyramid: Early factors and later treatment utilization in World Trade Center exposed firefighters. Issue 8 (4th June 2014)

• Record Type: Journal Article
• Authors: Niles, Justin K.; Webber, Mayris P.; Liu, Xiaoxue; Zeig‐Owens, Rachel; Hall, Charles B.; Cohen, Hillel W.; Glaser, Michelle S.; Weakley, Jessica; Schwartz, Theresa M.; Weiden, Michael D.; Nolan, Anna; Aldrich, Thomas K.; Glass, Lara; Kelly, Kerry J.; Prezant, David J.
• Is Part Of: American journal of industrial medicine. Volume 57:Issue 8(2014:Aug.)
• Page Start: 857
• Page End: 865
• Publication Date: 2014-06-04
• Subjects: Medicine, Industrial -- Periodicals; Médecine du travail -- Périodiques; 616.9803
• DOI: 10.1002/ajim.22326
• Languages: English
• ISSNs: 0271-3586

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ajim22326-sec-0001" sec-type="section"> <title>Background</title> <p>We investigated early post 9/11 factors that could predict rhinosinusitis healthcare utilization costs up to 11 years later in 8, 079 World Trade Center‐exposed rescue/recovery workers.</p> </sec> <sec id="ajim22326-sec-0002" sec-type="section"> <title>Methods</title> <p>We used bivariate and multivariate analytic techniques to investigate utilization outcomes; we also used a pyramid framework to describe rhinosinusitis healthcare groups at early (by 9/11/2005) and late (by 9/11/2012) time points.</p> </sec> <sec id="ajim22326-sec-0003" sec-type="section"> <title>Results</title> <p>Multivariate models showed that pre‐9/11/2005 chronic rhinosinusitis diagnoses and nasal symptoms predicted final year healthcare utilization outcomes more than a decade after WTC exposure. The relative proportion of workers on each pyramid level changed significantly during the study period.</p> </sec> <sec id="ajim22326-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Diagnoses of chronic rhinosinusitis within 4 years of a major inhalation event only partially explain future healthcare utilization. Exposure intensity, early symptoms and other factors must also be considered when anticipating future healthcare needs. Am. J. Ind. Med. 57:857–865, 2014. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>