World Trade Center responders with the greatest exposure to toxic dust
have a higher likelihood of liver disease, study finds

Date:
July 30, 2021
Source:
The Mount Sinai Hospital / Mount Sinai School of Medicine
Summary:
Researchers have found evidence that World Trade Center responders
had a higher likelihood of developing liver disease if they arrived
at the site right after the attacks as opposed to working at Ground
Zero later in the rescue and recovery efforts.



FULL STORY ========================================================================== Mount Sinai researchers have found evidence for the first time that
World Trade Center responders had a higher likelihood of developing liver disease if they arrived at the site right after the attacks as opposed to working at Ground Zero later in the rescue and recovery efforts. Their
study links the increase in liver disease risk to the quantity of toxic
dust the workers were exposed to, which was greatest immediately after
the September 11, 2001, attacks.


==========================================================================
The study was published in the American Journal of Industrial Medicine
in July.

The liver is often affected by chemical exposures due to its role in detoxifying foreign substances, and the liver disease whose early signs
were detected in this study, hepatic steatosis, is associated with
chemical exposures. Steatosis means that the liver contains abnormally
high levels of fat.

In the aftermath of the 2001 attack, more than 20,000 responders were
exposed to dust, airborne particulates, and chemicals known to cause
liver toxicity, increasing their risk for toxicant-associated fatty
liver disease, including the most serious form -- toxicant-associated steatohepatitis -- which can lead to liver failure and liver cancer. Mount Sinai monitors these responders as part of a federal World Trade Center
Health Program under the direction of Michael Crane, MD.

"Our study showed that continued monitoring for liver disease is warranted
in World Trade Center responders -- such as law enforcement, fire,
and recovery workers in any field at the site -- particularly those who
arrived at or shortly after the attacks and had a higher exposure to the
toxic dust," said the study's senior author, Claudia Henschke, MD, PhD, Professor of Diagnostic, Molecular and Interventional Radiology at the
Icahn School of Medicine at Mount Sinai. "At the moment, there are no
protocols to monitor responders for liver disease, so this study points
to the need to further study this issue in this at-risk population." Researchers discovered the liver disease by analyzing lung scans of
1,788 World Trade Center responders being monitored by Mount Sinai's
World Trade Center Health Program Clinical Center of Excellence. While
the scans were given to monitor the responders for lung disease that has
been well established as a health issue related to exposure at Ground
Zero, researchers developed an algorithm that found evidence of liver
disease in the portion of the liver visible in the scans.

The algorithm was able to find lower density in the liver, which is
evidence of hepatic steatosis, in slightly more than 14 percent of
the responders.

Researchers later found that responders who arrived earlier -- within
about two weeks of the attack -- and had a higher exposure to the toxic
dust at the World Trade Center site had more evidence of liver disease in
their scans. Responders with particularly low density are being evaluated
for possible referral to liver specialists for diagnosis and treatment.

"Our previous work found evidence of liver disease was three times
higher in the lung scans of World Trade Center responders compared to
other patients' lung scans, so this new study suggests that responders
who arrived at Ground Zero earlier should receive enhanced monitoring
for liver disease," said the study's first author, Artit Jirapatnakul,
PhD, Assistant Professor of Diagnostic, Molecular and Interventional
Radiology at Icahn Mount Sinai. "Now that we have this link, the next
step is to understand why or how the toxic dust actually causes liver
damage." It is also critical to further define the characteristics
and prevalence of liver damage in World Trade Center responders and to
educate the responders and their providers about the potential benefits
of liver cancer screening for those at high risk, according to another
author, Andrea D. Branch, PhD, Professor of Medicine (Liver Diseases)
at Icahn Mount Sinai and the director of an ongoing study sponsored
by the National Institute for Occupational Safety and Health that
is investigating evidence of toxicant-associated steatohepatitis in
responders to the World Trade Center attack.

========================================================================== Story Source: Materials provided by The_Mount_Sinai_Hospital_/_Mount_Sinai_School_of Medicine. Note: Content
may be edited for style and length.


==========================================================================


Link to news story: https://www.sciencedaily.com/releases/2021/07/210730104255.htm

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