Signs of Early Kidney Damage Found in Some 9/11 Responders11/11/13
SATURDAY, Nov. 9 (HealthDay News) -- Some first responders who
toiled at the World Trade Center site after the Sept. 11, 2001,
attacks are now showing signs of early kidney damage, a preliminary
Experts said it's the first time evidence of kidney trouble has
been found in 9/11 first responders, and more study is needed
before kidney disease is added to the list of health problems
connected to the disaster.
The study included 183 first responders who have been monitored
in a World Trade Center health program at the Mount Sinai School of
Medicine in New York. Doctors found that workers who spent the most
time in the toxic plume at the disaster site showed relatively high
levels of a protein called albumin in their urine.
Those urine tests were taken last year -- 11 years after the
attacks, said study author Dr. Mary Ann McLaughlin.
Her team found that workers with the highest exposure to
polluted air from the disaster site showed significantly higher
albumin levels than those who spent the least time at Ground
"It's very high exposure that seemed important," said McLaughlin, who is scheduled to present her findings Saturday at the American Society of Nephrology annual meeting in Atlanta. Research presented at medical meetings is considered preliminary until published in a peer-reviewed journal.
In this study, "high exposure" meant responders who had been at
the World Trade Center on 9/11, and then stayed for recovery
operations for at least 90 days, McLaughlin said.
The air around the disaster site was filled with smoke, dust,
glass fibers and heavy metals, and it's possible that inhaled
debris -- plus the immune system's inflammatory response to it --
caused damage to the lining of the arteries in some workers,
And that, in turn, could affect kidney function. When the
kidneys aren't working properly, albumin can leak into the urine --
in what doctors call albuminuria. Persistent albuminuria signals
some degree of kidney disease.
A kidney disease expert agreed that inflammation triggered by
air pollutants could be involved in the new findings, but it's not
a definitive discovery.
"Additional research would be needed to try to tease apart the impact of [air pollution] on albuminuria," said Dr. Kerri Cavanaugh, of the Vanderbilt University Medical Center in Nashville, Tenn.
Cavanaugh said it's too early to give any general
recommendations based on the study. "It generates a hypothesis
about particulate matter and the potential association with kidney
disease," she said.
Other health consequences of 9/11 have been more firmly
established. Soon after the attacks, some first responders and
others near Ground Zero started showing the type of health effects
you would expect in the short term, McLaughlin said. Those included
asthma and other respiratory problems, and mental health conditions
such as post-traumatic stress disorder.
But other health effects could take years to manifest
themselves. Just last year, certain cancers were added to the list
of conditions covered by the 9/11 Victim Compensation Fund.
McLaughlin said these latest findings suggest there's a "linear
relationship" between exposure to the World Trade Center site and
early signs of kidney dysfunction. What that could ultimately mean
for first responders' health is not yet clear. But a urine test to
detect albumin is simple and inexpensive, McLaughlin said.
"First responders should seek care as directed by their providers," Cavanaugh said.
In general, she said, albuminuria screening is not recommended
for healthy adults. But it is suggested for people with established
risk factors for kidney dysfunction, including diabetes, high blood
pressure and a family history of kidney disease.
Mount Sinai is home to one of the so-called clinical centers of
excellence that were set up to monitor the health of first
responders, recovery workers and residents affected by the World
Trade Center attacks. The programs are also collecting data to try
to get a handle on the long-range health risks.
"Even though 9/11 was over a decade ago," McLaughlin said, "some of the effects could be lifelong."
The National Kidney Foundation has more on
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