Environmental toxins exert damaging health effects in workers. Thousands of responders who worked or volunteered on the World Trade Center (WTC) rescue and recovery effort following the September 11, 2001 attacks suffer from health conditions or may be at increased risk for worsening health. In a pilot study, we have identified the first evidence of kidney damage in subjects with very high exposure at Ground Zero. Specifically, we note a preliminary association between the intensity of particulate mater exposure and albuminuria, a marker of early chronic kidney disease (CKD), systemic endothelial dysfunction, and increased cardiovascular risk. Our long-term goal is to minimize the risk of CKD and cardiovascular disease (CVD) among individuals exposed to inhaled toxins. The primary objective of the current proposal is to quantify the risk of kidney damage among first responders to the WTC attack and to determine the relationship to particulate matter exposure. We will also leverage existing resources in our WTC Center of Excellence to study the association between renal and cardiovascular damage in first responders and to explore potential mechanisms. Our central hypothesis is that exposure to inhaled particulate matter causes systemic inflammation and endothelial dysfunction that result in chronic kidney and cardiovascular damage. We will investigate this hypothesis in a subgroup of participants in the on-going NIOSH-funded study "Pulmonary Function Abnormalities, Diastolic Dysfunction and WTC Exposure: Implications for Diagnosis and Treatment" ("WTC-CHEST," PI Mary Ann McLaughlin). The proposed study will capitalize on unique resources in WTC-CHEST, including the standardized collection of data on particulate matter exposure and shared risk factors for CKD and cardiovascular disease, and cardiopulmonary function testing. The output from this proposal is anticipated to have a broad impact on understanding the health effects of inhaled particulate matter.

Public Health Relevance

The primary objective of the current proposal is to quantify the risk of kidney damage among responders to the World Trade Center (WTC) attacks and determine the relationship to intensity of particulate matter exposure. We predict that exposure to inhaled particulate matter leads to systemic inflammation and endothelial reactivity that contributes to kidney and cardiovascular damage. We will examine the association between renal and cardiovascular damage in first responders and explore potential mechanisms. Knowledge to be gained from this proposal can influence strategies to minimize the risk of chronic kidney and cardiovascular disease among first responders.

Agency
National Institute of Health (NIH)
Institute
National Institute for Occupational Safety and Health (NIOSH)
Type
Research Project--Cooperative Agreements (U01)
Project #
1U01OH010716-01
Application #
8777001
Study Section
Special Emphasis Panel (ZOH1-NXT (51))
Program Officer
Kubale, Travis
Project Start
2014-07-01
Project End
2016-06-30
Budget Start
2014-07-01
Budget End
2015-06-30
Support Year
1
Fiscal Year
2014
Total Cost
$555,058
Indirect Cost
$168,628
Name
Icahn School of Medicine at Mount Sinai
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
078861598
City
New York
State
NY
Country
United States
Zip Code
10029