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Lower Respiratory Symptoms Associated With Environmental and Reconstruction Exposures After Hurricane Sandy

Published online by Cambridge University Press:  21 January 2018

Lisa M. Gargano*
New York City Department of Health and Mental Hygiene, New York, NY
Sean Locke
New York City Department of Health and Mental Hygiene, New York, NY
Hannah T. Jordan
New York City Department of Health and Mental Hygiene, New York, NY
Robert M. Brackbill
New York City Department of Health and Mental Hygiene, New York, NY
Correspondence and reprints request to Lisa M. Gargano, PhD, MPH, New York City Department of Health and Mental Hygiene, 125 Worth Street, New York, NY (e-mail:



In a population with prior exposure to the World Trade Center (WTC) disaster, this study sought to determine the relationship between Hurricane Sandy-related inhalation exposures and post-Sandy lower respiratory symptoms (LRS).


Participants included 3835 WTC Health Registry enrollees who completed Wave 3 (2011-2012) and Hurricane Sandy (2013) surveys. The Sandy-related inhalational exposures examined were: (1) reconstruction exposure; (2) mold or damp environment exposure; and (3) other respiratory irritants exposure. LRS were defined as wheezing, persistent cough, or shortness of breath reported on ≥1 of the 30 days preceding survey completion. Associations between LRS and Sandy exposures, controlling for socio-demographic factors, post-traumatic stress disorder, and previously reported LRS and asthma were examined using multiple logistic regression.


Over one-third of participants (34.4%) reported post-Sandy LRS. Each of the individual exposures was also independently associated with post-Sandy LRS, each having approximately twice the odds of having post-Sandy LRS. We found a dose-response relationship between the number of types of Sandy-related exposures reported and post-Sandy LRS.


This study provides evidence that post-hurricane clean-up and reconstruction exposures can increase the risk for LRS. Public health interventions should emphasize the importance of safe remediation practices and recommend use of personal protective equipment. (Disaster Med Public Health Preparedness. 2018;12:697-702)

Original Research
Copyright © Society for Disaster Medicine and Public Health, Inc. 2018 

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