Small Airway Chronic Obstructive Disease Syndrome Following Exposure to WTC Dust

Inclusion criteria

sACOS patients

• Previously participated in ULRS study and signed consent to be recontacted, or
• Patient in the WTC EHC and signed consent to be recontacted
• Onset of lower respiratory symptoms (LRS) after 9/11/01
• ACT < 20 at WTC EHC Monitoring visit
• Presence of LRS on Study Visit 1
• ACT<20 at Study Visit 1
• FEV1 > 70% predicted Study Visit 1
• Using ICS/LABA (Advair HFA equivalent > 115/21 mcg bid) or Fluticasone (110 mcg bid or equivalent) for at least 1 month before Study Visit 1
• CXR without parenchymal abnormalities

Control

• Patient in the WTC EHC and signed consent to be recontacted
• of lower respiratory symptoms on WTC EHC Monitoring Visit of WTC EHC
• Absence of lower respiratory symptoms on Study Visit 1
• FEV1 > 70% predicted on monitoring
• Not on any ICS/LABA/LAMA

Exclusion criteria

sACOS

• >10py tobacco use
• Unstable cardiac disease
• Systolic BP > 180 mmHg or Diastolic BP > 120 mmHg
• Oxygen saturation < 90%
• Uncontrolled HTN, DM
• Musculoskeletal inability to exercise
• Use of long acting muscarinic antagonist in the past 2 weeks
• Current use of oral corticosteroids
• Other pulmonary disease, including sarcoidosis, ILD
• Currently pregnant or with plans to become pregnant or lactating
• History of narrow angle glaucoma
• Known prostate hyperplasia or bladder-neck obstruction

Control

• >10py tobacco use
• Unstable cardiac disease
• Systolic BP > 180 mmHg or Diastolic BP > 120 mmHg
• Oxygen saturation < 90%
• Uncontrolled HTN, DM
• Musculoskeletal inability to exercise
• Use of ICS/LABA/SABA/LAMA individually or in combined formulation
• Current use of oral corticosteroids
• Other pulmonary disease, including sarcoidosis, ILD
• Currently pregnant or with plans to become pregnant or lactating
• History of narrow angle glaucoma
• Known prostate hyperplasia or bladder-neck obstruction