Cough and Bronchial Responsiveness in Firefighters at the World Trade Center Site

To the Editor: Prezant and colleagues (Sept. 12 issue) 1 describe cough and bronchial responsiveness in firefighters at the World Trade Center. They attribute the observed sinusitis, bronchial hyperreactivity, and bronchial responsiveness to dust inhalation. Although the dust had settled after six days, the peak incidence of disability occurred in late October and early November. This points to an illness with two phases, with World Trade Center cough representing a late-phase reaction. If this is to be an adequate explanation, we must account for sinusitis, bronchial hyperreactivity, and bronchial responsiveness among healthy firefighters exposed to the dust from the collapsed buildings. . . .