(1207) Chronic Rhinosinusitis and Systemic Autoimmune Diseases Among Patients With World Trade Center Occupational Exposure

Introduction: Chronic rhinosinusitis (CRS) has been associated with systemic autoimmune diseases (SAID), but limited data exists investigating their association within high-risk populations. We therefore assessed whether SAID is an independent predictor of CRS in a population with World Trade Center (WTC) occupational exposure.

Methods: A retrospective cohort study was conducted using data linked to the medical records of patients seen within the Department of Otolaryngology – Head and Neck Surgery of a large NYC Health System who listed the WTC Health Program as the payer for the received medical service from 2010 to May 2022. Data was collected using Research Electronic Data Capture Software (REDCap, Vanderbilt University) for patients who had documented medical history. SAIDs were determined as those that were included in the list of autoimmune diseases by the Global Autoimmune Institute or Autoimmune Association. Descriptive statistics were used to characterize CRS among patients with and without SAID. Logistic regression models were used to determine the association between SAID and CRS while adjusting for sex, age, and history of asthma (R version 4.3.1).

Results: Of 3,101 WTC-exposed patients, there were 218 patients with at least one SAID: 45 (20.6%) had psoriasis, 37 (17.0%) had sarcoidosis, and 36 (16.5%) had an autoimmune arthritis. There was no significant difference in the prevalence of CRS among patients with an SAID (10.6%) and those without an SAID (10.3%) (p = 1). There was no increased odds of CRS in patients with SAID versus without SAID in unadjusted (odds ratio (OR): 1.023; 95% confidence interval (95% CI): 0.637-1.269) and adjusted analyses (OR: 0.978; 95% CI: 0.606-1.509).

Conclusions: This research did not confirm an increased risk of CRS in patients with a history of SAID even in this highly exposed population with increased independent risk of CRS and SAID. More research is needed with larger sample sizes to further investigate the potential link between SAID and CRS, including mechanistic pathways.