Epidemiologic Research on Man-Made Disasters: Strategies and Implications of Cohort Definition for World Trade Center Worker and Volunteer Surveillance Program

Details

• Personal Author:
  Herbert R ; Metzger KB ; Moline JM ; Oxman RT ; Savitz DA ; Stein D ; Wallenstein S
• Description:
  Studies of long-term health consequences of disasters face unique methodologic challenges. The authors focused on studies of the health of cleanup and recovery workers, who are often poorly enumerated at the outset and difficult to follow over time. Comparison of the experience at the World Trade Center disaster with 4 past incidents of chemical and radiation releases at Seveso, Italy; Bhopal, India; Chernobyl, Ukraine; and Three Mile Island, USA, provided useful contrasts. Each event had methodologic advantages and disadvantages that depended on the nature of the disaster and the availability of records on area residents, and the emergency-response and cleanup protocol. The World Trade Center Worker Monitoring Program has well-defined eligibility criteria but lacks information on the universe of eligible workers to characterize response proportions or the potential for distortion of reported health effects. Nonparticipation may result from lack of interest, lack of awareness of the program, availability of another source of medical care, medical conditions precluding participation, inability to take time off from work, moving out of the area, death, or shift from initially ineligible to eligible status. Some of these considerations suggest selective participation by the sickest individuals, whereas others favor participation by the healthiest. The greatest concern with the validity of inferences regarding elevated health risks relative to external populations is the potential for selective enrollment among those who are affected. If there were a large pool of nonparticipating workers and those who suffered ill health were most motivated to enroll, the rates of disease among participants would be substantially higher than among all those eligible for the program. Future disaster follow-up studies would benefit substantially by having access to accurate estimates of the number of workers and information on the individuals who contributed to the cleanup and recovery effort. [Description provided by NIOSH]
• Subjects:
  Disaster Planning Epidemiology Health Care Facilities Workforce And Services Health Personnel Mental Health Occupational Exposure Occupational Health Safety Stress, Psychological Workplace
• Keywords:
  Disaster-planning Health-care-personnel Health-services Mental-health Mental-stress Occupational-exposure Occupational-hazards Occupational-psychology Psychological-responses Psychological-stress Stress Work-analysis Work-environment Work-operations Worker-health Workplace-studies

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• ISSN:
  0027-2507
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  77-87
• Volume:
  75
• Issue:
  2
• NIOSHTIC Number:
  nn:20034598
• Citation:
  Mt Sinai J Med 2008 Mar-Apr; 75(2):77-87
• Contact Point Address:
  David A. Savitz, Department of Community and Preventive Medicine Mount Sinai School of Medicine New York, NY
• Email:
  david.savitz@mssm.edu
• Federal Fiscal Year:
  2008
• NORA Priority Area:
  Services
• Performing Organization:
  Mount Sinai School of Medicine of New York University
• Peer Reviewed:
  True
• Start Date:
  20040715
• Source Full Name:
  Mount Sinai Journal of Medicine
• End Date:
  20090714
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:0ff9311de38003e64ba94788cce9dce031aa9efa29715e1e57804ea62e6195faf5e05fa329509ac47e97ee84ebf4d2e79e13a76d0cdbc399b19bb46784a99497
• Download URL:
  https://stacks.cdc.gov/view/cdc/186750/cdc_186750_DS1.pdf
• File Type:
  [PDF - 105.84 KB ]