World Trade Center Response Activities and Cognitive Health: A Moderated Mediation Study of the Role of Surgical/Nuisance Dust Mask Usage

Details

• Personal Author:
  Babalola T ; Carr MA ; Clouston SAP ; Kritikos M ; Luft BJ ; Mann FD ; Meliker J ; Richmond LL ; Smith DM ; Yang Y
• Description:
  Objective: This study explores the relationship between World Trade Center (WTC) response activities (WRAs) and cognitive impairment (CI) and uses a moderated-mediation model to examine the role of wearing a surgical/nuisance dust mask. Methods: This study includes 3285 WTC responders. Responders were placed into eight WRA groups based on self-report structured responses and free-text descriptions of activities at the WTC. The presence/absence of surgical/nuisance dust mask usage was self-reported. The outcome was CI as determined using a Montreal Cognitive Assessment score < 23. Robust Poisson regression was used to examine the main effect, and counterfactual moderated-mediation analysis was used to determine the role of mask usage. Results: The risk of CI was higher across most WRAs when compared to supervision. Mask usage was reported by 63 % of responders and varied across WRAs and was associated with a reduced risk of CI (adjusted risk ratio [aRR]=0.77, p = 0.008) after controlling for WRAs. Moderation effects indicated that responders are more likely to wear masks when encountering more dangerous exposures, even within the same WRA group. Responders in the WRA-enclosed group had a lower risk of CI through a moderated intermediary effect of mask usage (aRR=0.92, p = 0.05). Conclusion: Surgical/nuisance dust mask usage provided mild protection against air pollution exposures during WTC response activities when compared to not wearing a mask. Results suggest that response workers at disaster sites might benefit from wearing surgical/nuisance dust masks when respirators are unavailable even when the air seems safe. [Description provided by NIOSH]
• Subjects:
  Dust Emergency Responders Nervous System Occupational Exposure Occupational Health Personal Protective Equipment Respiratory Protective Devices Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: World Trade Center Cognitive Function Cognitive Impairment Disaster Response Dust Exposure First Responders Nuisance Dust Mask Occupational Exposure Surgical Mask Surgical Masks World Trade Center WTC

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• ISSN:
  0161-813X
• Document Type:
  Text
• Funding:
  Contract
• Genre:
  Journal Article
• Place as Subject:
  New York ; New York City Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-10
• Volume:
  108
• NIOSHTIC Number:
  nn:20070560
• Citation:
  Neurotoxicology 2025 May; 108:1-10
• Contact Point Address:
  Sean A.P. Clouston, Program in Public Health, Health Sciences Center, #3-071, 101 Nichols Rd., Stony Brook, NY 11794-8338, USA
• Email:
  Sean.clouston@stonybrookmedicine.edu
• Federal Fiscal Year:
  2025
• Peer Reviewed:
  True
• Source Full Name:
  Neurotoxicology
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:f400b66d66b4f93f45adfadcb946cec8d7b24a09a8af3726ecebfe73d72fc744060c994930d0c421bd04067d90594e9eccb8ef16c920366b0f11e4c0d5b34c49
• Download URL:
  https://stacks.cdc.gov/view/cdc/208744/cdc_208744_DS1.pdf
• File Type:
  [PDF - 2.87 MB ]