Risk Factors for Head and Neck Cancer in the World Trade Center Health Program General Responder Cohort: Results from a Nested Case-Control Study

Details

• Personal Author:
  Black K ; Black TM ; Bover Manderski MT ; Crane M ; Dasaro CR ; Giuliano AR ; Graber JM ; Harrison D ; Lucchini RG ; Luft BJ ; Moline J ; Passannante MR ; Steinberg MB ; Strickland PO ; Todd AC ; Udasin IG
• Description:
  Objectives: Head and neck cancers (HNCs) may be among the health consequences of involvement in the World Trade Center (WTC) response on and after 11 September 2001. We conducted a nested case-control study of WTC Health Program (WTCHP) general responders to examine the effects of WTC exposures and behavioural risk factors on HNC. Methods: We enrolled 64 cases and 136 controls, matched on age, sex and race/ethnicity within risk sets. We assessed tobacco and alcohol use, sexual activity, and occupational exposures prior to, during and after WTC exposure until case diagnosis via questionnaire. We obtained WTC exposure information (duration (first to last day), total days and location of work) from the WTCHP General Responder Data Center. We assessed associations with HNC, and interaction among exposures, using conditional logistic regression. Results: Responders in protective services versus other occupations had increased odds (OR: 2.51, 95% CI 1.09 to 5.82) of HNC. Among those in non-protective services occupations, arriving to the WTC effort on versus after 11 September 2001 was significantly associated with HNC (OR: 3.77, 95% CI 1.00 to 14.11). Duration of work was not significantly associated with HNC. Lifetime and post-WTC years of cigarette smoking and post-WTC number of sex partners were positively and significantly associated with HNC, while alcohol consumption was not. Conclusions: These findings suggest opportunities for HNC risk factor mitigation (eg, smoking cessation, human papillomavirus vaccination) and contribute to a risk factor profile which may assist WTCHP clinicians with identifying high-risk responders and improve detection and treatment outcomes in this population. [Description provided by NIOSH]
• Subjects:
  Aging Alcoholic Beverages Behavior Carcinogens Demography Emergency Responders Environmental Exposure Hazardous Substances Men Neoplasms Occupational Health Race Factors Risk Assessment Risk Factors Safety September 11 Terrorist Attacks Surveys And Questionnaires Tobacco Products Women

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• Keywords:
  Age Groups Alcohol Cancer Case Control Studies Demographic Characteristics Emergency Responders Exposure Levels Humans Questionnaires Racial Factors Rescue Workers Risk Factors Sociological Factors Statistical Analysis Tobacco Toxins World Trade Center WTC

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• ISSN:
  1351-0711
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Florida ; New Jersey ; New York ; OSHA Region 2 ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  76
• Issue:
  11
• NIOSHTIC Number:
  nn:20057195
• Citation:
  Occup Environ Med 2019 Nov; 76(11):854-860
• Contact Point Address:
  Dr Michelle T Bover Manderski, Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ 08854, USA
• Email:
  bovermi@sph.rutgers.edu
• Federal Fiscal Year:
  2020
• Performing Organization:
  Rutgers Biomedical and Health Sciences - School of Public Health, Piscataway, New Jersey
• Peer Reviewed:
  True
• Start Date:
  20160901
• Source Full Name:
  Occupational and Environmental Medicine
• End Date:
  20180831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:f9b99b430eb03f1854abea5a5850a675ebde7f24bae7899b08be1a0e5f26855b456f13b7e036d6ec21edf866177b64857d57a7cf2ca84b3574cc131980ef0788
• Download URL:
  https://stacks.cdc.gov/view/cdc/214624/cdc_214624_DS1.pdf
• File Type:
  [PDF - 243.17 KB ]