Maintenance and Extension of a Cohort of Career Firefighters as a Non-WTC Exposed Comparison for the FDNY Firefighter Cohort

Details

• Personal Author:
  Webber MP
• Description:
  Background: Studies of World Trade Center (WTC)-exposed rescue/recovery workers report the increased occurrence of health conditions after work at the WTC disaster site. However, the extent to which these associations are due to WTC exposure is unclear, in part due to the lack of suitable comparison groups. Accordingly, we identified a previously assembled National Institute for Occupational Safety and Health (NIOSH) cohort of career firefighters from Chicago, Philadelphia, and San Francisco (n=29,992). The cohort was renamed the Career Firefighter Health Study, and the Fire Department of the City of New York (FDNY) firefighters were added. Methods: Follow-up process included institutional review board applications, data use agreements, 15 state cancer registry linkages and National Death Index linkage. After completion of these steps, we undertook outreach to the Chicago, Philadelphia, and San Francisco fire departments and union officials, prior to contact tracing and direct recruitment of 14,566 living firefighters to complete a confidential health survey. The health survey included both physical and mental health questions and was modeled off the FDNY health surveys. We staggered recruitment efforts by city, using letters, postcards, emails, videos and telephone outreach. Analyses compared FDNY WTC-exposed firefighters with non-exposed firefighters from the other three cities. Results: We identified 915 cancer cases in 841 FDNY firefighters and 1,002 cases in 909 CFHS firefighters. FDNY had: higher rates for all-cancers (RR=1.13; 95%CI=1.02-1.25), prostate (RR=1.39; 95%CI=1.19-1.63), and thyroid cancer (RR=2.53; 95%CI=1.37-4.70); younger median ages at diagnosis (55.6 vs. 59.4; p<.001, all-cancers); and more cases with localized disease when compared with CFHS. WTC-exposed firefighters had lower rates of all-cause and cancer-, heart disease- and respiratory disease-specific mortality compared with non-WTC-exposed firefighters. A total of 4,962 of 14,566 alive firefighters from Chicago, Philadelphia, and San Francisco responded to the baseline survey (34.1% response rate). Results from the survey found differences between FDNY WTC-exposed firefighters and non-WTC-exposed firefighters when assessing self-reported health outcomes. WTC-exposure was associated with fewer subjective cognitive concerns (β =-0.69+/-0.05, p<0.001) after controlling for covariates Odds of any self-reported obstructive airway disease and asthma specifically, were 4.5 and 6.3 times greater, respectively, in WTC-exposed vs. non-WTC-exposed. Greater WTC exposure was positively associated with combined self-reported coronary artery disease, myocardial infarction, and angina when comparing WTC-exposed to non-WTC-exposed firefighters. Conclusions: By expanding maintaining and updating the Career Firefighter Health Study cohort, we have created a valuable comparison cohort for the WTC-exposed firefighters. With this comparison, we found WTC-exposed firefighters have a greater incidence of cancer compared with non-exposed firefighters, but their risk of mortality is lower. Further, we found WTC-exposed firefighters reported more physical health diagnoses than non-exposed firefighters. The Career Firefighter Health Study cohort and survey can beneficial for future WTC studies as well as firefighting studies. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Emergency Responders Firefighters Mental Health Neoplasms Nervous System Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Cancer Rates Cohort Studies Disaster Recovery Fire Fighters Mental Health Mortality Studies Rescue Workers World Trade Center WTC
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Final Cooperative Agreement Report
• Place as Subject:
  California ; Illinois ; New York ; OSHA Region 2 ; OSHA Region 3 ; OSHA Region 5 ; OSHA Region 9 ; Pennsylvania
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-66
• NIOSHTIC Number:
  nn:20069622
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, U01-OH-011934, 2023 Dec; :1-66
• Contact Point Address:
  Mayris Webber, DrPH, Albert Einstein College of Medicine, 1301 Morris Park Avenue, Bronx, NY 10461
• Email:
  mwebber@montefiore.org
• Federal Fiscal Year:
  2024
• Performing Organization:
  Albert Einstein College of Medicine, Bronx, New York
• Peer Reviewed:
  False
• Start Date:
  20190101
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20230831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:6aacf72fdb36846c904a4710b2878740601b0317d792a6b4c6adc1d75c3a11663aeedea4c8e2dd1790229992b1eec95edf0e37d3478d4666419d136ac7d69e2b
• Download URL:
  https://stacks.cdc.gov/view/cdc/219249/cdc_219249_DS1.pdf
• File Type:
  [PDF - 2.00 MB ]