Cardiovascular Disease in the World Trade Center Health Program General Responder Cohort

Details

• Personal Author:
  Crane MA ; Dasaro CR ; Harrison DJ ; Luft BJ ; Moline JM ; Sabra A ; Shapiro MZ ; Sloan NL ; Teitelbaum SL ; Todd AC ; Udasin IG
• Description:
  Background: Over 90,000 rescue and recovery responders to the September 2001 World Trade Center (WTC) attacks were exposed to toxic materials that can impair cardiac function and increase cardiovascular disease (CVD) risk. We examined WTC-related exposures association with annual and cumulative CVD incidence and risk over 17 years in the WTC Health Program (HP) General Responder Cohort (GRC). Methods: Post 9/11 first occurrence of CVD was assessed in 37,725 responders from self-reported physician diagnosis of, or current treatment for, coronary artery disease, myocardial infarction, stroke and/or congestive heart failure from WTCHP GRC monitoring visits. Kaplan-Meier estimates of CVD incidence used the generalized Wilcoxon test statistic to account for censored data. Cox proportional hazards regression analyses estimated the CVD hazard ratio associated with 9/11/2001 arrival in responders with and without dust cloud exposure, compared with arrival on or after 9/12/2001. Additional analyses adjusted for comorbidities. Results: To date, 6.3% reported new CVD. In covariate-adjusted analyses, men's CVD 9/11/2001 arrival risks were 1.40 (95% confidence interval [CI] = 1.26, 1.56) and 1.43 (95% CI = 1.29, 1.58) and women's were 2.16 (95% CI = 1.49, 3.11) and 1.59 (95% CI = 1.11, 2.27) with and without dust cloud exposure, respectively. Protective service employment on 9/11 had higher CVD risk. Conclusions: WTCHP GRC members with 9/11/2001 exposures had substantially higher CVD risk than those initiating work afterward, consistent with observations among WTC-exposed New York City firefighters. Women's risk was greater than that of men's. GRC-elevated CVD risk may also be occurring at a younger age than in the general population. [Description provided by NIOSH]
• Subjects:
  Aging Cardiovascular Diseases Cardiovascular System Cohort Studies Diagnosis Dust Emergency Responders Environmental Exposure Environmental Pollution Hazardous Substances Health Care Facilities Workforce And Services Men Occupational Health Risk Assessment Safety September 11 Terrorist Attacks Women

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• Keywords:
  Age Groups Analytical Models Analytical Processes Author Keywords: Cardiovascular Disease Cardiac Function Cardiovascular Disease Cardiovascular Function Cardiovascular Health Cardiovascular System Disorders Clinical Diagnosis Cohort Studies Disaster Clean-up Disaster Response Dust Exposure Emergency Responders Environmental Contamination Environmental Exposure Heart Heart Disease Humans Medical Monitoring Medical Treatment Myocardial Disorders Occupation Regression Analysis Rescue Workers Responder/Recovery Worker Risk Analysis Risk Assessment Toxic Materials World Trade Center WTC

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• ISSN:
  0271-3586
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Contract
• Genre:
  Journal Article
• Place as Subject:
  New Jersey ; New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  97-107
• Volume:
  64
• Issue:
  2
• NIOSHTIC Number:
  nn:20061642
• Citation:
  Am J Ind Med 2021 Feb; 64(2):97-107
• Contact Point Address:
  Nancy L. Sloan, DrPH, Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, Box 1057, New York, NY 10029, USA
• Email:
  nancy.sloan@mssm.edu
• Federal Fiscal Year:
  2021
• Performing Organization:
  State University of New York Stony Brook
• Peer Reviewed:
  True
• Start Date:
  20040715
• Source Full Name:
  American Journal of Industrial Medicine
• End Date:
  20110630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:7ae037482909c5ea38fe2864b9de3e506ce690ad31da3b3e8aceffc040496c151476bbfd9da8fb74e0d85d3d502200e5aa6f6640a65eebe712ea5ff5ca14f263
• Download URL:
  https://stacks.cdc.gov/view/cdc/225106/cdc_225106_DS1.pdf
• File Type:
  [PDF - 948.36 KB ]