Impact of Healthcare Services on Thyroid Cancer Incidence Among World Trade Center-Exposed Rescue and Recovery Workers

Details

• Personal Author:
  Boffetta P ; Brackbill RM ; Colbeth HL ; Cone, James E. ; Dasaro CR ; Farfel MR ; Goldfarb DG ; Hall CB ; Kahn AR ; Kristjansson D ; Li J ; Prezant DJ ; Qiao B ; Schymura MJ ; Skerker M ; Todd AC ; Webber MP ; Yung J ; Zeig-Owens R
• Description:
  Background: A recent study of World Trade Center (WTC)-exposed firefighters and emergency medical service workers demonstrated that elevated thyroid cancer incidence may be attributable to frequent medical testing, resulting in the identification of asymptomatic tumors. We expand on that study by comparing the incidence of thyroid cancer among three groups: WTC-exposed rescue/recovery workers enrolled in a New York State (NYS) WTC-medical monitoring and treatment program (MMTP); WTC-exposed rescue/recovery workers not enrolled in an MMTP (non-MMTP); and the NYS population. Methods: Person-time began on 9/12/2001 or at enrollment in a WTC cohort and ended at death or on 12/31/2015. Cancer data were obtained through linkages with 13 state cancer registries. We used Poisson regression to estimate rate ratios (RRs) and 95% confidence intervals (CIs) for MMTP and non-MMTP participants. NYS rates were used as the reference. To estimate potential changes over time in WTC-associated risk, change points in RRs were estimated using profile likelihood. Results: The thyroid cancer incidence rate among MMTP participants was more than twice that of NYS population rates (RR=2.31; 95% CI=2.00-2.68). Non-MMTP participants had a risk similar to NYS (RR=0.96; 95% CI=0.72-1.28). We observed no change points in the follow-up period. Conclusion: Our findings support the hypothesis that no-cost screening (a benefit provided by WTC-MMTPs) is associated with elevated identification of thyroid cancer. Given the high survival rate for thyroid cancer, it is important to weigh the costs and benefits of treatment, as many of these cancers were asymptomatic and may have been detected incidentally. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Emergency Responders Epidemiology Firefighters Health Care Facilities Workforce And Services Neoplasms Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: Longitudinal Cohort Cancer Cohort Studies Disaster Recovery Fire Fighters First Responders Longitudinal Study Medical Monitoring Occupational Epidemiology Rescue Workers Surveillance Thyroid Cancer Thyroid Gland Disorders 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 York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  64
• Issue:
  10
• NIOSHTIC Number:
  nn:20063101
• Citation:
  Am J Ind Med 2021 Oct; 64(10):861-872
• Contact Point Address:
  Rachel Zeig-Owens, DrPH, Fire Department of the City of New York, Bureau of Health Services, FDNY Headquarters, 9 Metrotech Center, Brooklyn, NY 11201, USA
• Email:
  Rachel.Zeig-Owens@fdny.nyc.gov
• Federal Fiscal Year:
  2022
• Performing Organization:
  Albert Einstein College of Medicine, Inc., New York
• Peer Reviewed:
  True
• Start Date:
  20180701
• Source Full Name:
  American Journal of Industrial Medicine
• End Date:
  20200630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:afef60ed31280d67479150801a08594b1443df400794e7c23f1afbf4867f9a43ad2aa54c84d0b882960ffa931ac27df1f2b9c7cb690662796237bae4cf229276
• Download URL:
  https://stacks.cdc.gov/view/cdc/226224/cdc_226224_DS1.pdf
• File Type:
  [PDF - 1.50 MB ]