Cancer Survival Among World Trade Center Rescue and Recovery Workers: A Collaborative Cohort Study

Details

• Personal Author:
  Boffetta P ; Brackbill RM ; Cone, James E. ; Dasaro CR ; Farfel MR ; Goldfarb DG ; Hall CB ; Kahn AR ; Kristjansson D ; Li J ; Lucchini RG ; Prezant DJ ; Qiao B ; Schymura MJ ; Todd AC ; Webber MP ; Zeig-Owens R
• Description:
  Background: World Trade Center (WTC)-exposed responders may be eligible to receive no-cost medical monitoring and treatment for certified conditions, including cancer. The survival of responders with cancer has not previously been investigated. Methods: This study compared the estimated relative survival of WTC-exposed responders who developed cancer while enrolled in two WTC medical monitoring and treatment programs in New York City (WTC-MMTP responders) and WTC-exposed responders not enrolled (WTC-non-MMTP responders) to non-responders from New York State (NYS-non-responders), all restricted to the 11-southernmost NYS counties, where most responders resided. Parametric survival models estimated cancer-specific and all-cause mortality. Follow-up ended at death or on December 31, 2016. Results: From January 1, 2005 to December 31, 2016, there were 2,037 cancer cases and 303 deaths (248 cancer-related deaths) among WTC-MMTP responders, 564 cancer cases, and 143 deaths (106 cancer-related deaths) among WTC-non-MMTP responders, and 574,075 cancer cases and 224,040 deaths (158,645 cancer-related deaths) among the NYS-non-responder population. Comparing WTC-MMTP responders with NYS-non-responders, the cancer-specific mortality hazard ratio (HR) was 0.72 (95% confidence interval [CI] = 0.64-0.82), and all-cause mortality HR was 0.64 (95% CI = 0.58-0.72). The cancer-specific HR was 0.94 (95% CI = 0.78-1.14), and all-cause mortality HR was 0.93 (95% CI = 0.79-1.10) comparing WTC-non-MMTP responders to the NYS-non-responder population. Conclusions: WTC-MMTP responders had lower mortality compared with NYS-non-responders, after controlling for demographic factors and temporal trends. There may be survival benefits from no-out-of-pocket-cost medical care which could have important implications for healthcare policy, however, other occupational and socioeconomic factors could have contributed to some of the observed survival advantage. [Description provided by NIOSH]
• Subjects:
  Emergency Responders Epidemiology Health Care Facilities Workforce And Services Mortality Neoplasms Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: World Trade Center Cancer Disaster Recovery Emergency Responders First Responders Medical Monitoring Medical Monitoring And Treatment Mortality Mortality Rates Rescue/Recovery Work Treatment 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:20063124
• Citation:
  Am J Ind Med 2021 Oct; 64(10):815-826
• Contact Point Address:
  Paolo Boffetta, MD, MPH, Stony Brook Cancer Center, Stony Brook University, Lauterbur Dr., Stony Brook, NY 11794, USA
• Email:
  paolo.boffetta@stonybrookmedicine.edu
• Federal Fiscal Year:
  2022
• Performing Organization:
  Albert Einstein College of Medicine, Inc., Bronx, New York
• Peer Reviewed:
  True
• Start Date:
  20160901
• Source Full Name:
  American Journal of Industrial Medicine
• End Date:
  20200831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:f095478837cc3357bcfa9202aac1878db89d32ea39afe11141d169c22cd645a5d06e3f3c4730e24a6d29cbda44f1ac347a30f5282e644d03c92e193216735c52
• Download URL:
  https://stacks.cdc.gov/view/cdc/226244/cdc_226244_DS1.pdf
• File Type:
  [PDF - 1.93 MB ]