Cancer Incidence in World Trade Center Rescue and Recovery Workers: 14 Years of Follow-Up

Details

• Personal Author:
  Boffetta P ; Brackbill RM ; Cone, James E. ; Dasaro CR ; Farfel MR ; Goldfarb DG ; Hall CB ; Kahn AR ; Kristjansson D ; Li J ; Prezant DJ ; Qiao B ; Schymura MJ ; Shapiro MZ ; Takemoto E ; Todd AC ; Yung J ; Zeig-Owens R
• Description:
  Background: Statistically significantly increased cancer incidence has been reported from 3 cohorts of World Trade Center (WTC) disaster rescue and recovery workers. We pooled data across these cohorts to address ongoing public concerns regarding cancer risk 14 years after WTC exposure. Methods: From a combined deduplicated cohort of 69,102 WTC rescue and recovery workers, a sample of 57,402 workers enrolled before 2009 and followed through 2015 was studied. Invasive cancers diagnosed in 2002-2015 were identified from 13 state cancer registries. Standardized incidence ratios (SIRs) were used to assess cancer incidence. Adjusted hazard ratios (aHRs) were estimated from Cox regression to examine associations between WTC exposures and cancer risk. Results: Of the 3611 incident cancers identified, 3236 were reported as first-time primary (FP) cancers, with an accumulated 649 724 and 624 620 person-years of follow-up, respectively. Incidence for combined FP cancers was below expectation (SIR = 0.96, 95% confidence interval [CI] = 0.93 to 0.99). Statistically significantly elevated SIRs were observed for melanoma-skin (SIR = 1.43, 95% CI = 1.24 to 1.64), prostate (SIR = 1.19, 95% CI = 1.11 to 1.26), thyroid (SIR = 1.81, 95% CI = 1.57 to 2.09), and tonsil (SIR = 1.40, 95% CI = 1.00 to 1.91) cancer. Those arriving on September 11 had statistically significantly higher aHRs than those arriving after September 17, 2001, for prostate (aHR = 1.61, 95% CI = 1.33 to 1.95) and thyroid (aHR = 1.77, 95% CI = 1.11 to 2.81) cancers, with a statistically significant exposure-response trend for both. Conclusions: In the largest cohort of 9/11 rescue and recovery workers ever studied, overall cancer incidence was lower than expected, and intensity of WTC exposure was associated with increased risk for specific cancer sites, demonstrating the value of long-term follow-up studies after environmental disasters. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Emergency Responders Epidemiology Health Care Facilities Workforce And Services Neoplasms Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Cancer Rates Cohort Studies Emergency Responders Medical Monitoring Rescue Workers Surveillance World Trade Center WTC
• ISSN:
  0027-8874
• 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
• Pages in Document:
  210-219
• Volume:
  114
• Issue:
  2
• NIOSHTIC Number:
  nn:20063466
• Citation:
  J Natl Cancer Inst 2022 Feb; 114(2):210-219
• Contact Point Address:
  James E. Cone, MD, MPH, New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, 30-30 47th Avenue, Room 414, Long Island City, NY 11101, USA
• Email:
  jcone@health.nyc.gov
• Federal Fiscal Year:
  2022
• Performing Organization:
  Albert Einstein College of Medicine, Inc., Bronx, New York
• Peer Reviewed:
  True
• Start Date:
  20160901
• Source Full Name:
  Journal of the National Cancer Institute
• End Date:
  20200831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:1922ef4563e5de5185cc4fe362fa6e51c1f97e3078532ac9cc580669c7f62e71807e23f2d9f0712a7fe35ef6ea937490f9e7f9750430849eb8359c4bc7ad684a
• Download URL:
  https://stacks.cdc.gov/view/cdc/226528/cdc_226528_DS1.pdf
• File Type:
  [PDF - 768.29 KB ]