A 15-Year Follow-Up Study of Mortality in a Pooled Cohort of World Trade Center Rescue and Recovery Workers

Details

• Personal Author:
  Boffetta P ; Brackbill RM ; Cone, James E. ; Dasaro CR ; Farfel MR ; Hall CB ; Kehm RD ; Li J ; Prezant DJ ; Qiao B ; Schymura MJ ; Shapiro MZ ; Singh A ; Todd AC ; Yung J ; Zeig-Owens R
• Description:
  Introduction: Hazardous exposures from the World Trade Center (WTC) terrorist attacks have been linked to increased incidence of adverse health conditions, often associated with increased mortality. We assessed mortality in a pooled cohort of WTC rescue/recovery workers over 15 years of follow-up. Materials and methods: We analyzed mortality through 2016 in a pooled and deduplicated cohort of WTC rescue/recovery workers from three WTC-exposed cohorts (N = 60,631): the Fire Department of the City of New York (FDNY); the WTC Health Registry (WTCHR); and the General Responder Cohort (GRC). Standardized mortality ratios (SMRs) were estimated to assess mortality vs. the US and NY state populations. Multivariable Cox proportional hazards models were used to examine associations of WTC exposures (date of first arrival, working on the WTC debris pile) with mortality risk. Results: There were 1912 deaths over 697,943.33 person-years of follow-up. The SMR for all-cause mortality was significantly lower-than-expected, both when using US (SMR 0.43, 95% confidence interval [CI] 0.42-0.45) and NYS (SMR 0.51, 95% CI 0.49-0.53) as reference populations. SMRs were not elevated for any of the 28 major causes of death. Arriving at the WTC site on 9/11-9/17/2001 vs. 9/18/2001-6/30/2002 was associated with 30-50% higher risk of all-cause, heart disease and smoking-related mortality in non-FDNY/non-GRC members. Conversely, arriving on 9/11/2001 vs. 9/18/2001-6/30/2002 was associated with 40% lower all-cause and smoking-related mortality risk in FDNY members. Working on vs. off the WTC pile was associated with an increased risk of all-cause mortality in non-FDNY/non-GRC members (adjusted hazard ratio [aHR] 1.25, 95% CI 1.04-1.50), and cancer-specific mortality in GRC members (aHR 1.39, 95% CI 1.05-1.84), but lower mortality risks were found in FDNY members. Conclusions: We did not observe excess mortality among WTC rescue/recovery workers compared with general populations. However, significantly increased mortality risks among some sub-groups with high WTC exposure warrant further investigation. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Emergency Responders Mortality Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: 9/11 Cause Of Death Cohort Studies Disaster Recovery First Responders Mortality Rates Rescue And Recovery Workers Rescue Workers Surveillance Terrorist Attacks World Trade Center WTC

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• ISSN:
  0013-9351
• 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:
  219
• NIOSHTIC Number:
  nn:20067077
• Citation:
  Environ Res 2023 Feb; 219:115116
• Contact Point Address:
  Paolo Boffetta, Stony Brook Cancer Center Stony Brook University Lauterbur Dr. Stony Brook, NY, 11794, USA
• Email:
  paolo.boffetta@stonybrookmedicine.edu
• Federal Fiscal Year:
  2023
• Performing Organization:
  Albert Einstein College of Medicine, Inc., Bronx, New York
• Peer Reviewed:
  True
• Start Date:
  20160901
• Source Full Name:
  Environmental Research
• End Date:
  20200831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:17b7cd9477f665485683ee9ed9e27508828ed35c807611a6d20bf901c813b452e68c733f357b529cf304a1730d0ef909a7140dbf94b0040b2d3cc53ea8cc82f0
• Download URL:
  https://stacks.cdc.gov/view/cdc/231276/cdc_231276_DS1.pdf
• File Type:
  [PDF - 494.74 KB ]