Effect of World Trade Center Health Program on Mortality Among 9/11 Responders

Details

• Personal Author:
  Parvin, Afroza ; Kehm, Rebecca D. ; Qiao, Baozhen ; Cone, James E. ; Farfel, Mark R. ; Zeig-Owens, Rachel ; Goldfarb, David G. ; Shapiro, Moshe Z. ; Todd, Andrew C. ; Insaf, Tabassum ; Hall, Charles B. ; Boffetta, Paolo ; Li, Jiehui
• Description:
  Purpose: The World Trade Center Health Program (WTCHP) plays a critical role in medical monitoring and treatment to those exposed to the terrorist attacks of September 11, 2001 (9/11). We investigated the association of WTCHP membership with mortality risk among 9/11 responders while controlling for comorbidities using inverse probability weighting. Methods: We prospectively analyzed 28,430 9/11 responders, followed from the time of their enrollment into the WTCHP or the WTC Health Registry, through 2020. NDI linkage provided death data. Non-cancer comorbidities were self-reported physician-diagnosis and cancer was identified through cancer registry linkage. We estimated the adjusted hazard ratio (aHR) with 95 % confidence interval (CI) for the association between WTCHP membership and all-cause and cause-specific mortality using Cox proportional hazards models and cause-specific hazard regression models, respectively. Results: A total of 1657 deaths were identified over 444,425 person-years of follow-up. Compared to non-members, WTCHP members had a lower risk of all-cause mortality (aHR=0.87; 95 % CI=0.77-0.98) and smoking-related mortality (aHR=0.83; 0.69-0.99) after adjusting for demographics, WTC exposure, and weights of comorbidities. With the membership-sex interaction included, reduced risk of all-cause mortality remained statistically significant among males only (aHR=0.85; 0.75-0.96). Cancer- and heart-related mortality risk were not significantly different between WTCHP members and non-members. Conclusions: This study found that WTCHP membership may reduce risks of all-cause and smoking-related mortality among 9/11 responders, even after accounting for underlying medical conditions, underscoring the importance of comprehensive health monitoring and treatment services for disaster-relief workers.
• Subjects:
  Emergency Responders Mortality Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: World Trade Center; WTC; Terrorist Attacks; Mortality; Specific Cause Of Death; 9/11 Responders; WTC Health Program World Trade Center; WTC; Mortality Rates; Rescue Workers; Epidemiology; Disaster Recovery; Medical Treatment; Medical Monitoring; Smoking;
• ISSN:
  1047-2797
• Document Type:
  Text
• Funding:
  Cooperative Agreement; Contract
• Genre:
  Journal Article
• Place as Subject:
  New York ; New York City Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  7 pdf pages
• Volume:
  115
• NIOSHTIC Number:
  nn:20071146
• Citation:
  Ann Epidemiol 2026 Mar; 115:8-14
• Email:
  jli3@health.nyc.gov
• Federal Fiscal Year:
  2026
• Performing Organization:
  Albert Einstein College of Medicine, Inc., Bronx, New York
• Peer Reviewed:
  True
• Start Date:
  20160901
• Source Full Name:
  Annals of Epidemiology
• End Date:
  20200831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:033ad67c763bb1d205e674d5f63488ddb3db42d581ecc78a917ea11f57ffd74b45a7dcc648df3b4214fa13b4b9774ef11657d142405d16a46b52812745d96038
• Download URL:
  https://stacks.cdc.gov/view/cdc/257913/cdc_257913_DS1.pdf
• File Type:
  [PDF - 721.62 KB ]