scholarly journals Combining Three Cohorts of WTC Rescue/Recovery Workers for Assessing Cancer Incidence and Mortality

2021 ◽  
Author(s):  
Robert Brackbill ◽  
Amy Kahn ◽  
Jiehui LI ◽  
Rachel Zeig-Owens ◽  
David Goldfarb ◽  
...  
Keyword(s):  
New York ◽  
World Trade ◽  
World Trade Center ◽  
Fire Department ◽  
Analysis Data ◽  
Cancer Registries ◽  
Future Research ◽  
Incidence And Mortality ◽  
The World ◽  
Trade Center

Three cohorts including the Fire Department of the City of New York (FDNY), the World Trade Center Health Registry (WTCHR), and the General Responder Cohort (GRC), each funded by the World Trade Center Health Program have reported associations between WTC-exposures and cancer. Results have generally been consistent with effect estimates for excess incidence for all cancers ranging from 6 to 14% above background rates. Pooling would increase sample size and de-duplicate cases between the cohorts. Pooling required time consuming steps: obtaining IRB approvals and legal agreements from entities involved; establishing an honest broker for managing the data; de-duplicating the pooled cohort files; applying to State Cancer Registries (SCRs) for matched cancer cases; and finalizing analysis data files. Obtaining SCR data use agreements ranged from 6.5 to 114.5 weeks with six states requiring >20 weeks. Records from FDNY (n=16,221), WTCHR (n=29,372), and GRC (n=33,427) were combined de-duplicated resulting in 69,102 unique individuals. Overall, 7,894 cancer tumors were matched to the pooled cohort, increasing the number cancers by as much as 58% compared to previous analyses. Pooling resulted in a coherent resource for future research for studies on rare cancers and mortality, with more representative of occupations and WTC- exposure.

scholarly journals Combining Three Cohorts of World Trade Center Rescue/Recovery Workers for Assessing Cancer Incidence and Mortality

2021 ◽  
Vol 18 (4) ◽  
pp. 1386
Author(s):  
Robert M. Brackbill ◽  
Amy R. Kahn ◽  
Jiehui Li ◽  
Rachel Zeig-Owens ◽  
David G. Goldfarb ◽  
...  
Keyword(s):  
New York ◽  
World Trade ◽  
World Trade Center ◽  
Fire Department ◽  
Analysis Data ◽  
Cancer Registries ◽  
Future Research ◽  
Incidence And Mortality ◽  
The World ◽  
Trade Center

Three cohorts including the Fire Department of the City of New York (FDNY), the World Trade Center Health Registry (WTCHR), and the General Responder Cohort (GRC), each funded by the World Trade Center Health Program have reported associations between WTC-exposures and cancer. Results have generally been consistent with effect estimates for excess incidence for all cancers ranging from 6 to 14% above background rates. Pooling would increase sample size and de-duplicate cases between the cohorts. However, pooling required time consuming steps: obtaining Institutional Review Board (IRB) approvals and legal agreements from entities involved; establishing an honest broker for managing the data; de-duplicating the pooled cohort files; applying to State Cancer Registries (SCRs) for matched cancer cases; and finalizing analysis data files. Obtaining SCR data use agreements ranged from 6.5 to 114.5 weeks with six states requiring >20 weeks. Records from FDNY (n = 16,221), WTCHR (n = 29,372), and GRC (n = 33,427) were combined de-duplicated resulting in 69,102 unique individuals. Overall, 7894 cancer tumors were matched to the pooled cohort, increasing the number cancers by as much as 58% compared to previous analyses. Pooling resulted in a coherent resource for future research for studies on rare cancers and mortality, with more representative of occupations and WTC- exposure.

scholarly journals Pulmonary Function after Exposure to the World Trade Center Collapse in the New York City Fire Department

2006 ◽  
Vol 174 (3) ◽  
pp. 312-319 ◽  
Author(s):  
Gisela I. Banauch ◽  
Charles Hall ◽  
Michael Weiden ◽  
Hillel W. Cohen ◽  
Thomas K. Aldrich ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Pulmonary Function ◽  
York City ◽  
World Trade ◽  
World Trade Center ◽  
Fire Department ◽  
The World ◽  
Trade Center

scholarly journals Mortality among Fire Department of the City of New York Rescue and Recovery Workers Exposed to the World Trade Center Disaster, 2001–2017

2020 ◽  
Vol 17 (17) ◽  
pp. 6266
Author(s):  
Hilary L. Colbeth ◽  
Rachel Zeig-Owens ◽  
Charles B. Hall ◽  
Mayris P. Webber ◽  
Theresa M. Schwartz ◽  
...  
Keyword(s):  
New York ◽  
World Trade ◽  
Service Providers ◽  
Linear Trend ◽  
World Trade Center ◽  
Fire Department ◽  
Smoking History ◽  
The World ◽  
Trade Center ◽  
The City

The World Trade Center (WTC) attacks on 9/11/2001 have consistently been associated with elevated rates of physical and mental health morbidities, while evidence about mortality has been limited. We examined mortality between 9/12/2001 and 12/31/2017 among 15,431 WTC-exposed Fire Department of the City of New York (FDNY) firefighters and emergency medical service providers (EMS), specifically assessing associations between intensity of WTC-exposure and mortality risk. Standardized mortality ratios (SMR) and 95% confidence intervals (CI) compared FDNY cohort mortality with the US general population using life table analysis. Deaths were identified via linkage to the National Death Index. Cox proportional hazards regression models were used to identify associations between intensity of WTC-exposure and mortality, accounting for age, sex, race/ethnicity, smoking history, and other relevant confounders. We identified 546 deaths and a lower than expected all-cause mortality rate (SMR = 0.22; 95% CI, 0.20–0.24). No cause-specific SMRs were meaningfully elevated. Mortality hazard ratios showed no association or linear trend with level of WTC-exposure. Our results provide evidence of the healthy worker effect, despite exposure to the World Trade Center. More follow-up time may be needed to assess the full impact of WTC-exposure on mortality in this occupational population.

scholarly journals Cancer incidence in World Trade Center-exposed and non-exposed male firefighters, as compared with the US adult male population: 2001–2016

2021 ◽  
pp. oemed-2021-107570
Author(s):  
Mayris P Webber ◽  
Ankura Singh ◽  
Rachel Zeig-Owens ◽  
Joke Salako ◽  
Molly Skerker ◽  
...  
Keyword(s):  
New York ◽  
Cancer Incidence ◽  
World Trade ◽  
World Trade Center ◽  
Fire Department ◽  
Cancer Registries ◽  
Smoking History ◽  
Health Study ◽  
Male Population ◽  
Trade Center

ObjectiveTo compare cancer incidence in Fire Department of the City of New York (FDNY) firefighters who worked at the World Trade Center (WTC) site to incidence in a population of non-WTC-exposed firefighters, the Career Firefighter Health Study (CFHS) cohort, and to compare rates from each firefighter cohort to rates in demographically similar US males.MethodsFDNY (N=10 786) and CFHS (N=8813) cohorts included male firefighters who were active on 11 September 2001 (9/11) and were followed until death or 31 December 2016. Cases were identified from 15 state cancer registries. Poisson regression models assessed cancers in each group (FDNY and CFHS) versus US males, and associations between group and cancer rates; these models estimated standardised incidence ratios (SIRs) and adjusted relative rates (RRs), respectively. Secondary analyses assessed surveillance bias and smoking history.ResultsWe identified 915 cancer cases in 841 FDNY firefighters and 1002 cases in 909 CFHS firefighters. FDNY had: higher rates for all cancers (RR=1.13; 95% CI 1.02 to 1.25), prostate (RR=1.39; 95% CI 1.19 to 1.63) and thyroid cancer (RR=2.53; 95% CI 1.37 to 4.70); younger median ages at diagnosis (55.6 vs 59.4; p<0.001, all cancers); and more cases with localised disease when compared with CFHS. Compared with US males, both firefighter cohorts had elevated SIRs for prostate cancer and melanoma. Control for surveillance bias in FDNY reduced most differences.ConclusionsExcess cancers occurred in WTC-exposed firefighters relative to each comparison group, which may partially be explained by heightened surveillance. Two decades post-9/11, clearer understanding of WTC-related risk requires extended follow-up and modelling studies (laboratory or animal based) to identify workplace exposures in all firefighters.

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