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The World Trade Center disaster and the health of workers: five-year assessment of a unique medical screening program.

Authors
Herbert-R; Moline-J; Skloot-G; Metzger-K; Baron-S; Luft-B; Markowitz-S; Udasin-I; Harrison-D; Stein-D; Todd-A; Enright-P; Stellman-JM; Landrigan-PJ; Levin-SM
Source
Environ Health Perspect 2006 Dec; 114(12):1853-1858
NIOSHTIC No.
20031367
Abstract
Approximately 40,000 rescue and recovery workers were exposed to caustic dust and toxic pollutants following the 11 September 2001 attacks on the World Trade Center (WTC) . These workers included traditional first responders, such as firefighters and police, and a diverse population of construction, utility, and public sector workers. To characterize WTC-related health effects, the WTC Worker and Volunteer Medical Screening Program was established. This multicenter clinical program provides free standardized examinations to responders. Examinations include medical, mental health, and exposure assessment questionnaires ; physical examinations ; spirometry ; and chest X rays. Of 9,442 responders examined between July 2002 and April 2004, 69% reported new or worsened respiratory symptoms while performing WTC work. Symptoms persisted to the time of examination in 59% of these workers. Among those who had been asymptomatic before September 11, 61% developed respiratory symptoms while performing WTC work. Twenty-eight percent had abnormal spirometry ; forced vital capacity (FVC) was low in 21% ; and obstruction was present in 5%. Among nonsmokers, 27% had abnormal spirometry compared with 13% in the general U.S. population. Prevalence of low FVC among nonsmokers was 5-fold greater than in the U.S. population (20% vs. 4%) . Respiratory symptoms and spirometry abnormalities were significantly associated with early arrival at the site. WTC responders had exposure-related increases in respiratory symptoms and pulmonary function test abnormalities that persisted up to 2.5 years after the attacks. Long-term medical monitoring is required to track persistence of these abnormalities and identify late effects, including possible malignancies. Lessons learned should guide future responses to civil disasters.
Keywords
Occupational-hazards; Occupational-health; Workers; Worker-health; Medical-screening; Emergency-response; Emergency-responders; Occupational-exposure; Exposure-assessment; Dusts; Dust-exposure; Toxins; Pollutants; Fire-fighters; Police-officers; Law-enforcement-workers; Spirometry; Respiratory-system-disorders; Pulmonary-system-disorders; Surveillance-programs
Contact
R. Herbert, Department of Community and Preventive Medicine, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1057, New York, NY 10029 USA
CODEN
EVHPAZ
Publication Date
20061201
Document Type
Journal Article
Email Address
robin.herbert@mssm.edu
Funding Type
Cooperative Agreement; Contract
Fiscal Year
2007
NTIS Accession No.
NTIS Price
Identifying No.
Cooperative-Agreement-Number-U10-OH-008232; Contract-200-2002-0038; Cooperative-Agreement-Number-U10-OH-008216; Cooperative-Agreement-Number-U10-OH-008225; Cooperative-Agreement-Number-U10-OH-008275
Issue of Publication
12
ISSN
0091-6765
NIOSH Division
DSHEFS; DRDS
Source Name
Environmental Health Perspectives
State
NY; OH; WV
Performing Organization
Mount Sinai School of Medicine of New York
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