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Pulmonary fibrosis among World Trade Center responders: results from the WTC Health Registry Cohort.

Li J; Cone JE; Brackbill RM; Giesinger I; Young J; Farfel MR

Int J Environ Res Public Health 2019 Mar; 16(5):825

https://doi.org/10.3390/ijerph16050825

20055050

Dust created by the collapse of the World Trade Center (WTC) towers on 9/11 included metals and toxicants that have been linked to an increased risk of pulmonary fibrosis (PF) in the literature. Little has been reported on PF among WTC responders. This report used self-reported physician diagnosis of PF with an unknown sub-type to explore the association between levels of WTC dust exposure and PF. We included 19,300 WTC responders, enrolled in the WTC Health Registry in 2003-2004, who were followed for 11 years from 2004 to 2015. Exposure was defined primarily by intensity and duration of exposure to WTC dust/debris and work on the debris pile. Stratified Cox regression was used to assess the association. We observed 73 self-reported physician-diagnosed PF cases, with a PF incidence rate of 36.7/100,000 person-years. The adjusted hazard ratio (AHR) of PF was higher in those with a medium (AHR = 2.5, 95% CI = 1.1-5.8) and very high level of exposure (AHR = 4.5, 95% CI = 2.0-10.4), compared to those with low exposure. A test for exposure-response trend was statistically significant (Ptrend = 0.004). Future research on WTC dust exposure and PF would benefit from using data from multiple WTC Health Program responder cohorts for increased statistical power and clinically confirmed cases.

Pulmonary system disorders; Respiratory system disorders; Fibrosis; World Trade Center; WTC; First responders; Emergency responders; Dusts; Dust exposure; Exposure levels; Risk factors; Humans; Men; Women; Hazards; Statistical analysis; Toxins; Author Keywords: World Trade Center disaster; pulmonary fibrosis; dust

Jiehui Li, New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, New York City, NY 10013

IJERGQ

20190301

Journal Article

jli3@health.nyc.gov

Cooperative Agreement

2019

Cooperative-Agreement-Number-U50-OH-009739; Cooperative-Agreement-Number-U50-TS-272750

5

1660-4601

International Journal of Environmental Research and Public Health

NY

New York City Health/Mental Hygiene