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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
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
Publication Date
Document Type
Journal Article
Email Address
Funding Type
Cooperative Agreement
Fiscal Year
Identifying No.
Cooperative-Agreement-Number-U50-OH-009739; Cooperative-Agreement-Number-U50-TS-272750
Issue of Publication
Source Name
International Journal of Environmental Research and Public Health
Performing Organization
New York City Health/Mental Hygiene
Page last reviewed: May 11, 2023
Content source: National Institute for Occupational Safety and Health Education and Information Division