Pulmonary Fibrosis among World Trade Center Responders: Results from the WTC Health Registry Cohort

Li, Jiehui; Cone, James E.; Brackbill, Robert M.; Giesinger, Ingrid; Yung, Janette; Farfel, Mark R.

doi:10.3390/ijerph16050825

Open AccessArticle

Pulmonary Fibrosis among World Trade Center Responders: Results from the WTC Health Registry Cohort

by

Jiehui Li

^*,

James E. Cone

,

Robert M. Brackbill

,

Ingrid Giesinger

,

Janette Yung

and

Mark R. Farfel

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

^*

Author to whom correspondence should be addressed.

Int. J. Environ. Res. Public Health 2019, 16(5), 825; https://doi.org/10.3390/ijerph16050825

Submission received: 12 February 2019 / Revised: 1 March 2019 / Accepted: 4 March 2019 / Published: 7 March 2019

(This article belongs to the Special Issue Long-Term Health Effects of the 9/11 Disaster)

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Abstract

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 (P_trend = 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.

Keywords: World Trade Center disaster; pulmonary fibrosis; dust

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MDPI and ACS Style

Li, J.; Cone, J.E.; Brackbill, R.M.; Giesinger, I.; Yung, J.; Farfel, M.R. Pulmonary Fibrosis among World Trade Center Responders: Results from the WTC Health Registry Cohort. Int. J. Environ. Res. Public Health 2019, 16, 825. https://doi.org/10.3390/ijerph16050825

AMA Style

Li J, Cone JE, Brackbill RM, Giesinger I, Yung J, Farfel MR. Pulmonary Fibrosis among World Trade Center Responders: Results from the WTC Health Registry Cohort. International Journal of Environmental Research and Public Health. 2019; 16(5):825. https://doi.org/10.3390/ijerph16050825

Chicago/Turabian Style

Li, Jiehui, James E. Cone, Robert M. Brackbill, Ingrid Giesinger, Janette Yung, and Mark R. Farfel. 2019. "Pulmonary Fibrosis among World Trade Center Responders: Results from the WTC Health Registry Cohort" International Journal of Environmental Research and Public Health 16, no. 5: 825. https://doi.org/10.3390/ijerph16050825

APA Style

Li, J., Cone, J. E., Brackbill, R. M., Giesinger, I., Yung, J., & Farfel, M. R. (2019). Pulmonary Fibrosis among World Trade Center Responders: Results from the WTC Health Registry Cohort. International Journal of Environmental Research and Public Health, 16(5), 825. https://doi.org/10.3390/ijerph16050825

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Pulmonary Fibrosis among World Trade Center Responders: Results from the WTC Health Registry Cohort

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