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Introduction: It is unclear whether differences in health outcomes by racial and ethnic groups among World Trade Center (WTC) rescue and recovery workers reflect those of the population of New York State (NYS) or show distinct patterns. We assessed cancer incidence in WTC workers by self‐reported race and ethnicity, and compared it to population figures for NYS. Methods: A total of 61,031 WTC workers enrolled between September 11, 2001 and January 10, 2012 were followed to December 31, 2015. To evaluate the association between race/ethnicity and cancer risk, Poisson regression analysis was used to estimate hazard ratios (HR) adjusted for WTC exposure, age, calendar year, sex and, for lung cancer, cigarette smoking. Results: In comparison to Whites, Black workers had a higher incidence of prostate cancer (HR = 1.99, 95% CI = 1.69−2.34) and multiple myeloma (HR = 3.57, 95% CI = 1.97−6.45), and a lower incidence of thyroid (HR = 0.41, 95% CI = 0.22−0.78) and colorectal cancer (HR = 0.57; 95% CI = 0.33−0.98). Hispanic workers had a higher incidence of liver cancer (HR = 4.03, 95% CI = 2.23−7.28). Compared with NYS population, White workers had significantly higher incidence of prostate cancer (HR = 1.26, 95% CI = 1.18−1.35) and thyroid cancer (HR = 1.80, 95% CI = 1.55−2.08), while Black workers had significantly higher incidence of prostate cancer (HR = 1.22, 95% CI = 1.05−1.40). Conclusion: Cancer incidence in WTC workers generally reflects data from the NYS population, but some differences were identified that merit further investigation. [ABSTRACT FROM AUTHOR]

Background: While several studies have reported the association between 9/11 exposure and cancer risk, cancer survival has not been well studied in the World Trade Center (WTC) exposed population. We examined associations of 9/11‐related exposures with mortality in WTC Health Registry enrollees diagnosed with cancer before and after 9/11/2001. Patients and Methods: This is a longitudinal cohort study of 5061 enrollees with a first‐ever primary invasive cancer diagnosis between 1995 and 2015 and followed through 2016. Based on the timing of first cancer diagnosis, pre‐9/11 (n = 634) and post‐9/11 (n = 4427) cancer groups were examined separately. 9/11‐related exposures included witnessing traumatic events, injury on 9/11, and 9/11‐related post‐traumatic stress disorder (PTSD). Associations of exposures with all‐cause mortality were examined using Cox proportional hazards regression. In the post‐9/11 group, cancer‐specific mortality was evaluated by enrollee group (WTC rescue/recovery workers vs. non‐workers) using Fine and Gray's proportional sub‐distribution hazard models, adjusting for baseline covariates, tumor characteristics, and treatment. Results: In the pre‐9/11 group, 9/11‐related exposures were not associated with all‐cause mortality. In the post‐9/11 group, increased risk of all‐cause mortality was associated with PTSD (adjusted HR = 1.35; 95% CI = 1.11–1.65), but not with injury or witnessing traumatic events. Cancer‐specific mortality was not statistically significantly associated with 9/11‐related exposures. In rescue/recovery workers, increased non‐cancer mortality risk was associated with PTSD (aHR = 2.13, 95% CI = 1.13–4.00) and witnessing ≥3 traumatic events (aHR = 2.00, 95% CI = 1.13–3.55). Conclusions: We did not observe associations between 9/11‐related exposures and cancer‐specific mortality. Similar to findings in the non‐cancer WTC exposed population, PTSD was associated with increased risk of all‐cause mortality in cancer patients. [ABSTRACT FROM AUTHOR]

The study aims to evaluate whether exposure to the World Trade Centre terrorist attack was responsible for causing asthma and posttraumatic stress symptoms (PTS). The results indicated that exposure to the attack led to asthma and PTS even 5 to 6 years after the attack.

Background: Statistically significantly increased cancer incidence has been reported from 3 cohorts of World Trade Center (WTC) disaster rescue and recovery workers. We pooled data across these cohorts to address ongoing public concerns regarding cancer risk 14 years after WTC exposure.Methods: From a combined deduplicated cohort of 69 102 WTC rescue and recovery workers, a sample of 57 402 workers enrolled before 2009 and followed through 2015 was studied. Invasive cancers diagnosed in 2002-2015 were identified from 13 state cancer registries. Standardized incidence ratios (SIRs) were used to assess cancer incidence. Adjusted hazard ratios (aHRs) were estimated from Cox regression to examine associations between WTC exposures and cancer risk.Results: Of the 3611 incident cancers identified, 3236 were reported as first-time primary (FP) cancers, with an accumulated 649 724 and 624 620 person-years of follow-up, respectively. Incidence for combined FP cancers was below expectation (SIR = 0.96, 95% confidence interval [CI] = 0.93 to 0.99). Statistically significantly elevated SIRs were observed for melanoma-skin (SIR = 1.43, 95% CI = 1.24 to 1.64), prostate (SIR = 1.19, 95% CI = 1.11 to 1.26), thyroid (SIR = 1.81, 95% CI = 1.57 to 2.09), and tonsil (SIR = 1.40, 95% CI = 1.00 to 1.91) cancer. Those arriving on September 11 had statistically significantly higher aHRs than those arriving after September 17, 2001, for prostate (aHR = 1.61, 95% CI = 1.33 to 1.95) and thyroid (aHR = 1.77, 95% CI = 1.11 to 2.81) cancers, with a statistically significant exposure-response trend for both.Conclusions: In the largest cohort of 9/11 rescue and recovery workers ever studied, overall cancer incidence was lower than expected, and intensity of WTC exposure was associated with increased risk for specific cancer sites, demonstrating the value of long-term follow-up studies after environmental disasters. [ABSTRACT FROM AUTHOR]

Lead levels are researched by using floor mat dust collected from houses built before 1950, and in several newly built homes in the Baltimore City, Maryland area. Researchers concluded that more research is needed before it can be known whether floor mats are a reliable way of collecting dust.

Abstract Background Many individuals who have 9/11-related physical and mental health symptoms do not use or are unaware of 9/11-related health care services despite extensive education and outreach efforts by the World Trade Center (WTC) Health Registry (the Registry) and various other organizations. This study sought to evaluate Registry enrollees’ perceptions of the relationship between physical and mental health outcomes and 9/11, as well as utilization of and barriers to 9/11-related health care services. Methods Six focus groups were conducted in January 2010 with diverse subgroups of enrollees, who were likely eligible for 9/11-related treatment services. The 48 participants were of differing race/ethnicities, ages, and boroughs of residence. Qualitative analysis of focus group transcripts was conducted using open coding and the identification of recurring themes. Results Participants described a variety of physical and mental symptoms and conditions, yet their knowledge and utilization of 9/11 health care services were low. Participants highlighted numerous barriers to accessing 9/11 services, including programmatic barriers (lack of program visibility and accessibility), personal barriers such as stigmatization and unfamiliarity with 9/11-related health problems and services, and a lack of referrals from their primary care providers. Moreover, many participants were reluctant to connect their symptoms to the events of 9/11 due to lack of knowledge, the amount of time that had elapsed since 9/11, and the attribution of current health symptoms to the aging process. Conclusions Knowledge of the barriers to 9/11-related health care has led to improvements in the Registry’s ability to refer eligible enrollees to appropriate treatment programs. These findings highlight areas for consideration in the implementation of the new federal WTC Health Program, now funded under the James Zadroga 9/11 Health and Compensation Act (PL 111-347), which includes provisions for outreach and education.

It has been recognized for decades that lead-based paint causes lead poisoning in children who put paint chips in their mouths; this problem is especially common in poorly maintained buildings in low-income areas. Forty years ago in Baltimore, Maryland, abatement of lead-based paint was mandated in apartments and houses. This achieved a dramatic reduction in the numbers of children suffering severe brain damage and death from lead poisoning. However, over the years it has become clear that blood lead levels previously considered safe are not safe, and cause permanent neurological damage and developmental delays. Even blood lead levels that produce no immediate symptoms can be detrimental, and the maximum acceptable blood lead concentration has been lowered progressively over the years in response to new data. During the 1980s, researchers reported that traditional abatement procedures were not effective in removing lead from the home environment; children who returned to abated buildings after being treated for their lead poisoning often had recurrences of high blood lead levels. Modified abatement practices were devised that involve a thorough cleaning to remove dust and debris from the dwelling and that protect the occupants and contents of the building from the dust. The modified approach does not involve sanding of walls or open-flame burning, but does include repainting of surfaces stripped of lead paint. In this study, 53 dwellings in Baltimore were abated using traditional methods and 18 were abated using the modified approach. Neither method was adequate for protecting children from lead poisoning after they reoccupied the dwellings, although the modified method was somewhat better than the traditional method. Children remained at risk for permanent neurological damage and behavioral deficits, based upon their high blood lead levels. New, more effective abatement techniques are needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abstract Background Few studies have documented the experiences of individuals who participated in the recovery and cleanup efforts at the World Trade Center Recovery Operation at Fresh Kills Landfill, on debris loading piers, and on transport barges after the September 11, 2001 terrorist attack. Methods Semi-structured telephone interviews were conducted with a purposive sample of workers and volunteers from the World Trade Center Health Registry. Qualitative methods were used to analyze the narratives. Results Twenty workers and volunteers were interviewed. They described the transport of debris to the Landfill via barges, the tasks and responsibilities associated with their post-9/11 work at the Landfill, and their reflections on their post-9/11 experiences. Tasks included sorting through debris, recovering human remains, searching for evidence from the terrorist attacks, and providing food and counseling services. Exposures mentioned included dust, fumes, and odors. Eight years after the World Trade Center disaster, workers expressed frustration about poor risk communication during recovery and cleanup work. Though proud of their contributions in the months after 9/11, some participants were concerned about long-term health outcomes. Conclusions This qualitative study provided unique insight into the experiences, exposures, and concerns of understudied groups of 9/11 recovery and cleanup workers. The findings are being used to inform the development of subsequent World Trade Center Health Registry exposure and health assessments.