Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Mar 7;16(5):825.
doi: 10.3390/ijerph16050825.

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

Jiehui Li  1 , James E Cone  2 , Robert M Brackbill  3 , Ingrid Giesinger  4 , Janette Yung  5 , Mark R Farfel  6
Affiliations

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

Jiehui Li et al. Int J Environ Res Public Health. .

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 (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.

Keywords: World Trade Center disaster; dust; pulmonary fibrosis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Lioy P.J., Weisel C.P., Millette J.R., Eisenreich S., Vallero D., Offenberg J., Buckley B., Turpin B., Zhong M., Cohen M.D., et al. Characterization of the dust/smoke aerosol that settled east of the World Trade Center (WTC) in lower Manhattan after the collapse of the WTC 11 September 2001. Environ. Health Perspect. 2002;110:703–714. doi: 10.1289/ehp.02110703. - DOI - PMC - PubMed
    1. Kostrubiak M. World Trade Center Dust: Composition and Spatial-Temporal Considerations for Health. Springer; Cham, Switzerland: 2018.
    1. Woskie S.R., Kim H., Freund A., Stevenson L., Park B.Y., Baron S., Herbert R., de Hernandez M.S., Teitelbaum S., de la Hoz R.E., et al. World Trade Center disaster: Assessment of responder occupations, work locations, and job tasks. Am. J. Ind. Med. 2011;54:681–695. doi: 10.1002/ajim.20997. - DOI - PMC - PubMed
    1. Prezant D.J., Levin S., Kelly K.J., Aldrich T.K. Upper and lower respiratory diseases after occupational and environmental disasters. Mt. Sinai J. Med. 2008;75:89–100. doi: 10.1002/msj.20028. - DOI - PubMed
    1. Brackbill R.M., Hadler J.L., DiGrande L., Ekenga C.C., Farfel M.R., Friedman S., Perlman S.E., Stellman S.D., Walker D.J., Wu D., et al. Asthma and posttraumatic stress symptoms 5 to 6 years following exposure to the World Trade Center terrorist attack. JAMA. 2009;302:502–516. doi: 10.1001/jama.2009.1121. - DOI - PubMed

Publication types