World Trade Center Health Program: First Decade of Research

Abstract

The terrorist attacks on 11 September 2001 placed nearly a half million people at increased risk of adverse health. Health effects research began shortly after and continues today, now mostly as a coordinated effort under the federally mandated World Trade Center (WTC) Health Program (WTCHP). Established in 2011, the WTCHP provides medical monitoring and treatment of covered health conditions for responders and survivors and maintains a research program aimed to improve the care and well-being of the affected population. By 2020, funds in excess of USD 127 M had been awarded for health effects research. This review describes research findings and provides an overview of the WTCHP and its future directions. The literature was systematically searched for relevant articles published from 11 September 2001 through 30 June 2020. Synthesis was limited to broad categories of mental health, cancer, respiratory disease, vulnerable populations, and emerging conditions. In total, 944 WTC articles were published, including peer-reviewed articles funded by the WTCHP (n = 291) and other sources. Research has focused on characterizing the burden and etiology of WTC-related health conditions. As the program moves forward, translational research that directly enhances the care of individuals with chronic mental and physical health conditions is needed.

Keywords: 9/11; World Trade Center Health Program; disaster epidemiology; emerging medical conditions; review; special populations.

Figure 1

WTCHP Research funding in 2011–2020 by focus area (excluding Registry funding). “WTC Youth” is research targeting health effects among persons exposed before age 18 years and is the largest contributor to the vulnerable population category. (See Section 3.3.4).

Figure 2

Publication counts by funding source and focus area. Some articles address multiple focus areas (i.e., count sum > 944).