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Pulmonary Fibrosis Among World Trade Center Rescue and Recovery Workers: Results from the World Trade Center Health Registry
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A2585 - Pulmonary Fibrosis Among World Trade Center Rescue and Recovery Workers: Results from the World Trade Center Health Registry
Author Block: J. Li1, J. Cone2, M. Farfel1, J. Yung1, R. Brackbill1; 1World Trade Center Health Registry, New York City Dept of Health and Mental Hygiene, New York, NY, United States, 2New York CIty Department of Health and Mental Hygiene, World Trade Center Health Registry, New York, NY, United States.
RATIONALE: Known constituents of the plume following the World Trade Center (WTC) events include metals and some toxicants that have been reported to be linked to an increased risk of pulmonary fibrosis (PF). However, possibly due to a very small number of clinically diagnosed PF cases, PF has not been reported in a population-based study of WTC workers. This report explores the association between levels of WTC dust exposure and self-report of PF with unknown sub-type PF. METHODS: We prospectively followed 27,457 WTC rescue and recovery workers who enrolled in the WTC Health Registry in 2003-04 for 12 years. Self-reported physician-diagnosed PF and year of diagnosis were collected in two follow-up surveys in 2011-2012 and in 2015-2016. Workers with PF prior to enrollment were excluded. WTC dust exposure was defined based on date of arrival, duration of work at the site, dates or time period working on the pile, and being near the WTC site with potential exposure to dust/debris resulting from the collapse of buildings on 9/11. Person-years of observation were counted from the date of enrollment. We used Cox proportional hazards model to investigate the association between WTC dust exposure level and PF. RESULTS: A total of 75 physician-diagnosed PF cases were reported among 27,457 workers between 2004 and 2015. An average annual incidence of 23 cases per 100,000 was observed. Responders exposed to medium (Adjusted hazard ratio, AHR=2.5, 95% CI, 1.1-5.8), high (AHR=2.4, 95% CI, 1.03-5.6), and very high levels of WTC dust (AHR=4.1, 95% CI, 1.8-9.5) were at increased risk of having PF. A test for a dose-response trend was also significant (AHR=1.02, 95% CI, 1.01-1.04). CONCLUSIONS: PF among workers was significantly associated with the level of WTC dust exposure. Future in-depth research using medically-verified cases from multiple WTC health programs would help better understand the relationship between WTC dust exposure and PF.
Author Block: J. Li1, J. Cone2, M. Farfel1, J. Yung1, R. Brackbill1; 1World Trade Center Health Registry, New York City Dept of Health and Mental Hygiene, New York, NY, United States, 2New York CIty Department of Health and Mental Hygiene, World Trade Center Health Registry, New York, NY, United States.
RATIONALE: Known constituents of the plume following the World Trade Center (WTC) events include metals and some toxicants that have been reported to be linked to an increased risk of pulmonary fibrosis (PF). However, possibly due to a very small number of clinically diagnosed PF cases, PF has not been reported in a population-based study of WTC workers. This report explores the association between levels of WTC dust exposure and self-report of PF with unknown sub-type PF. METHODS: We prospectively followed 27,457 WTC rescue and recovery workers who enrolled in the WTC Health Registry in 2003-04 for 12 years. Self-reported physician-diagnosed PF and year of diagnosis were collected in two follow-up surveys in 2011-2012 and in 2015-2016. Workers with PF prior to enrollment were excluded. WTC dust exposure was defined based on date of arrival, duration of work at the site, dates or time period working on the pile, and being near the WTC site with potential exposure to dust/debris resulting from the collapse of buildings on 9/11. Person-years of observation were counted from the date of enrollment. We used Cox proportional hazards model to investigate the association between WTC dust exposure level and PF. RESULTS: A total of 75 physician-diagnosed PF cases were reported among 27,457 workers between 2004 and 2015. An average annual incidence of 23 cases per 100,000 was observed. Responders exposed to medium (Adjusted hazard ratio, AHR=2.5, 95% CI, 1.1-5.8), high (AHR=2.4, 95% CI, 1.03-5.6), and very high levels of WTC dust (AHR=4.1, 95% CI, 1.8-9.5) were at increased risk of having PF. A test for a dose-response trend was also significant (AHR=1.02, 95% CI, 1.01-1.04). CONCLUSIONS: PF among workers was significantly associated with the level of WTC dust exposure. Future in-depth research using medically-verified cases from multiple WTC health programs would help better understand the relationship between WTC dust exposure and PF.
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