Ten-year cancer incidence in rescue/recovery workers and civilians exposed to the September 11, 2001 terrorist attacks on the World Trade Center

Am J Ind Med. 2016 Sep;59(9):709-21. doi: 10.1002/ajim.22638.

Abstract

Background: Cancer incidence in exposed rescue/recovery workers (RRWs) and civilians (non-RRWs) was previously reported through 2008.

Methods: We studied occurrence of first primary cancer among World Trade Center Health Registry enrollees through 2011 using adjusted standardized incidence ratios (SIRs), and the WTC-exposure-cancer association, using Cox proportional hazards models.

Results: All-cancer SIR was 1.11 (95% confidence interval (CI) 1.03-1.20) in RRWs, and 1.08 (95% CI 1.02-1.15) in non-RRWs. Prostate cancer and skin melanoma were significantly elevated in both populations. Thyroid cancer was significantly elevated only in RRWs while breast cancer and non-Hodgkin's lymphoma were significantly elevated only in non-RRWs. There was a significant exposure dose-response for bladder cancer among RRWs, and for skin melanoma among non-RRWs.

Conclusions: We observed excesses of total and specific cancers in both populations, although the strength of the evidence for causal relationships to WTC exposures is somewhat limited. Continued monitoring of this population is indicated. Am. J. Ind. Med. 59:709-721, 2016. © 2016 Wiley Periodicals, Inc.

Keywords: September 11 attacks; World Trade Center; cancer incidence; environmental exposure.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Female
  • Humans
  • Incidence
  • Lymphoma, Non-Hodgkin / epidemiology
  • Male
  • Melanoma / epidemiology
  • Middle Aged
  • Neoplasms / epidemiology*
  • New York City / epidemiology
  • Occupational Diseases / epidemiology*
  • Occupational Exposure / statistics & numerical data*
  • Proportional Hazards Models
  • Prostatic Neoplasms / epidemiology
  • Rescue Work / statistics & numerical data*
  • September 11 Terrorist Attacks
  • Skin Neoplasms / epidemiology
  • Thyroid Neoplasms / epidemiology
  • Time Factors
  • Urinary Bladder Neoplasms / epidemiology
  • Young Adult