In the aftermath of September 11, 2001, thousands of rescue and recovery workers joined the New York City Fire Department (FDNY) in working directly on and adjacent to the debris pile. Analysis of bulk samples of WTC dust indicated the presence of a mixture of toxic particulates, combustion products, and debris fibers. Analysis of sputum of firefighters ten months after exposure showed an excess of these particles, thought to be causally related to upper and lower respiratory illnesses. Preliminary studies performed in firefighters, in the month after September 1 I, 2001 , as well as six months after exposure, indicated an excess of upper and lower respiratory illness, and an excess of stress related incidents. Based upon these results, investigators at Mount Sinai University Medical Center, supported by the Centers for Disease Control and Prevention (CDC), established a consortium of clinics, including the Clinical Center of EOHSI, where WTC workers and volunteers could receive medical and psychological screening. Over 9000 examinations have been completed to date in all of the centers, and 350 examinations have been completed at EOHSI. These examinations indicate an excess of upper and lower respiratory abnormalities and mental health symptoms, still present more than two years after exposure. We propose to continue our role in the surveillance of VVTC workers and volunteers as a clinical center (CC) for further evaluation of WTC workers. This evaluation will include medical and occupational history, physical examination, pulmonary function testing with and without bronchodilators, routine blood tests, urinalysis, and chest x-ray. Workers will complete a self-administered battery of psychological tests designed to screen for psychiatric issues including posttraumatic stress disorder, generalized anxiety disorder, major depression, and alcohol addiction. In particular, workers who continue to manifest upper respiratory problems will receive a directed physical assessment including detailed diagnostic testing of nasal function and structure and referral when appropriate. Workers with persistent mental health symptoms that manifest on standardized questionnaires or are diagnosed by the examining physicians will receive formal evaluation by a mental health clinician and referral for treatment. Data will be collected on the electronic medical record system, Logician, and will be integrated with the data collected at the Data Collection Center.

Agency
National Institute of Health (NIH)
Institute
National Institute for Occupational Safety and Health (NIOSH)
Type
Cooperative Clinical Research--Cooperative Agreements (U10)
Project #
3U10OH008239-05S4
Application #
8275116
Study Section
Special Emphasis Panel (ZOH1-SPC (04))
Program Officer
Fleming, Roy M
Project Start
2004-07-01
Project End
2011-06-30
Budget Start
2008-07-01
Budget End
2011-06-30
Support Year
5
Fiscal Year
2011
Total Cost
$496,000
Indirect Cost
Name
University of Medicine & Dentistry of NJ
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
617022384
City
Piscataway
State
NJ
Country
United States
Zip Code
08854
Graber, Judith M; Chuang, Connie T; Ward, Carolyn L et al. (2018) Head and Neck Cancer in World Trade Center Responders: A Case Series. J Occup Environ Med 60:e439-e444
Dasaro, Christopher R; Holden, William L; Berman, Karen D et al. (2017) Cohort Profile: World Trade Center Health Program General Responder Cohort. Int J Epidemiol 46:e9
Stein, Cheryl R; Wallenstein, Sylvan; Shapiro, Moshe et al. (2016) Mortality among World Trade Center rescue and recovery workers, 2002-2011. Am J Ind Med 59:87-95
Kotov, Roman; Bromet, Evelyn J; Schechter, Clyde et al. (2015) Posttraumatic stress disorder and the risk of respiratory problems in World Trade Center responders: longitudinal test of a pathway. Psychosom Med 77:438-48
Kim, Hyun; Herbert, Robin; Landrigan, Philip et al. (2012) Increased rates of asthma among World Trade Center disaster responders. Am J Ind Med 55:44-53
Luft, B J; Schechter, C; Kotov, R et al. (2012) Exposure, probable PTSD and lower respiratory illness among World Trade Center rescue, recovery and clean-up workers. Psychol Med 42:1069-79
Woskie, Susan R; Kim, Hyun; Freund, Alice et al. (2011) World Trade Center disaster: assessment of responder occupations, work locations, and job tasks. Am J Ind Med 54:681-95
Crowley, Laura E; Herbert, Robin; Moline, Jacqueline M et al. (2011) ""Sarcoid like"" granulomatous pulmonary disease in World Trade Center disaster responders. Am J Ind Med 54:175-84
Skloot, Gwen S; Schechter, Clyde B; Herbert, Robin et al. (2009) Longitudinal assessment of spirometry in the World Trade Center medical monitoring program. Chest 135:492-498
Moline, Jacqueline M; Herbert, Robin; Crowley, Laura et al. (2009) Multiple myeloma in World Trade Center responders: a case series. J Occup Environ Med 51:896-902