Since the inception of the WTC MMTP, health reports have focused on disorders of the aerodigestive tract andmental health consequences, and with the exception of spirometry, comparisons with general and normativepopulation data have not been made. Furthermore, none of the previous studies comprehensively evaluatedthe changes of socioeconomic status in WTC responders after 9/11. Lowered SES is an important potentialconsequence of WTC exposures that can negatively impact the physical and mental health status among WTCresponders. The main objective of the proposed study is to establish an expanded occupational healthsurveillance system that summarizes overall health status of WTC responders over time, and also providesinformation about symptoms not previously reported. Through this work, it is possible that other healthoutcomes will be identified and reported, such as autoimmune disorders. This expanded surveillance systemwill supplement reports the Data Center (DC) will be providing. To provide a reference population, the WTCcohort will be compared to the National Center for Health Statistics (NCHS) and the Behavioral Risk FactorSurveillance System (BRFSS) to compare physical and mental health status by matching variables. Thecomparison will estimate the magnitude of the impact of WTC exposure on the health of WTC responderscompared with the general population in U.S. and New York-White Plains-Wayne, NY/NJ metropolitan area.Findings from this expanded surveillance will be reported through an integrated occupational healthsurveillance report. The term 'integrated occupational health surveillance report' means a detailed and overalldescription of health status over time, with a comparison of groups both within the cohort and from the generalpopulation. The findings from this report will also aid in the future development of new guidelines for theimplementation of an occupational health surveillance system for disasters, which is essential for disasterpreparedness. Along with implementing a surveillance system, an additional objective will be to investigateambi-directional effect modification between SES and health status. By ascertaining effect modification, SESwill be added as one of the important variables necessary to perform surveillance. The study hypotheses forthe effect modification investigation are 1) WTC exposures lower health status; 2) WTC exposures lowersocioeconomic status; and 3) an interaction effect exists between these variables. This investigation for effectmodification between health and SES is a unique research topic that has not been studied for WTCresponders. Understanding the nature of the linkage between health and SES will help to identify high riskgroups and offer a primary target for prevention and intervention strategies. With successful completion of this2-year study, we expect a substantial improvement of the occupational health surveillance system for WTCresponders.
This study will comprehensively describe the overall physical, mental, and socioeconomic impact of the WTC disaster on responders, as well as identify the linkage between SES and health among all occupations of WTC responders. Results from this proposal have the potential to make a significant public health impact through the identification of new diseases and high risk groups within the WTC cohort, as well as aiding future development of new guidelines for the implementation of an occupational health surveillance system for disasters, which is essential for disaster preparedness.
| Kim, Hyun; Baidwan, Navneet Kaur; Kriebel, David et al. (2018) Asthma among World Trade Center First Responders: A Qualitative Synthesis and Bias Assessment. Int J Environ Res Public Health 15: |
| Liu, Bian; Tarigan, Lukman H; Bromet, Evelyn J et al. (2014) World Trade Center disaster exposure-related probable posttraumatic stress disorder among responders and civilians: a meta-analysis. PLoS One 9:e101491 |
