9/11 survivors may be at increased risk of heart and lung disease years later
People who were exposed to the dust cloud or sustained physical injuries during the terrorist attacks on the World Trade Centre on September 11, 2001 may be at increased long-term risk of asthma, other respiratory diseases and heart attack, according to a study published in the open access journal Injury Epidemiology.
Researchers at the New York City Department of Health and Mental Hygiene examined the association between physical injury or acute exposure to the dust cloud on the morning of September 11, 2001, and chronic disease up to ten to eleven years later (2010-2012).
Dr Robert Brackbill, the corresponding author said: "Our findings indicate that intense exposure on a single day — the first day of the disaster — contributes substantially to the risk of developing chronic conditions. Continued monitoring of people who were present in the vicinity of the World Trade Center on 11th September by medical providers is warranted for the foreseeable future."
The researchers found that the number of types of injuries, such as fractures, head injuries, or sprains, a person sustained on 11th September 2001 was associated with an increased risk of angina or heart attack in a dose-dependent manner, which means that the risk of having angina or a heart attack increased with every additional injury type. Dust exposure, PTSD and being a rescue worker, as well as current smoking were associated with a higher risk of non-neoplastic lung disease (lung conditions not involving tumors) other than asthma, while dust exposure on its own was associated with an increased risk of asthma. None of these risk factors were associated with a higher risk of diabetes.
Out of the total number of 8,701 people enrolled in this study, 41% had intense exposure to the dust cloud, 10% has a single injury, 2% had two types of injury and 1% had three or more. The researchers found 92 incident cases of heart disease, 327 new cases of diabetes, 308 cases of asthma, and 297 cases of non-neoplastic lung disease among 7,503 area workers, 249 rescue workers, 131 residents and 818 passersby — the most heavily exposed groups.
To examine the long term health effects of acute exposure to the dust cloud, or physical injury caused by the terrorist attack, the authors used data from the WTC Health Registry cohort. The WTC Health Registry monitors the physical and mental health of 71,431 persons exposed to the attacks on 9/11. It contains data collected during three waves in 2003-2004, 2006-2007 and 2011-2012. A fourth wave of data has been collected but not included in this study.
A lack of specific information on the severity, location and treatment of injuries, as well as on the circumstances in which they were sustained meant that the number of types of injuries was used as a proxy measure for injury severity. However, previous research has shown that more than one type of injury is associated with increased risk of death and longer stays in hospital, according to the authors.
E: [email protected]
Notes to editors:
1. Research article:
Injury, intense dust exposure, and chronic disease among survivors of the World Trade Center terrorist attacks of September 11, 2001.
Alper et al Injury Epidemiology 2017
For an embargoed copy of the research article please contact Anne Korn at BioMed Central.
After the embargo lifts, the article will be available at the journal website here: https://injepijournal.springeropen.com/articles/10.1186/s40621-017-0115-x
Please name the journal in any story you write. If you are writing for the web, please link to the article. All articles are available free of charge, according to BioMed Central's open access policy.
2. The editorial mission of Injury Epidemiology is to advance the science and practice of injury prevention and control through timely publication and dissemination of peer-reviewed research. Injury Epidemiology aims to be the premier venue for communicating epidemiologic studies of unintentional and intentional injuries, including, but not limited to, morbidity and mortality from motor vehicle crashes, drug overdose/poisoning, falls, drowning, fires/burns, iatrogenic injury, suicide, homicide, assaults, and abuse.
3. BioMed Central is an STM (Science, Technology and Medicine) publisher which has pioneered the open access publishing model. All peer-reviewed research articles published by BioMed Central are made immediately and freely accessible online, and are licensed to allow redistribution and reuse. BioMed Central is part of Springer Nature, a major new force in scientific, scholarly, professional and educational publishing, created in May 2015 through the combination of Nature Publishing Group, Palgrave Macmillan, Macmillan Education and Springer Science+Business Media. http://www.biomedcentral.com
4. SpringerOpen, launched in June 2010, includes Springer's portfolio of 200+ peer-reviewed fully open access journals across all areas of science. In August 2012, due to the growing demand for open access and the success of our SpringerOpen journals, we expanded our offering to open access books. Published under the SpringerOpen brand they complement our established open access journal portfolio. SpringerOpen journals and books are made freely and permanently available online immediately upon publication. They are subject to high-level peer review, author and production services ensuring quality and reliability of the work. Authors publishing with SpringerOpen retain the copyright to their work, licensing it under a Creative Commons license. To cover the cost of the publication process, all SpringerOpen journals and books charge an open access fee.
5. The WTC Health Registry responds to enrolee health needs and concerns through a dedicated program that reaches out to thousands of enrolees with 9/11-related symptoms and conditions to refer them to care at no cost to them through the federal WTC Health Program. This core Registry function plays an important role in disaster response to address unmet health care needs identified many years post-disaster.