Cancer incidence in World Trade Center rescue and recovery workers, 2001-2008

Samara Solan, Sylvan Wallenstein, Moshe Shapiro, Susan L. Teitelbaum, Lori Stevenson, Anne Kochman, Julia Kaplan, Cornelia Dellenbaugh, Amy Kahn, F. Noah Biro, Michael Crane, Laura Crowley, Janice Gabrilove, Lou Gonsalves, Denise Harrison, Robin Herbert, Benjamin Luft, Steven B. Markowitz, Jacqueline Moline, Xiaoling NiuHenry Sacks, Gauri Shukla, Iris Udasin, Roberto G. Lucchini, Paolo Boffetta, Philip J. Landrigan

Research output: Contribution to journalArticlepeer-review

94 Scopus citations


Background: World Trade Center (WTC) rescue and recovery workers were exposed to a complex mix of pollutants and carcinogens. Objective: The purpose of this investigation was to evaluate cancer incidence in responders during the first 7 years after 11 September 2001. Methods: Cancers among 20,984 consented participants in the WTC Health Program were identified through linkage to state tumor registries in New York, New Jersey, Connecticut, and Pennsylvania. Standardized incidence ratios (SIRs) were calculated to compare cancers diagnosed in responders to predicted numbers for the general population. Multivariate regression models were used to estimate associations with degree of exposure. Results: A total of 575 cancers were diagnosed in 552 individuals. Increases above registry-based expectations were noted for all cancer sites combined (SIR = 1.15; 95% CI: 1.06, 1.25), thyroid cancer (SIR = 2.39; 95% CI: 1.70, 3.27), prostate cancer (SIR = 1.21; 95% CI: 1.01, 1.44), combined hematopoietic and lymphoid cancers (SIR = 1.36; 95% CI: 1.07, 1.71), and soft tissue cancers (SIR = 2.26; 95% CI: 1.13, 4.05). When restricted to 302 cancers diagnosed ≥ 6 months after enrollment, the SIR for all cancers decreased to 1.06 (95% CI: 0.94, 1.18), but thyroid and prostate cancer diagnoses remained greater than expected. All cancers combined were increased in very highly exposed responders and among those exposed to significant amounts of dust, compared with responders who reported lower levels of exposure. Conclusion: Estimates should be interpreted with caution given the short follow-up and long latency period for most cancers, the intensive medical surveillance of this cohort, and the small numbers of cancers at specific sites. However, our findings highlight the need for continued follow-up and surveillance of WTC responders.

Original languageEnglish
Pages (from-to)699-704
Number of pages6
JournalEnvironmental Health Perspectives
Issue number6
StatePublished - Jun 2013


  • Cancer
  • Cancer incidence
  • Cancer registry
  • Epidemiology
  • September 11th
  • WTC health program
  • World trade center


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