Abstract

Background: In the aftermath of the World Trade Center (WTC) attack on 11 September 2001, rescue and recovery workers faced hazardous conditions and toxic agents. Prior research linked these exposures to adverse health effects, but mainly examined individual factors, overlooking complex mixture effects. Methods: This study applies an exposomic approach encompassing the totality of responders’ experience, defined as the WTC exposome. We analyzed data from 34,096 members of the WTC Health Program General Responder, including mental and physical health, occupational history, traumatic and environmental exposures using generalized weighted quantile sum regression. Results: We find a statistically significant association between the exposure mixture index and all investigated health outcomes. Factors identified as risk factors include working in an enclosed heavily contaminated area, construction occupation, and exposure to blood and body fluids. Conversely, full-time employment emerged as a protective factor. Conclusions: This exposomics study emphasizes the importance of considering combined exposures for the identification of harmful and protective factors within the WTC exposome, providing valuable insights for targeted interventions and preventive measures. In an era marked by more frequent and severe natural disasters due to the evolving climate crisis, the exposomic framework is a promising tool for disaster preparedness.

Original languageEnglish
Article number257
JournalCommunications Medicine
Volume4
Issue number1
DOIs
StatePublished - Dec 2024

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