4.5 Article

Temporal association of prostate cancer incidence with World Trade Center rescue/recovery work

期刊

OCCUPATIONAL AND ENVIRONMENTAL MEDICINE
卷 78, 期 10, 页码 699-706

出版社

BMJ PUBLISHING GROUP
DOI: 10.1136/oemed-2021-107405

关键词

materials; exposures or occupational groups; medical oncology; longitudinal studies; environmental exposure; risk assessment

资金

  1. National Institute for Occupational Safety and Health (NIOSH) [U01OH011315, U01 OH011932, U01 OH011681, U01 OH011931, U01 OH011480, 200-2011-39378, 200-2017-93325, 200-2017-93326]
  2. National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention (CDC) [U50/OH009739]
  3. Agency for Toxic Substances and Disease Registry (ATSDR) [U50/ATU272750]
  4. CDC
  5. National Center for Environmental Health
  6. New York City Department of Health and Mental Hygiene (NYC DOHMH)
  7. National Cancer Institute (NCI) [P30 CA013330]
  8. NIH. National Cancer Institute [U58 DP006309]

向作者/读者索取更多资源

The risk of prostate cancer significantly increased among WTC rescue/recovery workers starting in 2007, compared with the general male population in New York State. Unique exposures at the disaster site may have contributed to this effect, along with screening practices like routine prostate specific antigen screening.
Background The World Trade Center (WTC) attacks on 11 September 2001 created a hazardous environment with known and suspected carcinogens. Previous studies have identified an increased risk of prostate cancer in responder cohorts compared with the general male population. Objectives To estimate the length of time to prostate cancer among WTC rescue/recovery workers by determining specific time periods during which the risk was significantly elevated. Methods Person-time accruals began 6 months after enrolment into a WTC cohort and ended at death or 12/31/2015. Cancer data were obtained through linkages with 13 state cancer registries. New York State was the comparison population. We used Poisson regression to estimate hazard ratios and 95% CIs; change points in rate ratios were estimated using profile likelihood. Results The analytic cohort included 54 394 male rescue/recovery workers. We observed 1120 incident prostate cancer cases. During 2002-2006, no association with WTC exposure was detected. Beginning in 2007, a 24% increased risk (HR: 1.24, 95% CI 1.16 to 1.32) was observed among WTC rescue/recovery workers when compared with New York State. Comparing those who arrived earliest at the disaster site on the morning of 11 September 2001 or any time on 12 September 2001 to those who first arrived later, we observed a positive, monotonic, dose-response association in the early (2002-2006) and late (2007-2015) periods. Conclusions Risk of prostate cancer was significantly elevated beginning in 2007 in the WTC combined rescue/recovery cohort. While unique exposures at the disaster site might have contributed to the observed effect, screening practices including routine prostate specific antigen screening cannot be discounted.

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