Abstract：
BACKGROUND: In a single day, the September 11, 2001 US terrorist attacks (9/11) killed nearly 3,000 people, including 412 first responders. More than 91,000 responders were exposed to a range of hazards during the recovery and clean-up operation that followed. Various health programs track the on-going health effects of 9/11, including the World Trade Center (WTC) Health Program (WTCHP). The objective of this research was to review WTCHP statistics reported by the Centers for Disease Control and Prevention (CDC) to analyze health trends among enrolled responders as the 20-year anniversary of the terrorist attacks approaches.
METHODS: The WTCHP statistics reported by the CDC were analyzed to identify health trends among enrolled responders from 2011 through 2021. Statistics for non-responders were excluded.
RESULTS: A total of 80,745 responders were enrolled in the WTCHP as of March 2021: 62,773 were classified as general responders; 17,023 were Fire Department of New York (FDNY) responders; and 989 were Pentagon and Shanksville responders. Of the total responders in the program, 3,439 are now deceased. Just under 40% of responders with certified health issues were aged 45-64 and 83% were male. The top three certified conditions among enrolled responders were: aerodigestive disorders; cancer; and mental ill health. The top ten certified cancers have remained the same over the last five years, however, leukemia has now overtaken colon and bladder cancer as the 20-year anniversary approaches. Compared to the general population, 9/11 first responders had a higher rate of all cancers combined, as well as higher rates of prostate cancer, thyroid cancer, and leukemia.
CONCLUSIONS: Trends in these program statistics should be viewed with some caution. While certain illnesses have been linked with exposure to the WTC site, differences in age, sex, ethnicity, smoking status, and other factors between exposed and unexposed groups should also be considered. Increased rates of some illnesses among this cohort may be associated with heightened surveillance rather than an actual increase in disease. Still, cancer in general, as well as lung disease, heart disease, and posttraumatic stress disorder (PTSD), seem to be increasing among 9/11 responders, even now close to 20 years later.
CONCLUSIONS: Responders should continue to avail themselves of the health care and monitoring offered through programs like the WTCHP.
METHODS: The WTCHP statistics reported by the CDC were analyzed to identify health trends among enrolled responders from 2011 through 2021. Statistics for non-responders were excluded.
RESULTS: A total of 80,745 responders were enrolled in the WTCHP as of March 2021: 62,773 were classified as general responders; 17,023 were Fire Department of New York (FDNY) responders; and 989 were Pentagon and Shanksville responders. Of the total responders in the program, 3,439 are now deceased. Just under 40% of responders with certified health issues were aged 45-64 and 83% were male. The top three certified conditions among enrolled responders were: aerodigestive disorders; cancer; and mental ill health. The top ten certified cancers have remained the same over the last five years, however, leukemia has now overtaken colon and bladder cancer as the 20-year anniversary approaches. Compared to the general population, 9/11 first responders had a higher rate of all cancers combined, as well as higher rates of prostate cancer, thyroid cancer, and leukemia.
CONCLUSIONS: Trends in these program statistics should be viewed with some caution. While certain illnesses have been linked with exposure to the WTC site, differences in age, sex, ethnicity, smoking status, and other factors between exposed and unexposed groups should also be considered. Increased rates of some illnesses among this cohort may be associated with heightened surveillance rather than an actual increase in disease. Still, cancer in general, as well as lung disease, heart disease, and posttraumatic stress disorder (PTSD), seem to be increasing among 9/11 responders, even now close to 20 years later.
CONCLUSIONS: Responders should continue to avail themselves of the health care and monitoring offered through programs like the WTCHP.
摘要：
背景：在一天之内，2001年9月11日美国恐怖袭击（9/11）造成近3000人死亡，包括412名急救人员。在随后的恢复和清理行动中，超过91,000名响应者暴露于一系列危险之中。各种健康计划跟踪9/11的持续健康影响，包括世界贸易中心（WTC）健康计划（WTCHP）。这项研究的目的是回顾疾病控制和预防中心（CDC）报告的WTCHP统计数据，以分析在恐怖袭击20周年之际注册响应者的健康趋势。
方法：对CDC报告的WTCHP统计数据进行了分析，以确定2011年至2021年注册应答者的健康趋势。非响应者的统计数据被排除在外。
结果：截至2021年3月，WTCHP共有80,745名响应者：62,773人被归类为一般响应者；纽约消防局（FDNY）响应者17,023人；五角大楼和尚克斯维尔响应者989人。在计划的所有响应者中，现在有3439人死亡。有健康问题的受访者中，只有不到40%的人年龄在45-64岁之间，83%为男性。在注册的响应者中，前三个认证的条件是：空气消化系统疾病;癌症;和精神疾病。在过去的五年中，十大认证癌症保持不变，然而,随着20周年纪念日的临近，白血病现已超过结肠癌和膀胱癌。与普通人群相比，9/11第一反应者在所有癌症中的发病率更高，以及更高的前列腺癌发病率，甲状腺癌,和白血病。
结论：应谨慎看待这些程序统计的趋势。虽然某些疾病与接触WTC部位有关，年龄差异,性别,种族,吸烟状况,和其他因素之间的暴露和未暴露的群体也应考虑。该队列中某些疾病的发病率增加可能与加强监测有关，而不是疾病的实际增加。尽管如此，一般来说，癌症，以及肺部疾病，心脏病,和创伤后应激障碍（PTSD），9/11反应者似乎在增加，甚至现在将近20年后。
结论：响应者应继续利用通过WTCHP等项目提供的医疗保健和监测。
方法：对CDC报告的WTCHP统计数据进行了分析，以确定2011年至2021年注册应答者的健康趋势。非响应者的统计数据被排除在外。
结果：截至2021年3月，WTCHP共有80,745名响应者：62,773人被归类为一般响应者；纽约消防局（FDNY）响应者17,023人；五角大楼和尚克斯维尔响应者989人。在计划的所有响应者中，现在有3439人死亡。有健康问题的受访者中，只有不到40%的人年龄在45-64岁之间，83%为男性。在注册的响应者中，前三个认证的条件是：空气消化系统疾病;癌症;和精神疾病。在过去的五年中，十大认证癌症保持不变，然而,随着20周年纪念日的临近，白血病现已超过结肠癌和膀胱癌。与普通人群相比，9/11第一反应者在所有癌症中的发病率更高，以及更高的前列腺癌发病率，甲状腺癌,和白血病。
结论：应谨慎看待这些程序统计的趋势。虽然某些疾病与接触WTC部位有关，年龄差异,性别,种族,吸烟状况,和其他因素之间的暴露和未暴露的群体也应考虑。该队列中某些疾病的发病率增加可能与加强监测有关，而不是疾病的实际增加。尽管如此，一般来说，癌症，以及肺部疾病，心脏病,和创伤后应激障碍（PTSD），9/11反应者似乎在增加，甚至现在将近20年后。
结论：响应者应继续利用通过WTCHP等项目提供的医疗保健和监测。
