2001年9月11日之后,世贸中心救援人员中肺癌的发病率。

IF 9.7 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Sean A P Clouston, Jaymie Meliker, Frank D Mann, Pei-Fen Kuan, Yuan Yang, F Mehejabin Trina, Laura Sampson, Paolo Boffetta, Norman H Edelman, Benjamin J Luft
{"title":"2001年9月11日之后,世贸中心救援人员中肺癌的发病率。","authors":"Sean A P Clouston, Jaymie Meliker, Frank D Mann, Pei-Fen Kuan, Yuan Yang, F Mehejabin Trina, Laura Sampson, Paolo Boffetta, Norman H Edelman, Benjamin J Luft","doi":"10.1001/jamanetworkopen.2025.36655","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>Responders involved in rescue and recovery operations after the collapse of the World Trade Center (WTC) on September 11, 2001, were exposed to airborne carcinogens.</p><p><strong>Objectives: </strong>To examine the incidence of lung cancer after the WTC attacks and to compare the incidence of lung cancer among responders with varying degrees of exposure severity.</p><p><strong>Design, setting, and participants: </strong>In this prospective cohort study, data were collected between July 1, 2012, and December 31, 2023, from individuals who were enrolled in a medical monitoring program available to WTC responders residing on Long Island, New York. This study was restricted to people who survived and were followed up for incident lung cancer after a 10-year latency period.</p><p><strong>Exposures: </strong>Types and durations of exposures were based on responses to a detailed questionnaire about on-site work conditions, which included information about the type and duration of work, smells, and sights while working; exposure to dust; and the use of protective equipment. World Trade Center exposure characteristics and overall severity were measured as mild, moderate, and severe exposure using a validated approach.</p><p><strong>Main outcomes and measures: </strong>The incidence of lung cancer was the primary outcome. Diagnosis of lung cancer was ascertained following a standardized approach by trained clinicians, and diagnoses were verified by clinicians at the Centers for Disease Control and Prevention. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios.</p><p><strong>Result: </strong>Among 12 334 eligible responders (mean [SD] age at study inclusion, 49.3 [10.2] years; 11 213 men [90.9%]), 118 incident lung cancers were identified between July 1, 2012, and December 31, 2023 (incidence rate, 8.7/10 000 person-years [95% CI, 7.3-10.5 person-years]). When compared with mild exposures, the incidence of lung cancer was higher among moderately (adjusted hazard ratio [AHR], 1.86 [95% CI, 1.19-2.91]; P = .007) and severely (AHR, 2.90 [95% CI, 1.69-4.99]; P < .001) exposed groups. Specific WTC exposures, including smelling fumes (AHR, 1.05 [95% CI, 1.01-1.09]; P = .007) or sewage (AHR, 1.03 [95% CI, 1.01-1.05]; P = .004), were also associated with higher incidence of lung cancer after adjusting for demographics and measures of tobacco use.</p><p><strong>Conclusions and relevance: </strong>In this cohort study of WTC responders, the incidence of lung cancer was higher among those with greater exposure severity. Future studies may investigate specific WTC exposures and histologic changes and clarify the role of WTC exposure for prognosis.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 10","pages":"e2536655"},"PeriodicalIF":9.7000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Lung Cancer Incidence After September 11, 2001, Among World Trade Center Responders.\",\"authors\":\"Sean A P Clouston, Jaymie Meliker, Frank D Mann, Pei-Fen Kuan, Yuan Yang, F Mehejabin Trina, Laura Sampson, Paolo Boffetta, Norman H Edelman, Benjamin J Luft\",\"doi\":\"10.1001/jamanetworkopen.2025.36655\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Importance: </strong>Responders involved in rescue and recovery operations after the collapse of the World Trade Center (WTC) on September 11, 2001, were exposed to airborne carcinogens.</p><p><strong>Objectives: </strong>To examine the incidence of lung cancer after the WTC attacks and to compare the incidence of lung cancer among responders with varying degrees of exposure severity.</p><p><strong>Design, setting, and participants: </strong>In this prospective cohort study, data were collected between July 1, 2012, and December 31, 2023, from individuals who were enrolled in a medical monitoring program available to WTC responders residing on Long Island, New York. This study was restricted to people who survived and were followed up for incident lung cancer after a 10-year latency period.</p><p><strong>Exposures: </strong>Types and durations of exposures were based on responses to a detailed questionnaire about on-site work conditions, which included information about the type and duration of work, smells, and sights while working; exposure to dust; and the use of protective equipment. World Trade Center exposure characteristics and overall severity were measured as mild, moderate, and severe exposure using a validated approach.</p><p><strong>Main outcomes and measures: </strong>The incidence of lung cancer was the primary outcome. Diagnosis of lung cancer was ascertained following a standardized approach by trained clinicians, and diagnoses were verified by clinicians at the Centers for Disease Control and Prevention. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios.</p><p><strong>Result: </strong>Among 12 334 eligible responders (mean [SD] age at study inclusion, 49.3 [10.2] years; 11 213 men [90.9%]), 118 incident lung cancers were identified between July 1, 2012, and December 31, 2023 (incidence rate, 8.7/10 000 person-years [95% CI, 7.3-10.5 person-years]). When compared with mild exposures, the incidence of lung cancer was higher among moderately (adjusted hazard ratio [AHR], 1.86 [95% CI, 1.19-2.91]; P = .007) and severely (AHR, 2.90 [95% CI, 1.69-4.99]; P < .001) exposed groups. Specific WTC exposures, including smelling fumes (AHR, 1.05 [95% CI, 1.01-1.09]; P = .007) or sewage (AHR, 1.03 [95% CI, 1.01-1.05]; P = .004), were also associated with higher incidence of lung cancer after adjusting for demographics and measures of tobacco use.</p><p><strong>Conclusions and relevance: </strong>In this cohort study of WTC responders, the incidence of lung cancer was higher among those with greater exposure severity. Future studies may investigate specific WTC exposures and histologic changes and clarify the role of WTC exposure for prognosis.</p>\",\"PeriodicalId\":14694,\"journal\":{\"name\":\"JAMA Network Open\",\"volume\":\"8 10\",\"pages\":\"e2536655\"},\"PeriodicalIF\":9.7000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JAMA Network Open\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1001/jamanetworkopen.2025.36655\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JAMA Network Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1001/jamanetworkopen.2025.36655","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

摘要

重要性:2001年9月11日世界贸易中心(WTC)倒塌后,参与救援和恢复行动的响应者暴露在空气中的致癌物中。目的:研究WTC发作后的肺癌发病率,并比较不同暴露严重程度应答者的肺癌发病率。设计、环境和参与者:在这项前瞻性队列研究中,数据收集于2012年7月1日至2023年12月31日,来自居住在纽约长岛的WTC急救人员参加医疗监测项目的个人。这项研究仅限于活下来的人,并在10年的潜伏期后对肺癌事件进行随访。暴露:暴露的类型和持续时间是基于对现场工作条件的详细问卷的回答,其中包括工作类型和持续时间、工作时的气味和景象的信息;暴露于灰尘中;以及防护装备的使用。使用经过验证的方法测量世贸中心暴露特征和总体严重程度,分为轻度、中度和重度暴露。主要观察指标:肺癌发生率为主要观察指标。肺癌的诊断是由训练有素的临床医生按照标准化的方法确定的,诊断由疾病控制和预防中心的临床医生验证。Cox比例风险回归用于估计多变量调整后的风险比。结果:在12 334名符合条件的应答者中(纳入研究时的平均[SD]年龄为49.3[10.2]岁;11 213名男性[90.9%]),在2012年7月1日至2023年12月31日期间发现118例肺癌(发病率为8.7/10 000人-年[95% CI, 7.3-10.5人-年])。与轻度暴露相比,中度暴露的肺癌发病率更高(校正危险比[AHR], 1.86 [95% CI, 1.19-2.91]; P =。结论及相关性:在这项WTC应答者的队列研究中,暴露严重程度越高,肺癌发病率越高。未来的研究可能会探讨特定的WTC暴露和组织学变化,并阐明WTC暴露对预后的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lung Cancer Incidence After September 11, 2001, Among World Trade Center Responders.

Importance: Responders involved in rescue and recovery operations after the collapse of the World Trade Center (WTC) on September 11, 2001, were exposed to airborne carcinogens.

Objectives: To examine the incidence of lung cancer after the WTC attacks and to compare the incidence of lung cancer among responders with varying degrees of exposure severity.

Design, setting, and participants: In this prospective cohort study, data were collected between July 1, 2012, and December 31, 2023, from individuals who were enrolled in a medical monitoring program available to WTC responders residing on Long Island, New York. This study was restricted to people who survived and were followed up for incident lung cancer after a 10-year latency period.

Exposures: Types and durations of exposures were based on responses to a detailed questionnaire about on-site work conditions, which included information about the type and duration of work, smells, and sights while working; exposure to dust; and the use of protective equipment. World Trade Center exposure characteristics and overall severity were measured as mild, moderate, and severe exposure using a validated approach.

Main outcomes and measures: The incidence of lung cancer was the primary outcome. Diagnosis of lung cancer was ascertained following a standardized approach by trained clinicians, and diagnoses were verified by clinicians at the Centers for Disease Control and Prevention. Cox proportional hazards regression was used to estimate multivariable-adjusted hazard ratios.

Result: Among 12 334 eligible responders (mean [SD] age at study inclusion, 49.3 [10.2] years; 11 213 men [90.9%]), 118 incident lung cancers were identified between July 1, 2012, and December 31, 2023 (incidence rate, 8.7/10 000 person-years [95% CI, 7.3-10.5 person-years]). When compared with mild exposures, the incidence of lung cancer was higher among moderately (adjusted hazard ratio [AHR], 1.86 [95% CI, 1.19-2.91]; P = .007) and severely (AHR, 2.90 [95% CI, 1.69-4.99]; P < .001) exposed groups. Specific WTC exposures, including smelling fumes (AHR, 1.05 [95% CI, 1.01-1.09]; P = .007) or sewage (AHR, 1.03 [95% CI, 1.01-1.05]; P = .004), were also associated with higher incidence of lung cancer after adjusting for demographics and measures of tobacco use.

Conclusions and relevance: In this cohort study of WTC responders, the incidence of lung cancer was higher among those with greater exposure severity. Future studies may investigate specific WTC exposures and histologic changes and clarify the role of WTC exposure for prognosis.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
JAMA Network Open
JAMA Network Open Medicine-General Medicine
CiteScore
16.00
自引率
2.90%
发文量
2126
审稿时长
16 weeks
期刊介绍: JAMA Network Open, a member of the esteemed JAMA Network, stands as an international, peer-reviewed, open-access general medical journal.The publication is dedicated to disseminating research across various health disciplines and countries, encompassing clinical care, innovation in health care, health policy, and global health. JAMA Network Open caters to clinicians, investigators, and policymakers, providing a platform for valuable insights and advancements in the medical field. As part of the JAMA Network, a consortium of peer-reviewed general medical and specialty publications, JAMA Network Open contributes to the collective knowledge and understanding within the medical community.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信