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Article ; Online: Association of firefighting exposures with lung function using a novel job exposure matrix (JEM).

Goldfarb, David G / Prezant, David J / Zeig-Owens, Rachel / Hall, Charles B / Schwartz, Theresa / Liu, Yang / Kavouras, Ilias G

Occupational and environmental medicine

2024 Volume 81, Issue 2, Page(s) 84–91

Abstract: Objectives: Characterisation of firefighters' exposures to dangerous chemicals in smoke from non-wildfire incidents, directly through personal monitoring and indirectly from work-related records, is scarce. The aim of this study was to evaluate the ... ...

Abstract	Objectives: Characterisation of firefighters' exposures to dangerous chemicals in smoke from non-wildfire incidents, directly through personal monitoring and indirectly from work-related records, is scarce. The aim of this study was to evaluate the association between smoke particle exposures (P) and pulmonary function. Methods: The study period spanned from January 2010 through September 2021. Routine firefighting P were estimated using fire incident characteristics, response data and emission factors from a novel job exposure matrix. Linear mixed effects modelling was employed to estimate changes in pulmonary function as measured by forced expiratory volume in one second (FEV Results: Every 1000 kg P was associated with 13 mL lower FEV Discussion: Smoke particle exposures were observed to have modest short-term and long-term associations with pulmonary function, particularly in those who, previously, had high levels of WTC exposure. Future work examining the association between P and pulmonary function among non-WTC exposed firefighters will be essential for disentangling the effects of ageing, routine firefighting and WTC exposures.
MeSH term(s)	Humans ; Occupational Exposure/adverse effects ; Lung ; Forced Expiratory Volume ; Smoking/adverse effects ; Smoke/adverse effects ; Firefighters ; September 11 Terrorist Attacks
Chemical Substances	Smoke
Language	English
Publishing date	2024-02-02
Publishing country	England
Document type	Journal Article
ZDB-ID	1180733-7
ISSN	1470-7926 ; 1351-0711
ISSN (online)	1470-7926
ISSN	1351-0711
DOI	10.1136/oemed-2023-109155
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Article ; Online: Association of Lung Function Decline with All-Cause and Cancer-Cause Mortality after World Trade Center Dust Exposure.

Goldfarb, David G / Hall, Charles B / Choi, Jaeun / Zeig-Owens, Rachel / Cohen, Hillel W / Cannon, Madeline / Prezant, David J / Weiden, Michael D

Annals of the American Thoracic Society

2023 Volume 20, Issue 8, Page(s) 1136–1143

Abstract: Rationale: ...

Abstract	Rationale:
MeSH term(s)	Humans ; Prospective Studies ; Lung Diseases ; Lung ; Dust ; Neoplasms ; Smoke ; Occupational Exposure/adverse effects ; New York City/epidemiology
Chemical Substances	Dust ; Smoke
Language	English
Publishing date	2023-03-23
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	2717461-X
ISSN	2325-6621 ; 1943-5665 ; 2325-6621
ISSN (online)	2325-6621 ; 1943-5665
ISSN	2325-6621
DOI	10.1513/AnnalsATS.202212-1011OC
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Article ; Online: Normal Lung Function and Mortality in World Trade Center Responders and NHANES III Participants.

Cannon, Madeline F / Goldfarb, David G / Zeig-Owens, Rachel A / Hall, Charles B / Choi, Jaeun / Cohen, Hillel W / Prezant, David J / Weiden, Michael D

American journal of respiratory and critical care medicine

2024

Abstract: Rationale: Low forced expiratory volume at one second (FEV: Objective: To evaluate the FEV: Methods: 10,999 Fire Department of the City of New York (FDNY) responders and 10,901 NHANES III participants, ages 18-65 with FEV: Measurements and main ... ...

Abstract	Rationale: Low forced expiratory volume at one second (FEV Objective: To evaluate the FEV Methods: 10,999 Fire Department of the City of New York (FDNY) responders and 10,901 NHANES III participants, ages 18-65 with FEV Measurements and main results: We observed 504/10,999 deaths (4.6%) for FDNY and 1,237/10,901 deaths (9.4% [weighted]) for NHANES III. Relative to FEV Conclusions: In both cohorts, higher FEV
Language	English
Publishing date	2024-01-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.202309-1654OC
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Article ; Online: Risk Factors for COVID-19 in a Retired FDNY WTC-Exposed Cohort.

Cleven, Krystal L / Zeig-Owens, Rachel / Goldfarb, David G / Schwartz, Theresa / Prezant, David J

International journal of environmental research and public health

2022 Volume 19, Issue 15

Abstract: We evaluated the incidence and risk factors for COVID-19 in a prospectively followed cohort of Fire Department of the City of New York (FDNY) World Trade Center (WTC)-exposed workers, thus reducing the potential for selection bias, a limitation in ... ...

Abstract	We evaluated the incidence and risk factors for COVID-19 in a prospectively followed cohort of Fire Department of the City of New York (FDNY) World Trade Center (WTC)-exposed workers, thus reducing the potential for selection bias, a limitation in published studies of hospitalized individuals. Participants were retired FDNY WTC-exposed rescue/recovery workers with ≥1 medical visit between 1 March 2020 and 1 August 2021. The cumulative incidence was calculated using self-reported COVID-19 diagnoses. Cox regression was performed to evaluate the association of WTC-exposure and COVID-19, adjusting for history of comorbidities, age, race, work assignment (emergency medical service providers vs. firefighter), and sex. The cumulative incidence of COVID-19 was 130 per 1000. The adjusted models showed the risk of infection was greater in those with highest WTC exposure versus less exposure (hazard ratio (HR) = 1.14 (95% CI 1.00-1.31)). Older age was associated with a lower risk of infection HR = 0.97 (95% CI 0.96-0.98). WTC-associated diseases (obstructive airways disease and interstitial lung disease) were not COVID-19 risk factors. This study is the first to show an association between WTC exposure and the risk of COVID-19. While participants are retired from FDNY work, the youngest individuals may still be in the workforce, explaining why younger age was a significant risk for COVID-19.
MeSH term(s)	COVID-19/epidemiology ; Firefighters ; Humans ; New York City/epidemiology ; Occupational Exposure/adverse effects ; Rescue Work ; Risk Factors ; September 11 Terrorist Attacks
Language	English
Publishing date	2022-07-22
Publishing country	Switzerland
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S. ; Research Support, N.I.H., Extramural
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph19158891
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Article ; Online: Development of a job-exposure matrix (JEM) for exposure to smoke particle mass among firefighters of the Fire Department of the City of New York (FDNY).

Goldfarb, David G / Prezant, David J / Zeig-Owens, Rachel / Schwartz, Theresa / Liu, Yang / Kavouras, Ilias G

Occupational and environmental medicine

2023 Volume 80, Issue 2, Page(s) 104–110

Abstract: Objectives: A refined job exposure matrix (JEM) based on incident types and severities and response characteristics was developed for firefighters to estimate quantities of smoke particles emitted during structural and non-structural fire incidents from ...

Abstract	Objectives: A refined job exposure matrix (JEM) based on incident types and severities and response characteristics was developed for firefighters to estimate quantities of smoke particles emitted during structural and non-structural fire incidents from 2010 to 2021. Methods: The cohort included a subset of 3237 Fire Department of the City of New York firefighters who responded to at least one incident between 2010 and 2021, prior to retirement. Fire incident data included dates, type, severity (alarm level) and location. Response data included dates worked, firehouse, position titles and shift lengths for each firefighter. The quantity of smoke particle mass generated during structural and non-structural fires adjusted by individual firefighter engagement was computed using the United States Environmental Protection Agency AP-42 emissions framework. Correlations between years of employment, fire responses and career total particle mass concentration by firefighter were examined. Linear regression models were fit and corresponding R Results: Firefighters responded to a median of 424.7 (IQR=202.3-620.0) annual incidents/person; 17.6% were fire incidents (median=77.1; IQR=40.4-114.0). Structural fires were the most common type of fire incident (72.5% of annual incidents/person; median=55.9; IQR=29.6-85.5). Incident severity (alarm level) and firefighter engagement (position title) appeared to differentiate between high and low exposure regimes (R Conclusions: Using the JEM, job-related smoke particle concentrations were estimated to vary by incident type, incident severity and firefighter engagement, highlighting the importance of using refined measures, so that future studies can more accurately evaluate associations between firefighting and health outcomes.
MeSH term(s)	United States ; Humans ; Occupational Exposure/adverse effects ; Firefighters ; New York/epidemiology ; Occupations ; Smoking
Language	English
Publishing date	2023-01-12
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1180733-7
ISSN	1470-7926 ; 1351-0711
ISSN (online)	1470-7926
ISSN	1351-0711
DOI	10.1136/oemed-2022-108549
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Article ; Online: Correction: Colbeth et al. Mortality among Fire Department of the City of New York Rescue and Recovery Workers Exposed to the World Trade Center Disaster, 2001-2017.

Colbeth, Hilary L / Zeig-Owens, Rachel / Hall, Charles B / Webber, Mayris P / Schwartz, Theresa M / Prezant, David J

International journal of environmental research and public health

2023 Volume 20, Issue 16

Abstract: The original publication [ ... ]. ...

Abstract	The original publication [...].
Language	English
Publishing date	2023-08-16
Publishing country	Switzerland
Document type	Published Erratum
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20166585
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Article ; Online: Self-reported Cardiovascular Disease in Career Firefighters With and Without World Trade Center Exposure.

Mueller, Alexandra K / Cohen, Hillel / Singh, Ankura / Webber, Mayris P / Hall, Charles B / Prezant, David J / Zeig-Owens, Rachel

Journal of occupational and environmental medicine

2023 Volume 66, Issue 2, Page(s) 135–140

Abstract: Objective: To assess the effect of World Trade Center (WTC) exposure on cardiovascular disease (CVD) in career firefighters. Methods: Firefighters from four US cities completed health questionnaires that provide information about demographics, CVD ... ...

Abstract	Objective: To assess the effect of World Trade Center (WTC) exposure on cardiovascular disease (CVD) in career firefighters. Methods: Firefighters from four US cities completed health questionnaires that provide information about demographics, CVD diagnoses, and CVD risk factors. Firefighters were also compared with respondents of the 2019 National Health Interview Survey. Results: Greater WTC exposure was positively associated with combined coronary artery disease, myocardial infarction, and angina (termed "CAD") when comparing WTC-exposed with non-WTC-exposed firefighters. Compared with the National Health Interview Survey population, firefighters had lower odds of CAD and stroke. Conclusions: An occupationally appropriate comparison is important to mitigate potential bias from the healthy worker effect. While the risk of CVD in WTC-exposed and non-WTC-exposed firefighters was significantly lower than a general US population, we observed an exposure gradient where greater WTC exposure was associated with greater odds of CVD.
MeSH term(s)	Humans ; Self Report ; Cardiovascular Diseases/epidemiology ; Firefighters ; September 11 Terrorist Attacks ; Surveys and Questionnaires ; Occupational Exposure/adverse effects ; New York City/epidemiology
Language	English
Publishing date	2023-11-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1223932-x
ISSN	1536-5948 ; 1076-2752
ISSN (online)	1536-5948
ISSN	1076-2752
DOI	10.1097/JOM.0000000000003007
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Article ; Online: Comparing self-reported obstructive airway disease in firefighters with and without World Trade Center exposure.

Mueller, Alexandra K / Singh, Ankura / Webber, Mayris P / Hall, Charles B / Prezant, David J / Zeig-Owens, Rachel

American journal of industrial medicine

2023 Volume 66, Issue 3, Page(s) 243–251

Abstract: Background: The degree to which routine, non-World Trade Center (WTC) firefighting exposures contribute to the WTC exposure-obstructive airway disease (OAD) relationship is unknown. Our objective was to compare the frequency of self-reported OAD ... ...

Abstract	Background: The degree to which routine, non-World Trade Center (WTC) firefighting exposures contribute to the WTC exposure-obstructive airway disease (OAD) relationship is unknown. Our objective was to compare the frequency of self-reported OAD diagnoses in WTC-exposed firefighters from the Fire Department of the City of New York (FDNY) compared with non-WTC-exposed firefighters from other cities and the general population. Methods: A total of 9792 WTC-exposed male FDNY firefighters and 3138 non-WTC-exposed male firefighters from Chicago, Philadelphia, and San Francisco who were actively employed on 9/11/01 and completed a health questionnaire were included. Logistic regression estimated odds ratios of self-reported asthma and COPD diagnoses in firefighters (WTC-exposed vs. non-WTC-exposed; all firefighters vs. general population), adjusting for age, race, smoking status, and last medical visit. Results: WTC-exposed firefighters were, on average, younger on 9/11 (mean ± SD = 40.2 ± 7.4 vs. 44.1 ± 9.1) and less likely to report ever-smoking (32.9% vs. 41.8%) than non-WTC-exposed firefighters. Odds of any OAD and asthma were 4.5 and 6.3 times greater, respectively, in WTC-exposed versus non-WTC-exposed. Odds of COPD were also greater in WTC-exposed versus non-WTC-exposed, particularly among never-smokers. Compared with the general population, WTC-exposed firefighters had greater odds of both asthma and COPD, while the nonexposed had lower odds of asthma and greater odds of COPD. Conclusions: Odds ratios for OAD diagnoses were greater in WTC-exposed firefighters versus both non-WTC-exposed and the general population after adjusting for covariates. While asthma and other OADs are known occupational hazards of firefighting, WTC exposure significantly compounded these adverse respiratory effects.
MeSH term(s)	Humans ; Male ; Firefighters ; Self Report ; September 11 Terrorist Attacks ; Occupational Exposure/adverse effects ; Asthma/epidemiology ; Asthma/etiology ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Pulmonary Disease, Chronic Obstructive/etiology ; New York City/epidemiology
Language	English
Publishing date	2023-01-04
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	604538-8
ISSN	1097-0274 ; 0271-3586
ISSN (online)	1097-0274
ISSN	0271-3586
DOI	10.1002/ajim.23455
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Article ; Online: Risk Factors for COVID-19 in a Retired FDNY WTC-Exposed Cohort

Krystal L. Cleven / Rachel Zeig-Owens / David G. Goldfarb / Theresa Schwartz / David J. Prezant

International Journal of Environmental Research and Public Health, Vol 19, Iss 8891, p

2022 Volume 8891

Abstract	We evaluated the incidence and risk factors for COVID-19 in a prospectively followed cohort of Fire Department of the City of New York (FDNY) World Trade Center (WTC)-exposed workers, thus reducing the potential for selection bias, a limitation in published studies of hospitalized individuals. Participants were retired FDNY WTC-exposed rescue/recovery workers with ≥1 medical visit between 1 March 2020 and 1 August 2021. The cumulative incidence was calculated using self-reported COVID-19 diagnoses. Cox regression was performed to evaluate the association of WTC-exposure and COVID-19, adjusting for history of comorbidities, age, race, work assignment (emergency medical service providers vs. firefighter), and sex. The cumulative incidence of COVID-19 was 130 per 1000. The adjusted models showed the risk of infection was greater in those with highest WTC exposure versus less exposure (hazard ratio (HR) = 1.14 (95% CI 1.00–1.31)). Older age was associated with a lower risk of infection HR = 0.97 (95% CI 0.96–0.98). WTC-associated diseases (obstructive airways disease and interstitial lung disease) were not COVID-19 risk factors. This study is the first to show an association between WTC exposure and the risk of COVID-19. While participants are retired from FDNY work, the youngest individuals may still be in the workforce, explaining why younger age was a significant risk for COVID-19.
Keywords	World Trade Center ; COVID-19 ; FDNY ; Fire Department of City of New York (FDNY) ; occupational lung disease ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
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Article ; Online: All-cause and cause-specific mortality in a cohort of WTC-exposed and non-WTC-exposed firefighters.

Singh, Ankura / Zeig-Owens, Rachel / Cannon, Madeline / Webber, Mayris P / Goldfarb, David G / Daniels, Robert D / Prezant, David J / Boffetta, Paolo / Hall, Charles B

Occupational and environmental medicine

2023 Volume 80, Issue 6, Page(s) 297–303

Abstract: Objective: To compare mortality rates in World Trade Center (WTC)-exposed Fire Department of the City of New York (FDNY) firefighters with rates in similarly healthy, non-WTC-exposed/non-FDNY firefighters, and compare mortality in each firefighter ... ...

Abstract	Objective: To compare mortality rates in World Trade Center (WTC)-exposed Fire Department of the City of New York (FDNY) firefighters with rates in similarly healthy, non-WTC-exposed/non-FDNY firefighters, and compare mortality in each firefighter cohort with the general population. Methods: 10 786 male WTC-exposed FDNY firefighters and 8813 male non-WTC-exposed firefighters from other urban fire departments who were employed on 11 September 2001 were included in the analyses. Only WTC-exposed firefighters received health monitoring via the WTC Health Programme (WTCHP). Follow-up began 11 September 2001 and ended at the earlier of death date or 31 December 2016. Death data were obtained from the National Death Index and demographics from the fire departments. We estimated standardised mortality ratios (SMRs) in each firefighter cohort versus US males using demographic-specific US mortality rates. Poisson regression models estimated relative rates (RRs) of all-cause and cause-specific mortality in WTC-exposed versus non-WTC-exposed firefighters, controlling for age and race. Results: Between 11 September 2001 and 31 December 2016, there were 261 deaths among WTC-exposed firefighters and 605 among non-WTC-exposed. Both cohorts had reduced all-cause mortality compared with US males (SMR (95% CI)=0.30 (0.26 to 0.34) and 0.60 (0.55 to 0.65) in WTC-exposed and non-WTC-exposed, respectively). WTC-exposed firefighters also had lower rates of all-cause mortality (RR=0.54, 95% CI=0.49 to 0.59) and cancer-specific, cardiovascular-specific and respiratory disease-specific mortality compared with non-WTC-exposed firefighters. Conclusion: Both firefighter cohorts had lower than expected all-cause mortality. Fifteen years post 11 September 2001, mortality was lower in WTC-exposed versus non-WTC-exposed firefighters. Lower mortality in the WTC-exposed suggests not just a healthy worker effect, but additional factors such as greater access to free health monitoring and treatment that they receive via the WTCHP.
MeSH term(s)	Humans ; Male ; Firefighters ; Rescue Work ; Cause of Death ; New York/epidemiology ; Neoplasms/epidemiology ; September 11 Terrorist Attacks ; Occupational Exposure/adverse effects ; New York City/epidemiology
Language	English
Publishing date	2023-03-27
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1180733-7
ISSN	1470-7926 ; 1351-0711
ISSN (online)	1470-7926
ISSN	1351-0711
DOI	10.1136/oemed-2022-108703
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