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Article: Potential phytoconstituents of Ficus religiosa L. and Ficus benghalensis L. with special reference to the treatment of blood disorders

Kumar, Sunil / Arif, Muhammad / Shafi, Sheeba / Al-Jaber, Nadia / Alsultan, Abdulrahman A.

Medicinal Plants. 2022 June, v. 14, no. 2

2022

Abstract: Ficus plants are woody trees found all over the world. It has a long history in indigenous medical systems such as Ayurveda, Siddha, Unani, and Homoeopathy. The barks, leaves, and fruits of these trees are documented in use for several health ailments. ... ...

Abstract	Ficus plants are woody trees found all over the world. It has a long history in indigenous medical systems such as Ayurveda, Siddha, Unani, and Homoeopathy. The barks, leaves, and fruits of these trees are documented in use for several health ailments. Several phytochemicals of pharmaceutical values have been identified in these plants. Blood disorders including haemorrhage, hemophilia, different kinds of blood cancers, leukorrhea, and anemia are the major health issues, especially in women. Different parts of Ficus religiosa and F. benghalensis, are common components in Ayurvedic and traditional formulas for the treatment of several blood disorders. The limited literature on the pharmacological action of Ficus religiosa and F. bengalensisin in the treatment of blood diseases has been documented, hence, in the present review, a comprehensive overview of phytoconstituents and the role of both the species of Ficus against blood diseases are discussed.
Keywords	Ayurvedic medicine ; Ficus benghalensis ; Ficus religiosa ; anemia ; blood ; chemical constituents of plants ; hemophilia ; hemorrhage ; phytochemicals
Language	English
Dates of publication	2022-06
Size	p. 221-232.
Publishing place	Society for Conservation and Resource Development of Medicinal Plants
Document type	Article
ZDB-ID	2881592-0
ISSN	0975-6892 ; 0975-4261
ISSN (online)	0975-6892
ISSN	0975-4261
DOI	10.5958/0975-6892.2022.00025.9
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Class III PI3K Vps34: essential roles in autophagy, endocytosis, and heart and liver function.

Jaber, Nadia / Zong, Wei-Xing

Annals of the New York Academy of Sciences

2013 Volume 1280, Page(s) 48–51

Abstract: Mammalian phosphatidylinositol (PI) 3-kinases are a family of proteins that share the ability to phosphorylate phosphoinositides at the 3 position of the inositol ring. By doing so, these kinases produce phospholipid molecules that are involved in ... ...

Abstract	Mammalian phosphatidylinositol (PI) 3-kinases are a family of proteins that share the ability to phosphorylate phosphoinositides at the 3 position of the inositol ring. By doing so, these kinases produce phospholipid molecules that are involved in various cell signaling pathways, such as insulin signaling and endocytosis. The pathways regulated by PI3-kinases are crucial for maintaining cellular homeostasis and thus must be tightly regulated. Irregular PI3-kinase activity is observed in numerous human pathological conditions, such as diabetes, cancer, and inflammation. One family member, Vps34, is of particular interest because it is the only PI3-kinase identified in yeast and it has been evolutionarily conserved through mammals. Vps34 plays an essential role in the cellular process of autophagy, a process linked to human health and disease. Understanding the precise role of mammalian Vps34 will likely be integral to drug development for various diseases.
MeSH term(s)	Animals ; Autophagy ; Class III Phosphatidylinositol 3-Kinases/genetics ; Class III Phosphatidylinositol 3-Kinases/metabolism ; Endocytosis/physiology ; Gene Knockout Techniques ; Humans ; Liver/metabolism ; Liver/pathology ; Myocardium/metabolism ; Myocardium/pathology ; Saccharomyces cerevisiae Proteins/metabolism ; Signal Transduction
Chemical Substances	Saccharomyces cerevisiae Proteins ; Class III Phosphatidylinositol 3-Kinases (EC 2.7.1.137)
Language	English
Publishing date	2013-05-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	211003-9
ISSN	1749-6632 ; 0077-8923
ISSN (online)	1749-6632
ISSN	0077-8923
DOI	10.1111/nyas.12026
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Article ; Online: Cancer incidence in World Trade Center-exposed and non-exposed male firefighters, as compared with the US adult male population: 2001-2016.

Webber, Mayris P / Singh, Ankura / Zeig-Owens, Rachel / Salako, Joke / Skerker, Molly / Hall, Charles B / Goldfarb, David G / Jaber, Nadia / Daniels, Robert D / Prezant, David J

Occupational and environmental medicine

2021 Volume 78, Issue 10, Page(s) 707–714

Abstract: Objective: To compare cancer incidence in Fire Department of the City of New York (FDNY) firefighters who worked at the World Trade Center (WTC) site to incidence in a population of non-WTC-exposed firefighters, the Career Firefighter Health Study (CFHS) ...

Abstract	Objective: To compare cancer incidence in Fire Department of the City of New York (FDNY) firefighters who worked at the World Trade Center (WTC) site to incidence in a population of non-WTC-exposed firefighters, the Career Firefighter Health Study (CFHS) cohort, and to compare rates from each firefighter cohort to rates in demographically similar US males. Methods: FDNY (N=10 786) and CFHS (N=8813) cohorts included male firefighters who were active on 11 September 2001 (9/11) and were followed until death or 31 December 2016. Cases were identified from 15 state cancer registries. Poisson regression models assessed cancers in each group (FDNY and CFHS) versus US males, and associations between group and cancer rates; these models estimated standardised incidence ratios (SIRs) and adjusted relative rates (RRs), respectively. Secondary analyses assessed surveillance bias and smoking history. Results: We identified 915 cancer cases in 841 FDNY firefighters and 1002 cases in 909 CFHS firefighters. FDNY had: higher rates for all cancers (RR=1.13; 95% CI 1.02 to 1.25), prostate (RR=1.39; 95% CI 1.19 to 1.63) and thyroid cancer (RR=2.53; 95% CI 1.37 to 4.70); younger median ages at diagnosis (55.6 vs 59.4; p<0.001, all cancers); and more cases with localised disease when compared with CFHS. Compared with US males, both firefighter cohorts had elevated SIRs for prostate cancer and melanoma. Control for surveillance bias in FDNY reduced most differences. Conclusions: Excess cancers occurred in WTC-exposed firefighters relative to each comparison group, which may partially be explained by heightened surveillance. Two decades post-9/11, clearer understanding of WTC-related risk requires extended follow-up and modelling studies (laboratory or animal based) to identify workplace exposures in all firefighters.
MeSH term(s)	Adult ; Case-Control Studies ; Firefighters/statistics & numerical data ; Humans ; Male ; Middle Aged ; Neoplasms/epidemiology ; Neoplasms/etiology ; New York City/epidemiology ; Occupational Diseases/epidemiology ; Occupational Diseases/etiology ; Occupational Exposure/adverse effects ; Registries ; September 11 Terrorist Attacks/statistics & numerical data ; United States/epidemiology
Language	English
Publishing date	2021-09-10
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	1180733-7
ISSN	1470-7926 ; 1351-0711
ISSN (online)	1470-7926
ISSN	1351-0711
DOI	10.1136/oemed-2021-107570
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Article ; Online: Evaluation of Medical Surveillance and Incidence of Post-September 11, 2001, Thyroid Cancer in World Trade Center-Exposed Firefighters and Emergency Medical Service Workers.

Colbeth, Hilary L / Genere, Natalia / Hall, Charles B / Jaber, Nadia / Brito, Juan P / El Kawkgi, Omar M / Goldfarb, David G / Webber, Mayris P / Schwartz, Theresa M / Prezant, David J / Zeig-Owens, Rachel

JAMA internal medicine

2020 Volume 180, Issue 6, Page(s) 888–895

Abstract: Importance: Elevated incidence rates of thyroid cancer among World Trade Center (WTC)-exposed individuals may be associated with the identification of asymptomatic cancers during medical surveillance.: Objective: To examine the association between ... ...

Abstract	Importance: Elevated incidence rates of thyroid cancer among World Trade Center (WTC)-exposed individuals may be associated with the identification of asymptomatic cancers during medical surveillance. Objective: To examine the association between WTC exposure and thyroid cancer among Fire Department of the City of New York (hereafter, Fire Department) rescue/recovery workers as well as the association with medical surveillance. Design, setting, and participants: This closed-cohort study classified the method of detection (asymptomatic and symptomatic) of thyroid cancers in 14 987 men monitored through the Fire Department-WTC Health Program diagnosed from September 12, 2001, to December 31, 2018. Age-, sex-, and histologic-specific Fire Department incidence rates were calculated and compared with demographically similar men in Olmsted County, Minnesota, from the Rochester Epidemiology Project using age-standardized rates, relative rates (RRs), and 95% CIs. The secondary analysis was restricted to papillary carcinomas. Exposures: World Trade Center exposure was defined as rescue/recovery work at the WTC site from September 11, 2001, to July 25, 2002. Main outcomes and measures: The outcomes evaluated comprised (1) number of incident thyroid cancers and their detection method categorizations in the Fire Department and Rochester Epidemiology Project cohorts; (2) Fire Department, Rochester Epidemiology Project, and Surveillance, Epidemiology, and End Results-21 age-standardized incidence rates of thyroid cancer; and (3) RRs comparing Fire Department and Rochester Epidemiology Project overall and by detection method categorization. Results: Seventy-two post-9/11 Fire Department cases of thyroid cancer were identified. Among the 65 cases (90.3%) with a categorized detection method, 53 cases (81.5%) were asymptomatic and 12 cases (18.5%) were symptomatic. Median (interquartile range) age at diagnosis was 50.2 (44.0-58.6) vs 46.6 (43.9-52.9) years for asymptomatic vs symptomatic cases. Associated primarily with asymptomatic cancers, the overall age-standardized incidence of Fire Department thyroid cancers (24.7; 95% CI, 17.4-52.3) was significantly higher than the Rochester Epidemiology Project (10.4; 95% CI, 8.5-12.7) and Surveillance, Epidemiology, and End Results-21 (9.1; 95% CI, 9.0-9.1) per 100 000 person-years. Furthermore, the RR of thyroid cancer among symptomatic men in Fire Department cases was not significantly different from that of men in the Rochester Epidemiology Project (0.8; 95% CI, 0.4-1.5); however, the rate of asymptomatic cancers was more than 3-fold that of the Rochester Epidemiology Project rate (RR, 3.1; 95% CI, 2.1-4.7). Conclusions and relevance: Excess asymptomatic thyroid cancer in Fire Department WTC-exposed rescue/recovery workers is apparently attributable to the identification of occult lesions during medical surveillance. Among WTC-exposed cohorts and the general population, these findings appear to have important implications for how thyroid cancer incidence rates are interpreted and how diagnoses should be managed.
MeSH term(s)	Adult ; Emergency Medical Services/statistics & numerical data ; Female ; Firefighters/statistics & numerical data ; Humans ; Incidence ; Male ; Middle Aged ; New York City/epidemiology ; Occupational Exposure/adverse effects ; Rescue Work ; Retrospective Studies ; Risk Factors ; September 11 Terrorist Attacks ; Thyroid Neoplasms/epidemiology ; Thyroid Neoplasms/etiology
Language	English
Publishing date	2020-04-20
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	2699338-7
ISSN	2168-6114 ; 2168-6106
ISSN (online)	2168-6114
ISSN	2168-6106
DOI	10.1001/jamainternmed.2020.0950
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Article ; Online: Performance of Risk Factor-Based Guidelines and Model-Based Chest CT Lung Cancer Screening in World Trade Center-Exposed Fire Department Rescue/Recovery Workers.

Cleven, Krystal L / Vaeth, Brandon / Zeig-Owens, Rachel / Colbeth, Hilary L / Jaber, Nadia / Schwartz, Theresa / Weiden, Michael D / Markowitz, Steven B / Silvestri, Gerard A / Prezant, David J

Chest

2020 Volume 159, Issue 5, Page(s) 2060–2071

Abstract: Background: Lung cancer is a leading cause of cancer incidence and death in the United States. Risk factor-based guidelines and risk model-based strategies are used to identify patients who could benefit from low-dose chest CT (LDCT) screening. Few ... ...

Abstract	Background: Lung cancer is a leading cause of cancer incidence and death in the United States. Risk factor-based guidelines and risk model-based strategies are used to identify patients who could benefit from low-dose chest CT (LDCT) screening. Few studies compare guidelines or models within the same cohort. We evaluate lung cancer screening performance of two risk factor-based guidelines (US Preventive Services Task Force 2014 recommendations [USPSTF-2014] and National Comprehensive Cancer Network Group 2 [NCCN-2]) and two risk model-based strategies, Prostate Lung Colorectal and Ovarian Cancer Screening (PLCOm2012) and the Bach model) in the same occupational cohort. Research question: Which risk factor-based guideline or model-based strategy is most accurate in detecting lung cancers in a highly exposed occupational cohort? Study design and methods: Fire Department of City of New York (FDNY) rescue/recovery workers exposed to the September 11, 2001 attacks underwent LDCT lung cancer screening based on smoking history and age. The USPSTF-2014, NCCN-2, PLCOm2012 model, and Bach model were retrospectively applied to determine how many lung cancers were diagnosed using each approach. Results: Among the study population (N = 3,953), 930 underwent a baseline scan that met at least one risk factor or model-based LDCT screening strategy; 73% received annual follow-up scans. Among the 3,953, 63 lung cancers were diagnosed, of which 50 were detected by at least one LDCT screening strategy. The NCCN-2 guideline was the most sensitive (79.4%; 50/63). When compared with NCCN-2, stricter age and smoking criteria reduced sensitivity of the other guidelines/models (USPSTF-2014 [44%], PLCOm2012 [51%], and Bach[46%]). The 13 missed lung cancers were mainly attributable to smoking less and quitting longer than guideline/model eligibility criteria. False-positive rates were similar across all four guidelines/models. Interpretation: In this cohort, our findings support expanding eligibility for LDCT lung cancer screening by lowering smoking history from ≥30 to ≥20 pack-years and age from 55 years to 50 years old. Additional studies are needed to determine its generalizability to other occupational/environmental exposed cohorts.
MeSH term(s)	Aged ; Allied Health Personnel ; Early Detection of Cancer ; Female ; Firefighters ; Humans ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/etiology ; Male ; Mass Screening/methods ; Middle Aged ; Occupational Exposure ; Practice Guidelines as Topic ; Risk Factors ; September 11 Terrorist Attacks ; Tomography, X-Ray Computed
Language	English
Publishing date	2020-12-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2020.11.028
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Article ; Online: Reply: To PMID 25779102.

Webber, Mayris P / Berman, Jessica / Qayyum, Basit / Jaber, Nadia / Prezant, David J

Arthritis & rheumatology (Hoboken, N.J.)

2015 Volume 67, Issue 10, Page(s) 2791

MeSH term(s)	Autoimmune Diseases/epidemiology ; Emergency Responders/statistics & numerical data ; Environmental Exposure/statistics & numerical data ; Female ; Humans ; Male ; Rescue Work ; September 11 Terrorist Attacks
Language	English
Publishing date	2015-10
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	2756371-6
ISSN	2326-5205 ; 2326-5191
ISSN (online)	2326-5205
ISSN	2326-5191
DOI	10.1002/art.39263
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Article ; Online: Long-term Cardiovascular Disease Risk Among Firefighters After the World Trade Center Disaster.

Cohen, Hillel W / Zeig-Owens, Rachel / Joe, Cynthia / Hall, Charles B / Webber, Mayris P / Weiden, Michael D / Cleven, Krystal L / Jaber, Nadia / Skerker, Molly / Yip, Jennifer / Schwartz, Theresa / Prezant, David J

JAMA network open

2019 Volume 2, Issue 9, Page(s) e199775

Abstract: Importance: Published studies examining the association between World Trade Center (WTC) exposure on and after September 11, 2001, and longer-term cardiovascular disease (CVD) outcomes have reported mixed findings.: Objective: To assess whether WTC ... ...

Abstract	Importance: Published studies examining the association between World Trade Center (WTC) exposure on and after September 11, 2001, and longer-term cardiovascular disease (CVD) outcomes have reported mixed findings. Objective: To assess whether WTC exposure was associated with elevated CVD risk in Fire Department of the City of New York (FDNY) firefighters. Design, settings, and participants: In this cohort study, the association between WTC exposure and the risk of CVD was assessed between September 11, 2001, and December 31, 2017, in FDNY male firefighters. Multivariable Cox regression analyses were used to estimate CVD risk in association with 2 measures of WTC exposure: arrival time to the WTC site and duration of work at the WTC site. Data analyses were conducted from May 1, 2018, to March 8, 2019. Main outcomes and measures: The primary CVD outcome included myocardial infarction, stroke, unstable angina, coronary artery surgery or angioplasty, or CVD death. The secondary outcome (all CVD) included all primary outcome events or any of the following: transient ischemic attack; stable angina, defined as either use of angina medication or cardiac catheterization without intervention; cardiomyopathy; and other CVD (aortic aneurysm, peripheral arterial vascular intervention, and carotid artery surgery). Results: There were 489 primary outcome events among 9796 male firefighters (mean [SD] age on September 11, 2001, was 40.3 [7.4] years and 7210 individuals [73.6%] were never smokers). Age-adjusted incident rates of CVD were higher for firefighters with greater WTC exposure. The multivariable adjusted hazard ratio (HR) for the primary CVD outcome was 1.44 (95% CI, 1.09-1.90) for the earliest arrival group compared with those who arrived later. Similarly, those who worked at the WTC site for 6 or more months vs those who worked less time at the site were more likely to have a CVD event (HR, 1.30; 95% CI, 1.05-1.60). Well-established CVD risk factors, including hypertension (HR, 1.41; 95% CI, 1.10-1.80), hypercholesterolemia (HR, 1.56; 95% CI, 1.28-1.91), diabetes (HR, 1.99; 95% CI, 1.33-2.98), and smoking (current: HR, 2.13; 95% CI, 1.68-2.70; former: HR, 1.55; 95% CI, 1.23-1.95), were significantly associated with CVD in the multivariable models. Analyses with the all-CVD outcome were similar. Conclusions and relevance: The findings of the study suggest a significant association between greater WTC exposure and long-term CVD risk. The findings appear to reinforce the importance of long-term monitoring of the health of survivors of disasters.
MeSH term(s)	Adult ; Air Pollution/adverse effects ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/physiopathology ; Cohort Studies ; Disease Susceptibility ; Dust/analysis ; Firefighters ; Follow-Up Studies ; Humans ; Inhalation Exposure/adverse effects ; Inhalation Exposure/statistics & numerical data ; Male ; Middle Aged ; New York/epidemiology ; Occupational Diseases/epidemiology ; Occupational Diseases/etiology ; Occupational Diseases/physiopathology ; Proportional Hazards Models ; Rescue Work ; September 11 Terrorist Attacks ; Survivors/statistics & numerical data ; Time Factors
Chemical Substances	Dust
Language	English
Publishing date	2019-09-04
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2019.9775
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Article ; Online: Genetic Variants Associated with FDNY WTC-Related Sarcoidosis.

Cleven, Krystal L / Ye, Kenny / Zeig-Owens, Rachel / Hena, Kerry M / Montagna, Cristina / Shan, Jidong / Hosgood, H Dean / Jaber, Nadia / Weiden, Michael D / Colbeth, Hilary L / Goldfarb, David G / Spivack, Simon D / Prezant, David J

International journal of environmental research and public health

2019 Volume 16, Issue 10

Abstract: Sarcoidosis is a systemic granulomatous disease of unknown etiology. It may develop in response to an exposure or inflammatory trigger in the background of a genetically primed abnormal immune response. Thus, genetic studies are potentially important to ... ...

Abstract	Sarcoidosis is a systemic granulomatous disease of unknown etiology. It may develop in response to an exposure or inflammatory trigger in the background of a genetically primed abnormal immune response. Thus, genetic studies are potentially important to our understanding of the pathogenesis of sarcoidosis. We developed a case-control study which explored the genetic variations between firefighters in the Fire Department of the City of New York (FDNY) with World Trade Center (WTC)-related sarcoidosis and those with WTC exposure, but without sarcoidosis. The loci of fifty-one candidate genes related to granuloma formation, inflammation, immune response, and/or sarcoidosis were sequenced at high density in enhancer/promoter, exonic, and 5' untranslated regions. Seventeen allele variants of human leukocyte antigen (HLA) and non-HLA genes were found to be associated with sarcoidosis, and all were within chromosomes 1 and 6. Our results also suggest an association between extrathoracic involvement and allele variants of HLA and non-HLA genes found not only on chromosomes 1 and 6, but also on chromosomes 16 and 17. We found similarities between genetic variants with WTC-related sarcoidosis and those reported previously in sporadic sarcoidosis cases within the general population. In addition, we identified several allele variants never previously reported in association with sarcoidosis. If confirmed in larger studies with known environmental exposures, these novel findings may provide insight into the gene-environment interactions key to the development of sarcoidosis.
MeSH term(s)	Adult ; Case-Control Studies ; Environmental Exposure/adverse effects ; Environmental Exposure/statistics & numerical data ; Female ; Firefighters/statistics & numerical data ; Humans ; Male ; New York City/epidemiology ; Occupational Diseases/epidemiology ; Occupational Exposure/adverse effects ; Occupational Exposure/statistics & numerical data ; Sarcoidosis/epidemiology ; Sarcoidosis/genetics ; September 11 Terrorist Attacks
Language	English
Publishing date	2019-05-23
Publishing country	Switzerland
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ISSN	1660-4601
ISSN (online)	1660-4601
DOI	10.3390/ijerph16101830
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Article ; Online: Incidence and prevalence of antibody to hepatitis C virus in FDNY first responders before and after work at the World Trade Center disaster site.

Webber, Mayris P / Liu, Yang / Cohen, Hillel W / Schwartz, Theresa / Weiden, Michael D / Kelly, Kerry / Ortiz, Viola / Zeig-Owens, Rachel / Jaber, Nadia / Colbeth, Hilary L / Prezant, David J

American journal of industrial medicine

2018

Abstract: Background: The goals of this study were to assess the impact of work at the World Trade Center (WTC) site in relation to new, post-9/11/2001 (9/11) antibody to hepatitis C Virus (anti-HCV); and, evaluate secular trends in WTC-exposed male Fire ... ...

Abstract	Background: The goals of this study were to assess the impact of work at the World Trade Center (WTC) site in relation to new, post-9/11/2001 (9/11) antibody to hepatitis C Virus (anti-HCV); and, evaluate secular trends in WTC-exposed male Fire Department of New York City (FDNY) Firefighters and Emergency Medical Services (EMS) responders. Methods: FDNY monitors responder health through physical exams and routine blood work. We used descriptive statistics to compare trans-9/11 and post-9/11 incidence and to assess trends in prevalence from 2000 to 2012. Results: Trans-9/11 incidence of new anti-HCV was 0.42 per 100 persons compared with post-9/11 incidence of 0.34 (P = 0.68). Overall seroprevalence was 1.3%; rates declined from 1.79 per 100 to 0.49 per 100 over time (P < 0.0001). Conclusions: Work at the WTC was not associated with new infection. Biennial seroprevalence in responders declined over time, supporting the FDNY decision to discontinue routine annual testing in this cohort.
Language	English
Publishing date	2018-06-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	604538-8
ISSN	1097-0274 ; 0271-3586
ISSN (online)	1097-0274
ISSN	0271-3586
DOI	10.1002/ajim.22871
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Article ; Online: Estimation of Future Cancer Burden Among Rescue and Recovery Workers Exposed to the World Trade Center Disaster.

Singh, Ankura / Zeig-Owens, Rachel / Moir, William / Hall, Charles B / Schwartz, Theresa / Vossbrinck, Madeline / Jaber, Nadia / Webber, Mayris P / Kelly, Kerry J / Ortiz, Viola / Koffler, Ellen / Prezant, David J

JAMA oncology

2018 Volume 4, Issue 6, Page(s) 828–831

Abstract: Importance: Elevated rates of cancer have been reported in individuals exposed to the World Trade Center (WTC) disaster, including Fire Department of the City of New York (FDNY) rescue and recovery workers.: Objective: To project the future burden of ...

Abstract	Importance: Elevated rates of cancer have been reported in individuals exposed to the World Trade Center (WTC) disaster, including Fire Department of the City of New York (FDNY) rescue and recovery workers. Objective: To project the future burden of cancer in WTC-exposed FDNY rescue and recovery workers by estimating the 20-year cancer incidence. Design, setting, and participants: A total of 14 474 WTC-exposed FDNY employees who were cancer-free on January 1, 2012; subgroup analyses were conducted of the cohort's white male population (n = 12 374). In this closed-cohort study, we projected cancer incidence for the January 1, 2012, to December 31, 2031, period. Simulations were run using demographic-specific New York City (NYC) cancer and national mortality rates for each individual, summed for the whole cohort, and performed 1000 times to produce mean estimates. Additional analyses in the subgroup of white men compared case counts produced by using 2007-2011 FDNY WTC Health Program (FDNY-WTCHP) cancer rates vs NYC rates. Average and 20-year aggregate costs of first-year cancer care were estimated using claims data. Exposures: World Trade Center disaster exposure defined as rescue and recovery work at the WTC site at any time from September 11, 2001, to July 25, 2002. Main outcomes and measures: (1) Projected number of incident cancers in the full cohort, based on NYC cancer rates; (2) cancer incidence estimates in the subgroup projected using FDNY-WTCHP vs NYC rates; and (3) estimated first-year treatment costs of incident cancers. Results: On January 1, 2012, the cohort was 96.8% male, 87.1% white, and had a mean (SD) age of 50.2 (9.2) years. The projected number of incident cancer cases was 2960 (95% CI, 2883-3037). In our subgroup analyses using FDNY-WTCHP vs NYC cancer rates, the projected number of new cases in white men was elevated (2714 [95% CI, 2638-2786] vs 2596 [95% CI, 2524-2668]). Accordingly, we expect more prostate (1437 [95% CI, 1383-1495] vs 863 [95% CI, 816-910]), thyroid (73 [95% CI, 60-86] vs 57 [95% CI, 44-69]), and melanoma cases (201 [95% CI, 179-223] vs 131 [95% CI, 112-150), but fewer lung (237 [95% CI, 212-262] vs 373 [95% CI, 343-405]), colorectal (172 [95% CI, 152-191] vs 267 [95% CI, 241-292]), and kidney cancers (66 [95% CI, 54-80] vs 132 [95% CI, 114-152]) (P < .001 for all comparisons). The estimated 20-year cost of first-year treatment was $235 835 412 (95% CI, $187 582 227-$284 088 597). Conclusions and relevance: We project that the FDNY-WTCHP cohort will experience a greater cancer burden than would be expected from a demographically similar population. This underscores the importance of cancer prevention efforts and routine screening in WTC-exposed rescue and recovery workers.
MeSH term(s)	Adult ; Aged ; Air Pollutants/toxicity ; Carcinogens, Environmental/toxicity ; Cohort Studies ; Disasters ; Emergency Responders ; Environmental Restoration and Remediation ; Firefighters ; Forecasting ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasms/economics ; Neoplasms/epidemiology ; Neoplasms/etiology ; New York City/epidemiology ; Occupational Diseases/epidemiology ; Occupational Diseases/etiology ; Rescue Work ; September 11 Terrorist Attacks
Chemical Substances	Air Pollutants ; Carcinogens, Environmental
Language	English
Publishing date	2018-04-28
Publishing country	United States
Document type	Journal Article
ISSN	2374-2445
ISSN (online)	2374-2445
DOI	10.1001/jamaoncol.2018.0504
Database	MEDical Literature Analysis and Retrieval System OnLINE

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