Yip Jennifer, Zeig-Owens Rachel, Webber Mayris P, Kablanian Andrea, Hall Charles B, Vossbrinck Madeline, Liu Xiaoxue, Weakley Jessica, Schwartz Theresa, Kelly Kerry J, Prezant David J
Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA Department of Medicine, Montefiore Medical Center, Bronx, New York, USA.
Fire Department of the City of New York, Bureau of Health Services, Brooklyn, New York, USA Department of Epidemiology and Population Health, Montefiore Medical Center, Bronx, New York, USA Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA.
Occup Environ Med. 2016 Jan;73(1):13-20. doi: 10.1136/oemed-2014-102601. Epub 2015 Apr 15.
To describe the health burden among Fire Department of the City of New York (FDNY) emergency medical service (EMS) workers and examine its association with work at the World Trade Center (WTC) disaster site.
In this observational cohort study, we used FDNY physician diagnoses to estimate the cumulative incidence of physical health conditions including rhinosinusitis, gastroesophageal reflux disease (GERD), obstructive airways disease (OAD) and cancer among EMS workers and demographically similar firefighters who were active on 11 September 2001 (9/11). Validated screening instruments were used to estimate the prevalence of probable post-traumatic stress disorder (PTSD), probable depression and probable harmful alcohol use. We also analysed the association between health conditions and WTC-exposure.
Among 2281 EMS workers, the 12-year post-9/11 cumulative incidence (11 September 2001 to 31 December 2013) of rhinosinusitis was 10.6%; GERD 12.1%; OAD 11.8%; cancer 3.1%. The prevalence of probable PTSD up to 12 years after exposure was 7%; probable depression 16.7%; and probable harmful alcohol use 3%. Compared with unexposed, EMS workers who arrived earliest at the site had higher adjusted relative risks (aRR) for most conditions, including rhinosinusitis (aRR=3.7; 95% CI 2.2 to 6.0); GERD (aRR=3.8; 95% CI 2.4 to 6.1); OAD (aRR=2.4: 95% CI 1.7 to 3.6); probable PTSD (aRR=7.0; 95% CI 3.6 to 13.5); and, probable depression (aRR=2.3; 95% CI 1.6 to 3.1).
In this 12-year study, we documented a high burden of health conditions associated with WTC-exposure among FDNY EMS workers. These findings underscore the importance of continued monitoring and treatment of this workforce.
描述纽约市消防局（FDNY）紧急医疗服务（EMS）工作人员的健康负担，并研究其与在世贸中心（WTC）灾难现场工作之间的关联。
在这项观察性队列研究中，我们利用FDNY医生的诊断结果来估算2001年9月11日（9·11事件）当天在职的EMS工作人员以及人口统计学特征相似的消防员中，包括鼻窦炎、胃食管反流病（GERD）、阻塞性气道疾病（OAD）和癌症在内的身体健康状况的累积发病率。使用经过验证的筛查工具来估算可能患有创伤后应激障碍（PTSD）、可能患有抑郁症以及可能有害饮酒的患病率。我们还分析了健康状况与世贸中心暴露之间的关联。
在2281名EMS工作人员中，9·11事件后12年（2001年9月11日至2013年12月31日）鼻窦炎的累积发病率为10.6%；胃食管反流病为12.1%；阻塞性气道疾病为11.8%；癌症为3.1%。暴露后长达12年，可能患有创伤后应激障碍的患病率为7%；可能患有抑郁症的患病率为16.7%；可能有害饮酒的患病率为3%。与未暴露的人员相比，最早到达现场的EMS工作人员在大多数疾病方面的调整后相对风险（aRR）更高，包括鼻窦炎（aRR = 3.7；95%置信区间2.2至6.0）；胃食管反流病（aRR = 3.8；95%置信区间2.4至6.1）；阻塞性气道疾病（aRR = 2.4：95%置信区间1.7至3.6）；可能患有创伤后应激障碍（aRR = 7.0；95%置信区间3.6至13.5）；以及可能患有抑郁症（aRR = 2.3；95%置信区间1.6至3.1）。
在这项为期12年的研究中，我们记录了FDNY的EMS工作人员中与世贸中心暴露相关的高健康负担。这些发现强调了对这一群体持续进行监测和治疗的重要性。
