Department of Medicine, Division of Pulmonary Medicine, Montefiore Medical Center, Bronx, New York, USA.
Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York, USA.
Occup Environ Med. 2021 Oct;78(10):699-706. doi: 10.1136/oemed-2021-107405. Epub 2021 Sep 10.
The World Trade Center (WTC) attacks on 11 September 2001 created a hazardous environment with known and suspected carcinogens. Previous studies have identified an increased risk of prostate cancer in responder cohorts compared with the general male population.
To estimate the length of time to prostate cancer among WTC rescue/recovery workers by determining specific time periods during which the risk was significantly elevated.
Person-time accruals began 6 months after enrolment into a WTC cohort and ended at death or 12/31/2015. Cancer data were obtained through linkages with 13 state cancer registries. New York State was the comparison population. We used Poisson regression to estimate hazard ratios and 95% CIs; change points in rate ratios were estimated using profile likelihood.
The analytic cohort included 54 394 male rescue/recovery workers. We observed 1120 incident prostate cancer cases. During 2002-2006, no association with WTC exposure was detected. Beginning in 2007, a 24% increased risk (HR: 1.24, 95% CI 1.16 to 1.32) was observed among WTC rescue/recovery workers when compared with New York State. Comparing those who arrived earliest at the disaster site on the morning of 11 September 2001 or any time on 12 September 2001 to those who first arrived later, we observed a positive, monotonic, dose-response association in the early (2002-2006) and late (2007-2015) periods.
Risk of prostate cancer was significantly elevated beginning in 2007 in the WTC combined rescue/recovery cohort. While unique exposures at the disaster site might have contributed to the observed effect, screening practices including routine prostate specific antigen screening cannot be discounted.
2001 年 9 月 11 日的世贸中心袭击事件造成了一个充满已知和疑似致癌物的危险环境。先前的研究已经确定，与普通男性人群相比， responder 队列中前列腺癌的风险增加。
通过确定风险显著升高的特定时间段，来估计世贸中心救援/恢复工作人员中前列腺癌的发病时间。
人员时间累积从登记进入世贸中心队列后 6 个月开始，截止日期为死亡或 2015 年 12 月 31 日。癌症数据通过与 13 个州癌症登记处的链接获得。纽约州是比较人群。我们使用泊松回归估计风险比和 95%置信区间；使用轮廓似然估计率比的变化点。
分析队列包括 54394 名男性救援/恢复工作人员。我们观察到 1120 例前列腺癌新发病例。在 2002-2006 年期间，没有发现与 WTC 暴露有关。从 2007 年开始，与纽约州相比，WTC 救援/恢复人员的风险增加了 24%（HR：1.24，95%CI 1.16-1.32）。与那些在 2001 年 9 月 11 日早上最早到达灾难现场的人或 2001 年 9 月 12 日任何时间到达的人相比，我们观察到在早期（2002-2006 年）和晚期（2007-2015 年）期间存在正向、单调、剂量反应关联。
从 2007 年开始，世贸中心联合救援/恢复队列中前列腺癌的风险显著升高。虽然灾难现场的独特暴露可能促成了观察到的效果，但不能排除筛查实践，包括常规前列腺特异性抗原筛查。
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