Ayers Caleb D, Kehm Rebecca D, Cone James E, Li Jiehui
World Trade Center Health Registry, Center for Population Health Data Science, New York City Department of Health and Mental Hygiene, Long Island City, NY 11101, USA.
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
Int J Environ Res Public Health. 2025 Apr 19;22(4):643. doi: 10.3390/ijerph22040643.
The 11 September 2001 World Trade Center (WTC) rescue and recovery workers (RRWs) included first responders (FDNY and NYPD), volunteers, and other workers. Volunteers were often more vulnerable than first responders to adverse health outcomes resulting from the exposure. It is not yet known whether there are differences in WTC Health Program (WTCHP) utilization by worker type. This is a cross-sectional study of 20,012 WTCHP-eligible RRWs to examine whether worker type was associated with WTCHP utilization based on self-reported data from four WTC Health Registry follow-up surveys (2006-2021), using multivariable log-binomial regression adjusted for sociodemographic factors and comorbidities. We also examined factors associated with WTCHP utilization by worker type. Overall, 9584 RRWs (47.9%) reported receiving WTCHP services, but only 22.5% of volunteers reported WTCHP utilization. After adjustment, first responders and other workers were, respectively, 2.73 (95% CI = 2.56, 2.92) and 1.69 (95% CI = 1.58, 1.80) times more likely to utilize WTCHP service than volunteers. Sociodemographic factors and comorbidities were consistently associated with WTCHP utilization across worker types, except for race/ethnicity. Among those eligible, the volunteer group reported the lowest utilization of WTCHP among worker types, suggesting that WTC volunteers should be a priority group for outreach regarding access and utilization of WTCHP.
2001年9月11日世贸中心（WTC）救援和恢复工作人员（RRWs）包括第一响应者（纽约市消防局和纽约市警察局）、志愿者及其他工作人员。与第一响应者相比，志愿者往往更容易因接触而出现不良健康后果。目前尚不清楚不同类型的工作人员在使用世贸中心健康计划（WTCHP）方面是否存在差异。这是一项对20,012名符合WTCHP资格的RRWs进行的横断面研究，旨在根据来自四项世贸中心健康登记随访调查（2006 - 2021年）的自我报告数据，使用经社会人口因素和合并症调整的多变量对数二项回归，研究工作人员类型是否与WTCHP的使用相关。我们还研究了按工作人员类型划分的与WTCHP使用相关的因素。总体而言，9584名RRWs（47.9%）报告接受了WTCHP服务，但只有22.5%的志愿者报告使用了WTCHP。调整后，第一响应者和其他工作人员使用WTCHP服务的可能性分别是志愿者的2.73倍（95%置信区间 = 2.56, 2.92）和1.69倍（95%置信区间 = 1.58, 1.80）。除种族/民族外，社会人口因素和合并症在不同类型的工作人员中均与WTCHP的使用始终相关。在符合条件的人群中，志愿者组在各类工作人员中WTCHP使用率最低，这表明世贸中心志愿者应成为关于WTCHP获取和使用的宣传推广的优先群体。
