World Trade Center Site Exposure Linked to Lasting CVD Risk

Greater exposure to the World Trade Center (WTC) site is associated with increased long-term cardiovascular disease (CVD) risk, according to a study published online in JAMA Network Open.

Hillel W. Cohen, Dr.P.H., M.P.H., from Albert Einstein College of Medicine in Bronx, New York, and colleagues examined the correlation between WTC exposure and risk for CVD among New York City Fire Department firefighters between Sept. 11, 2001, and Dec. 31, 2017.

The researchers identified 489 primary outcome events among 9,796 male firefighters. Firefighters with greater WTC exposure had higher age-adjusted incident rates of CVD. For the primary CVD outcome, the multivariable adjusted hazard ratio was 1.44 for the earliest arrival group versus those who arrived later. The likelihood of having a CVD event was also increased for those who worked at the WTC site for six or more months versus those who worked less time (hazard ratio, 1.30). In the multivariable models, well-established CVD risk factors were significantly associated with CVD, including hypertension, hypercholesterolemia, and diabetes (hazard ratios, 1.41, 1.56, and 1.99, respectively), as well as smoking (current: hazard ratio, 2.13; former: hazard ratio, 1.55).

"The findings appear to reinforce the importance of long-term monitoring of the health of survivors of disasters," the authors write. "Future studies are warranted to address whether identifying and addressing changes in other CVD risk factors can mitigate elevated CVD risk associated with disaster exposure."

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