Abstract:
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Lower mortality rates were observed in World Trade Center (WTC)-exposed workers compared with general populations, but findings may be influenced by the healthy worker effect or access to care. No study has compared mortality in WTC-exposed workers to that in a comparable occupational cohort. We assessed mortality rates in New York City WTC-exposed firefighters vs a comparison cohort of non-WTC-exposed firefighters from Chicago, Philadelphia and San Francisco. Analyses included 10,786 WTC-exposed and 8,813 non-exposed male firefighters. Follow-up began on 9/11/01 and ended at death date or 12/31/16. Poisson regression models estimated relative rates (RR) of all-cause and cause-specific mortality in WTC-exposed vs non-exposed firefighters controlling for age and race. WTC-exposed firefighters had lower rates of mortality from all causes (RR=0.54 95%CI=0.49-0.59), cancer (RR=0.72 95%CI=0.66-0.79), heart disease (RR=0.61 95%CI=0.55-0.68) and respiratory diseases (RR=0.69 95%CI=0.62-0.77) compared to non-WTC-exposed. Reduced mortality in the WTC-exposed cohort may be a result of free routine health monitoring, including cancer screenings, they receive as part of the WTC Health Program.
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