Steven Stellman - Association between World Trade Center exposure and excess cancer risk

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      Publication Details (including relevant citation   information):

      Li, J., Cone, J. E., Kahn, A. R., Brackbill, R. M., Farfel, M.   R., Greene, C. M., Hadler, J. L., Stayner, L. T., Stellman, S. D.   308 (23) 2479-88-

      Abstract: CONTEXT: The terrorist attacks of   September 11, 2001, resulted in the release of known and   suspected carcinogens into the environment. There is public   concern that exposures may have resulted in increased cancers.   OBJECTIVE: To evaluate cancer incidence among persons enrolled in   the World Trade Center Health Registry. DESIGN, SETTING, AND   PARTICIPANTS: Observational study of 55,778 New York State   residents enrolled in the World Trade Center Health Registry in   2003-2004, including rescue/recovery workers (n = 21,850) and   those not involved in rescue/recovery (n = 33,928), who were   followed up from enrollment through December 31, 2008.   Within-cohort comparisons using Cox proportional hazards models   assessed the relationship between intensity of World Trade Center   exposure and selected cancers. MAIN OUTCOME MEASURES: Cases were   identified through linkage with 11 state cancer registries.   Standardized incidence ratios (SIRs) adjusted for age,   race/ethnicity, and sex were computed with 2003-2008 New York   State rates as the reference, focusing on cancers diagnosed in   2007-2008 as being most likely to be related to exposure during   September 11 and its aftermath. The total and site-specific   incidence rate differences (RDs) per 100,000 person-years between   the study population and the New York State population in   2007-2008 also were calculated. RESULTS: There were 1187 incident   cancers diagnosed, with an accumulated 253,269 person-years (439   cancers among rescue/recovery workers and 748 among those not   involved in rescue/recovery). The SIR for all cancer sites   combined in 2007-2008 was not significantly elevated (SIR, 1.14   [95% CI, 0.99 to 1.30]; RD, 67 [95% CI, -6 to 126] per 100,000   person-years among rescue/recovery workers vs SIR, 0.92 [95% CI,   0.83 to 1.03]; RD, -45 [95% CI, -106 to 15] per 100,000   person-years among those not involved in rescue/recovery). Among   rescue/recovery workers, the SIRs had significantly increased by   2007-2008 for 3 cancer sites and were 1.43 (95% CI, 1.11 to 1.82)   for prostate cancer (n = 67; RD, 61 [95% CI, 20 to 91] per   100,000 person-years), 2.02 (95% CI, 1.07 to 3.45) for thyroid   cancer (n = 13; RD, 16 [95% CI, 2 to 23] per 100,000   person-years), and 2.85 (95% CI, 1.15 to 5.88) for multiple   myeloma (n = 7; RD, 11 [95% CI, 2 to 14] per 100,000   person-years). No increased incidence was observed in 2007-2008   among those not involved in rescue/recovery. Using within-cohort   comparisons, the intensity of World Trade Center exposure was not   significantly associated with cancer of the lung, prostate,   thyroid, non-Hodgkin lymphoma, or hematological cancer in either   group. CONCLUSIONS: Among persons enrolled in the World Trade   Center Health Registry, there was an excess risk for prostate   cancer, thyroid cancer, and myeloma in 2007-2008 compared with   that for New York State residents; however, these findings were   based on a small number of events and multiple comparisons. No   significant associations were observed with intensity of World   Trade Center exposures. Longer follow-up for typically   long-latency cancers and attention to specific cancer sites are   needed.

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