Injury, intense dust exposure, and chronic disease among survivors of the World Trade Center terrorist attacks of September 11, 2001.
Injury, intense dust exposure, and chronic disease among survivors of the World Trade Center terrorist attacks of September 11, 2001.
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DOI：
10.1186/s40621-017-0115-x
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发表时间：
2017-12
影响因子：
2.2
通讯作者：
Brackbill RM
中科院分区：
文献类型：
--
作者：
Alper HE;Yu S;Stellman SD;Brackbill RM
2001年9月11日发生在纽约市的世界贸易中心袭击事件（9/11）使成千上万的人暴露在高浓度的危险物质中，导致哮喘、心脏病、糖尿病和其他慢性病沿着心理疾病如创伤后应激障碍（PTSD）的报告增加。很少有研究区分直接（短期或急性）高强度接触与长期居住或工作场所接触的健康后果。我们使用比例风险方法来确定急性暴露的几个组成部分（例如，在8701名暴露前无上述疾病、在世贸中心遭受袭击期间或袭击后立即在场的人中，对4种慢性疾病后果（哮喘、其他非肿瘤性肺病、心血管疾病和糖尿病）进行了研究。参与者在9/11事件后进行了长达11年的前瞻性随访。心脏病与持续性损伤呈剂量反应关系（1种损伤类型：AHR =2.0，95% CI（置信区间）1.1-3.6; 2种损伤类型：AHR = 3.1，95% CI 1.2-7.9; 3种或3种以上损伤类型：AHR = 6.8，95%CI 2.0-22.6），而哮喘和其他肺部疾病均与尘云暴露显著相关（AHR = 1.3，95%CI 1.0-1.6）。糖尿病与本研究中评估的任何预测因子均不相关。在这项研究中，我们证明了2001年9月11日持续的急性损伤和尘云暴露与后来的心脏和呼吸系统疾病有显着的关联。在可预见的未来，医疗服务提供者有必要继续监测9/11事件暴露者的健康状况。
The World Trade Center attack of September 11, 2001 in New York City (9/11) exposed thousands of people to intense concentrations of hazardous materials that have resulted in reports of increased levels of asthma, heart disease, diabetes, and other chronic diseases along with psychological illnesses such as post-traumatic stress disorder (PTSD). Few studies have discriminated between health consequences of immediate (short-term or acute) intense exposures versus chronic residential or workplace exposures. We used proportional hazards methods to determine adjusted hazard ratios (AHRs) for associations between several components of acute exposures (e.g., injury, immersion in the dust cloud) and four chronic disease outcomes: asthma, other non-neoplastic lung diseases, cardiovascular disease, and diabetes, in 8701 persons free of those conditions prior to exposure and who were physically present during or immediately after the World Trade Center attacks. Participants were followed prospectively up to 11 years post-9/11. Heart disease exhibited a dose-response association with sustaining injury (1 injury type: AHR =2.0, 95% CI (Confidence Interval) 1.1–3.6; 2 injury types: AHR = 3.1, 95% CI 1.2–7.9; 3 or more injury types: AHR = 6.8, 95% CI 2.0–22.6), while asthma and other lung diseases were both significantly associated with dust cloud exposure (AHR = 1.3, 95% CI 1.0–1.6). Diabetes was not associated with any of the predictors assessed in this study. In this study we demonstrated that the acute exposures of injury and dust cloud that were sustained on 9/11/2001 had significant associations with later heart and respiratory diseases. Continued monitoring of 9/11 exposed persons’ health by medical providers is warranted for the foreseeable future.