Development and implementation of a comparison occupational cohort for the WTC GRC

项目摘要 世界贸易中心(WTC)的第一反应人员遭受了许多疾病和状况的结果 他们在9/11事件及之后的努力。例如，人们已经注意到，有许多案例 应答者的空气消化障碍，包括鼻窦炎、哮喘、间质性肺病和 胃食道反流。同样，也有报告称某些癌症的发病率高于预期，例如 多发性骨髓瘤、前列腺和甲状腺。据报道，创伤后应激障碍的发生率也相对较高。 精神障碍、焦虑、抑郁和睡眠呼吸暂停。这些报告的共同点是比较组 对照WTC一般响应者队列(WTC-GRC)的数据进行测量。这个 比较小组由国家或地方组织(如纽约州癌症登记处)组成，包括 一般人群的成员，而不是职业群体。这项建议的目的是为了 一个独特的职业队列，部分基于西奈山塞利科夫中心的患者 职业健康(SCOH)，以及向西奈山其他部门介绍情况的工人，以及 通过外展努力招募的工人。理由是，对于第一个人的健康状况的有效估计 应答者，比较必须针对工作人口，而不是一般人口，这可能会导致 顽固的偏见和错误的评估。 拟议项目的具体目标包括：1)将现有的SCOH数据转换为一个可用的数据库，以便 WTC相关健康状况的比较分析；2)建立新的职业队列，作为 WTC-GRC中纵向健康评估的比较；以及3)利用新创建的 比较队列以确定胃食道反流病(GERD)在WTC-GRC中的发病率是否不同 从未接触过的工人群体中分离出来。 拟议项目的结果将提高正在进行的与健康有关的研究的质量 提供一个更合适的比较组，可以在以下几个重要方面与响应者相匹配 特征，包括职业、年龄、性别和种族/族裔。这样的研究将导致改进 对疾病风险的估计，并为我们目前对暴露于 9/11有毒物质和压力源。

Project Summary World Trade Center (WTC) first responders have suffered numerous diseases and conditions as a result of their efforts on 9/11 and afterwards. For example, it has been noted that there are numerous cases of aerodigestive disorders amongst the responders, including sinusitis, asthma, interstitial lung disease, and gastroesophageal reflux. Similarly, there are reports of higher than expected rates of certain cancers, such as multiple myeloma, prostate, and thyroid. Also reported are relatively high rates of post-traumatic stress disorder, anxiety, depression, and sleep apnea. The commonality in these reports is the comparator groups against which the data from the WTC General Responders Cohort (WTC-GRC) were measured. The comparator groups were either national or local (e.g., the NY State Cancer Registry) and were composed of members of the general population, not occupational groups. The purpose of this proposal is the development of a unique occupational cohort, based in part on patients attending the Mount Sinai Selikoff Centers for Occupational Health (SCOH), as well as workers presenting to other departments within Mount Sinai, and workers recruited through outreach efforts. The reasoning is that for valid estimates of the health of the first responders, comparisons must be against a working population and not the general population, which can lead to intractable bias and faulty assessments. The specific aims of the proposed project include: 1) converting existing SCOH data into a usable database for comparative analyses of WTC-related health conditions; 2) building a new occupational cohort to serve as a comparison in the longitudinal assessment of health in the WTC-GRC; and 3) utilizing the newly created comparison cohort to determine if gastroesophageal reflux disease (GERD) incidence in the WTC-GRC differs from an unexposed worker population. The results of the proposed project will improve the quality of the health related studies being done by providing a more appropriate comparison group that can be matched to responders on several important characteristics, including occupation, age, sex and race/ethnicity. Such studies will result in improved estimates of disease risk and add important knowledge to what we currently understand about exposure to 9/11 toxins and stressors.