Health and Socioeconomic Sequelae of the WTC Disaster Among Responders

7.项目摘要 自世界贸易中心MMTP成立以来，健康报告的重点是呼吸消化道疾病， 心理健康后果，以及除肺活量测定外，与一般和规范的比较 没有人口数据。此外，以前的研究都没有全面评估 9·11事件后世贸中心响应者社会经济地位的变化。降低社会经济地位是一个重要的潜力 WTC暴露的后果可能对WTC中的身心健康状况产生负面影响 响应者。拟议研究的主要目标是建立一个扩大的职业健康 监测系统，总结了WTC响应者的整体健康状况，并提供 关于以前未报告的症状的信息。通过这项工作，其他健康 将确定和报告结果，如自身免疫性疾病。这个扩大的监视系统 将补充数据中心（DC）将提供的报告。为了提供参考人口，世贸中心 队列将与国家卫生统计中心（NCHS）和行为风险因素进行比较。 监测系统（BRFSS）通过匹配变量比较身心健康状况。的 比较将估计WTC暴露对WTC响应者健康的影响程度 与美国和纽约-怀特普莱恩斯-韦恩，纽约/新泽西大都市区的一般人口相比。 这项扩大的监测结果将通过一个综合的职业健康 监视报告职业健康监护综合报告，是指 描述一段时间内的健康状况，比较队列内和一般人群中的组 人口本报告的调查结果也将有助于未来制定新的指南， 实施灾害职业健康监测系统，这对灾害管理至关重要。 做好准备沿着实施监测系统，另一个目标是调查 SES与健康状况之间存在双向效应修正。通过确定效应修正，SES 将被添加为进行监测所需的重要变量之一。该研究假设， 影响修正调查结果为：1）WTC暴露降低健康状况; 2）WTC暴露降低 社会经济地位; 3）这些变量之间存在交互作用。这次调查的效果 健康和社会经济地位之间的修正是一个独特的研究课题，尚未被研究的世界贸易中心 响应者。了解健康和社会经济地位之间的联系的性质将有助于识别高风险 这是一个群体，为预防和干预战略提供了主要目标。随着这项工作的顺利完成， 2-经过一年的研究，我们期望世贸中心的职业健康监测系统得到实质性的改善 响应者。

7. Project Summary Since the inception of the WTC MMTP, health reports have focused on disorders of the aerodigestive tract and mental health consequences, and with the exception of spirometry, comparisons with general and normative population data have not been made. Furthermore, none of the previous studies comprehensively evaluated the changes of socioeconomic status in WTC responders after 9/11. Lowered SES is an important potential consequence of WTC exposures that can negatively impact the physical and mental health status among WTC responders. The main objective of the proposed study is to establish an expanded occupational health surveillance system that summarizes overall health status of WTC responders over time, and also provides information about symptoms not previously reported. Through this work, it is possible that other health outcomes will be identified and reported, such as autoimmune disorders. This expanded surveillance system will supplement reports the Data Center (DC) will be providing. To provide a reference population, the WTC cohort will be compared to the National Center for Health Statistics (NCHS) and the Behavioral Risk Factor Surveillance System (BRFSS) to compare physical and mental health status by matching variables. The comparison will estimate the magnitude of the impact of WTC exposure on the health of WTC responders compared with the general population in U.S. and New York-White Plains-Wayne, NY/NJ metropolitan area. Findings from this expanded surveillance will be reported through an integrated occupational health surveillance report. The term "integrated occupational health surveillance report" means a detailed and overall description of health status over time, with a comparison of groups both within the cohort and from the general population. The findings from this report will also aid in the future development of new guidelines for the implementation of an occupational health surveillance system for disasters, which is essential for disaster preparedness. Along with implementing a surveillance system, an additional objective will be to investigate ambi-directional effect modification between SES and health status. By ascertaining effect modification, SES will be added as one of the important variables necessary to perform surveillance. The study hypotheses for the effect modification investigation are 1) WTC exposures lower health status; 2) WTC exposures lower socioeconomic status; and 3) an interaction effect exists between these variables. This investigation for effect modification between health and SES is a unique research topic that has not been studied for WTC responders. Understanding the nature of the linkage between health and SES will help to identify high risk groups and offer a primary target for prevention and intervention strategies. With successful completion of this 2-year study, we expect a substantial improvement of the occupational health surveillance system for WTC responders.