Post-9/11 Cancer Incidence in FDNY Firefighters

描述(由申请人提供)：尽管自2001年9月11日以来随访时间有限，但现在所有三组救援/恢复人员都报告称，暴露在世贸中心(WTC)灾难现场后，癌症发病率略有上升。WTC的首个重大癌症发病率研究是由我们的研究小组进行的，并推动将癌症添加到2010年詹姆斯·扎德罗加9/11健康和补偿法案涵盖的健康状况清单中，该法案由国家职业安全与健康研究所(NIOSH)赞助。NIOSH已经主办了会议，讨论WTC暴露与癌症可能联系的评估。从这些会议中得出的一个重要结论是，人们认识到，暴露于WTC的队列缺乏适当的比较人群；另一个重要结论是，很难准确地描述暴露于WTC场所的特征。我们当前提案的首要目标是解决这些问题，从而加深我们对WTC暴露与癌症风险之间关系的理解。NIOSH对未接触WTC的消防员的研究结果最近发表，其调查人员已同意与我们合作，作为当前提案的一部分。这项合作将首次为纽约市消防局(FDNY)队列中接触WTC的消防员提供理想的比较人群，使我们能够区分可能因消防接触而导致的过量癌症与可能因WTC现场工作而导致的过量癌症。此外，我们建议使用纽约联邦储备银行的工作记录来更好地估计10个月救援/恢复期间WTC工作暴露的持续时间，从而创建一个独立于回忆偏差的暴露指标。最后，我们将使用这项提案产生的新信息来预测到2035年暴露于WTC的消防员中预期的新癌症病例范围，以促进长期规划。这项建议的具体目的是：目的1)比较接触WTC的消防员和非接触WTC的消防员的癌症发病率；目的2)根据FDNY的工作分配记录开发一种新的WTC暴露持续时间的衡量标准，并根据首次到达WTC地点的时间和新的持续时间指标建立癌症发病率模型；以及目的3)估计暴露于WTC的消防员未来的癌症负担，以便于规划和政策决策。

DESCRIPTION (provided by applicant): Modest elevations in cancer rates post-exposure to the World Trade Center (WTC) disaster site have now been reported in all three cohorts of rescue/recovery workers, despite limited follow-up time since 9/11/2001. The first major WTC cancer incidence study was carried out by our research group and served as the impetus for adding cancer to the list of health conditions covered by the James Zadroga 9/11 Health and Compensation Act of 2010, under the auspices of the National Institute for Occupational Safety and Health (NIOSH). NIOSH has sponsored meetings to discuss assessment of the possible association of WTC exposure with cancer. One important conclusion from those meetings was the realization that WTC-exposed cohorts lack appropriate comparison populations; another was that it is difficult to accurately characterize exposure to the WTC site. The overarching goal of our current proposal is to address these problems and thereby further our understanding of the association between WTC exposure and cancer risk. Results from a NIOSH study of non- WTC-exposed firefighters were recently published and its investigators have agreed to collaborate with us as part of the current proposal. This collaboration will, for the first time, provide an ideal comparison population for WTC-exposed firefighters from the Fire Department of the City of New York (FDNY) cohort, allowing us to differentiate between excess cancers potentially attributable to firefighting exposures from excess cancers potentially attributable to work at the WTC site. In addition, we propose to use FDNY work records to better estimate the duration of WTC work exposure during the 10-month rescue/recovery period, creating an exposure metric that is independent of recall bias. Finally, we will use new information generated by this proposal to project the range of expected new cancer cases among WTC-exposed firefighters through 2035 to facilitate long-term planning. The specific aims of this proposal are: Aim 1) Compare cancer incidence rates in FDNY WTC-exposed firefighters to rates in non-WTC-exposed firefighters; Aim 2) Develop a new measure of duration of WTC exposure based on FDNY work assignment records and model cancer incidence rates as a function of first arrival time to the WTC site and the new duration measure; and Aim 3) Estimate the future burden of cancer in WTC-exposed firefighters to facilitate planning and policy decisions.