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，但据报道，在世界贸易中心（WTC）灾难现场暴露后，所有三组救援/恢复工作者的癌症发病率均有适度上升。我们的研究小组进行了第一项主要的世贸中心癌症发病率研究，并推动了在国家职业安全与健康研究所（NIOSH）的主持下，将癌症添加到2010年詹姆斯·扎德罗加9/11健康与赔偿法案所涵盖的健康状况列表中。NIOSH主办了会议，讨论WTC暴露与癌症的可能联系。这些会议得出的一个重要结论是认识到接触wtc的队列缺乏适当的比较人群；另一个原因是很难准确地描述接触世贸中心遗址的特征。我们目前建议的首要目标是解决这些问题，从而进一步了解WTC暴露与癌症风险之间的关系。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）队列中暴露于世贸中心的消防员提供理想的比较人群，使我们能够区分可能归因于消防暴露的过量癌症和可能归因于世贸中心现场工作的过量癌症。此外，我们建议使用FDNY工作记录来更好地估计在10个月的救援/恢复期间WTC工作暴露的持续时间，创建一个独立于回忆偏差的暴露度量。最后，我们将使用该提案产生的新信息来预测到2035年wtc暴露的消防员中预期的新癌症病例范围，以促进长期规划。本提案的具体目的是：目的1)比较FDNY接触wtc的消防员与未接触wtc的消防员的癌症发病率；目标2)基于FDNY的工作分配记录和模型癌症发病率作为首次到达世贸中心地点的时间的函数和新的持续时间测量，开发一种新的世贸中心暴露时间测量方法；评估接触wtc的消防员未来的癌症负担，以促进规划和政策决策。

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.