The World Trade Center exposome and health effects in 9/11 rescue and recovery workers

• Published in: Communications medicine 2024-12, Vol.4 (1), p.257-7, Article 257
• Main Authors: Rechtman, Elza, Rodriguez, Michelle A., Colicino, Elena, Hahn, Christopher J., Navarro, Esmeralda, Invernizzi, Azzurra, Dasaro, Christopher R., Teitelbaum, Susan L., Todd, Andrew C., Horton, Megan K.
• Format: Article
• Language: English
• Subjects: 692/699; 692/700; Certification; Diabetes; Disease prevention; Gastroesophageal reflux; Medical laboratories; Medicine; Medicine & Public Health; Mental disorders; Mental health; Post traumatic stress disorder; Questionnaires; September 11 terrorist attacks-2001; Sociodemographics; Socioeconomic factors; Socioeconomic status
• ISSN: 2730-664X; 2730-664X
• DOI: 10.1038/s43856-024-00683-9

Background In the aftermath of the World Trade Center (WTC) attack on 11 September 2001, rescue and recovery workers faced hazardous conditions and toxic agents. Prior research linked these exposures to adverse health effects, but mainly examined individual factors, overlooking complex mixture effects. Methods This study applies an exposomic approach encompassing the totality of responders’ experience, defined as the WTC exposome. We analyzed data from 34,096 members of the WTC Health Program General Responder, including mental and physical health, occupational history, traumatic and environmental exposures using generalized weighted quantile sum regression. Results We find a statistically significant association between the exposure mixture index and all investigated health outcomes. Factors identified as risk factors include working in an enclosed heavily contaminated area, construction occupation, and exposure to blood and body fluids. Conversely, full-time employment emerged as a protective factor. Conclusions This exposomics study emphasizes the importance of considering combined exposures for the identification of harmful and protective factors within the WTC exposome, providing valuable insights for targeted interventions and preventive measures. In an era marked by more frequent and severe natural disasters due to the evolving climate crisis, the exposomic framework is a promising tool for disaster preparedness. Plain language summary After the 9/11 World Trade Center attacks, rescue and recovery workers were exposed to many harmful substances and hazardous conditions. We assessed all aspects of these exposures and compared these with responders’ health and work history. We found that exposure to harmful substances and hazardous conditions was associated with all investigated health problems. Working in contaminated areas, in construction, or with blood and body fluids increased health risks. However, being employed full-time seemed to protect against some health issues. This research highlights the need to consider all things that rescue and recovery workers are exposed to during disasters to better understand and prevent health problems during and after future events. Rechtman et al. analyse the exposome of rescue and recovery workers who attended the World Trade Center on and after September 11, 2001. Mental and physical health outcomes associate with all aspects of occupational history, as well as traumatic and environmental exposures.