Upper Respiratory Symptoms and Other Health Effects among Residents Living Near the World Trade Center Site after September 11, 2001

• Published in: American journal of epidemiology 2005-09, Vol.162 (6), p.499-507
• Main Authors: Lin, Shao, Reibman, Joan, Bowers, James A., Hwang, Syni-An, Hoerning, Anne, Gomez, Marta I., Fitzgerald, Edward F.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Air pollution; Analysis. Health state; Asthma; Asthma - complications; Asthma - epidemiology; Biological and medical sciences; Child; Child, Preschool; Chronic obstructive pulmonary disease, asthma; CIR; Cohort Studies; confidence interval; cumulative incidence ratio; environmental pollution; Epidemiology; Female; General aspects; Health risk assessment; Health Services - utilization; Humans; Incidence; Infant; Male; Medical sciences; Miscellaneous; New York City; New York City - epidemiology; Pneumology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Respiratory diseases; Respiratory System Agents - administration & dosage; respiratory tract diseases; Respiratory Tract Diseases - epidemiology; Retrospective Studies; September 11 Terrorist Attacks; Terrorism; Urban Health; World Trade Center; WTC
• ISSN: 0002-9262; 1476-6256
• DOI: 10.1093/aje/kwi233

The authors investigated changes in respiratory health after September 11, 2001 (“9/11”) among residents of the area near the World Trade Center (WTC) site in New York City as compared with residents of a control area. In 2002, self-administered questionnaires requesting information on the presence and persistence of respiratory symptoms, unplanned medical visits, and medication use were sent to 9,200 households (22.3% responded) within 1.5 km of the WTC site (affected area) and approximately 1,000 residences (23.3% responded) in Upper Manhattan, more than 9 km from the site (control area). Residents of the affected area reported higher rates of new-onset upper respiratory symptoms after 9/11 (cumulative incidence ratio = 2.22, 95% confidence interval (CI): 1.88, 2.63). Most of these symptoms persisted 1 year after 9/11 in the affected area. Previously healthy residents of the affected area had more respiratory-related unplanned medical visits (prevalence ratio = 1.73, 95% CI: 1.13, 2.64) and more new medication use (prevalence ratio = 2.89, 95% CI: 1.75, 4.76) after 9/11. Greater impacts on respiratory functional limitations were also found in the affected area. Although bias may have contributed to these increases, other analyses of WTC-related pollutants support their biologic plausibility. Further analyses are needed to examine whether these increases were related to environmental exposures and to monitor long-term health effects.