Risk Factors for COVID-19 in a Retired FDNY WTC-Exposed Cohort

Krystal L. Cleven, Rachel Zeig-Owens, David G. Goldfarb, Theresa Schwartz, David J. Prezant

Research output: Contribution to journalArticlepeer-review


We evaluated the incidence and risk factors for COVID-19 in a prospectively followed cohort of Fire Department of the City of New York (FDNY) World Trade Center (WTC)-exposed workers, thus reducing the potential for selection bias, a limitation in published studies of hospitalized individuals. Participants were retired FDNY WTC-exposed rescue/recovery workers with ≥1 medical visit between 1 March 2020 and 1 August 2021. The cumulative incidence was calculated using self-reported COVID-19 diagnoses. Cox regression was performed to evaluate the association of WTC-exposure and COVID-19, adjusting for history of comorbidities, age, race, work assignment (emergency medical service providers vs. firefighter), and sex. The cumulative incidence of COVID-19 was 130 per 1000. The adjusted models showed the risk of infection was greater in those with highest WTC exposure versus less exposure (hazard ratio (HR) = 1.14 (95% CI 1.00–1.31)). Older age was associated with a lower risk of infection HR = 0.97 (95% CI 0.96–0.98). WTC-associated diseases (obstructive airways disease and interstitial lung disease) were not COVID-19 risk factors. This study is the first to show an association between WTC exposure and the risk of COVID-19. While participants are retired from FDNY work, the youngest individuals may still be in the workforce, explaining why younger age was a significant risk for COVID-19.

Original languageEnglish (US)
Article number8891
JournalInternational journal of environmental research and public health
Issue number15
StatePublished - Aug 2022


  • COVID-19
  • FDNY
  • Fire Department of City of New York (FDNY)
  • World Trade Center
  • occupational lung disease

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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