Temporal association of prostate cancer incidence with World Trade Center rescue/recovery work

David G. Goldfarb, Rachel Zeig-Owens, Dana Kristjansson, Jiehui Li, Robert M. Brackbill, Mark R. Farfel, James E. Cone, Janette Yung, Amy R. Kahn, Baozhen Qiao, Maria J. Schymura, Mayris P. Webber, Christopher R. Dasaro, Moshe Shapiro, Andrew C. Todd, David J. Prezant, Paolo Boffetta, Charles B. Hall

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: The World Trade Center (WTC) attacks on 11 September 2001 created a hazardous environment with known and suspected carcinogens. Previous studies have identified an increased risk of prostate cancer in responder cohorts compared with the general male population. OBJECTIVES: To estimate the length of time to prostate cancer among WTC rescue/recovery workers by determining specific time periods during which the risk was significantly elevated. METHODS: Person-time accruals began 6 months after enrolment into a WTC cohort and ended at death or 12/31/2015. Cancer data were obtained through linkages with 13 state cancer registries. New York State was the comparison population. We used Poisson regression to estimate hazard ratios and 95% CIs; change points in rate ratios were estimated using profile likelihood. RESULTS: The analytic cohort included 54 394 male rescue/recovery workers. We observed 1120 incident prostate cancer cases. During 2002-2006, no association with WTC exposure was detected. Beginning in 2007, a 24% increased risk (HR: 1.24, 95% CI 1.16 to 1.32) was observed among WTC rescue/recovery workers when compared with New York State. Comparing those who arrived earliest at the disaster site on the morning of 11 September 2001 or any time on 12 September 2001 to those who first arrived later, we observed a positive, monotonic, dose-response association in the early (2002-2006) and late (2007-2015) periods. CONCLUSIONS: Risk of prostate cancer was significantly elevated beginning in 2007 in the WTC combined rescue/recovery cohort. While unique exposures at the disaster site might have contributed to the observed effect, screening practices including routine prostate specific antigen screening cannot be discounted.

Original languageEnglish (US)
Pages (from-to)699-706
Number of pages8
JournalOccupational and Environmental Medicine
Volume78
Issue number10
DOIs
StatePublished - Oct 1 2021

Keywords

  • environmental exposure
  • exposures or occupational groups
  • longitudinal studies
  • materials
  • medical oncology
  • risk assessment

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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