ArticleOccupational and environmental medicine2023
All-cause and cause-specific mortality in a cohort of WTC-exposed and non-WTC-exposed firefighters.
Article in Occupational and environmental medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Non-cancer mortality among firefighters: a meta-analytic review of heart disease, stroke, respiratory disease, liver disease, accidents, and suicide.Frontiers in public health · 2026Pooled it
- Non-invasive liver fibrosis scores and mortality in a cohort of World Trade Center rescue/recovery workers.BMJ open gastroenterology · 2025Article
- Amyotrophic Lateral Sclerosis (ALS)-Related Mortality Among World Trade Center-Exposed and Non-World Trade Center-Exposed Rescue and Recovery Workers.International journal of environmental research and public health · 2025Article
- Assessing cancer risk in firefighters in Northern Germany: a retrospective cohort study.BMC public health · 2025Article
- Exposure to the World Trade Center Disaster, Health, and Health-Related Quality of Life Nearly 20 Years After 9/11.American journal of industrial medicine · 2025Article
- The Fire Fighter Cancer Cohort Study: Protocol for a Longitudinal Occupational Cohort Study.JMIR research protocols · 2025Article
- Exposure-Informed Care Following Toxic Environmental Exposures: A Lifestyle Medicine Approach.American journal of lifestyle medicine · 2025Review
- Mortality in a cohort of WTC-exposed law-enforcement officers compared to non-WTC law-enforcement officers.International archives of occupational and environmental health · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectiveTo compare mortality rates in World Trade Center (WTC)-exposed Fire Department of the City of New York (FDNY) firefighters with rates in similarly healthy, non-WTC-exposed/non-FDNY firefighters, and compare mortality in each firefighter cohort with the general population.
methods10 786 male WTC-exposed FDNY firefighters and 8813 male non-WTC-exposed firefighters from other urban fire departments who were employed on 11 September 2001 were included in the analyses. Only WTC-exposed firefighters received health monitoring via the WTC Health Programme (WTCHP). Follow-up began 11 September 2001 and ended at the earlier of death date or 31 December 2016. Death data were obtained from the National Death Index and demographics from the fire departments. We estimated standardised mortality ratios (SMRs) in each firefighter cohort versus US males using demographic-specific US mortality rates. Poisson regression models estimated relative rates (RRs) of all-cause and cause-specific mortality in WTC-exposed versus non-WTC-exposed firefighters, controlling for age and race.
resultsBetween 11 September 2001 and 31 December 2016, there were 261 deaths among WTC-exposed firefighters and 605 among non-WTC-exposed. Both cohorts had reduced all-cause mortality compared with US males (SMR (95% CI)=0.30 (0.26 to 0.34) and 0.60 (0.55 to 0.65) in WTC-exposed and non-WTC-exposed, respectively). WTC-exposed firefighters also had lower rates of all-cause mortality (RR=0.54, 95% CI=0.49 to 0.59) and cancer-specific, cardiovascular-specific and respiratory disease-specific mortality compared with non-WTC-exposed firefighters.
conclusionBoth firefighter cohorts had lower than expected all-cause mortality. Fifteen years post 11 September 2001, mortality was lower in WTC-exposed versus non-WTC-exposed firefighters. Lower mortality in the WTC-exposed suggests not just a healthy worker effect, but additional factors such as greater access to free health monitoring and treatment that they receive via the WTCHP.
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