ArticleAnnals of epidemiology2026
Effect of World Trade Center Health Program on mortality among 9/11 responders.
Article in Annals of epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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13 authors.
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Abstract
purposeThe World Trade Center Health Program (WTCHP) plays a critical role in medical monitoring and treatment to those exposed to the terrorist attacks of September 11, 2001 (9/11). We investigated the association of WTCHP membership with mortality risk among 9/11 responders while controlling for comorbidities using inverse probability weighting.
methodsWe prospectively analyzed 28,430 9/11 responders, followed from the time of their enrollment into the WTCHP or the WTC Health Registry, through 2020. NDI linkage provided death data. Non-cancer comorbidities were self-reported physician-diagnosis and cancer was identified through cancer registry linkage. We estimated the adjusted hazard ratio (aHR) with 95 % confidence interval (CI) for the association between WTCHP membership and all-cause and cause-specific mortality using Cox proportional hazards models and cause-specific hazard regression models, respectively.
resultsA total of 1657 deaths were identified over 444,425 person-years of follow-up. Compared to non-members, WTCHP members had a lower risk of all-cause mortality (aHR=0.87; 95 % CI=0.77-0.98) and smoking-related mortality (aHR=0.83; 0.69-0.99) after adjusting for demographics, WTC exposure, and weights of comorbidities. With the membership-sex interaction included, reduced risk of all-cause mortality remained statistically significant among males only (aHR=0.85; 0.75-0.96). Cancer- and heart-related mortality risk were not significantly different between WTCHP members and non-members.
conclusionsThis study found that WTCHP membership may reduce risks of all-cause and smoking-related mortality among 9/11 responders, even after accounting for underlying medical conditions, underscoring the importance of comprehensive health monitoring and treatment services for disaster-relief workers.
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