American Journal of Epidemiology Advance Access originally published online on August 17, 2005
American Journal of Epidemiology 2005 162(6):499-507; doi:10.1093/aje/kwi233
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ORIGINAL CONTRIBUTIONS |
Upper Respiratory Symptoms and Other Health Effects among Residents Living Near the World Trade Center Site after September 11, 2001
1 Center for Environmental Health, New York State Department of Health, Troy, NY
2 Department of Medicine, Division of Pulmonary and Critical Care Medicine, New York University School of Medicine, New York, NY
3 Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Renssalaer, NY
Correspondence to Dr. Shao Lin, Bureau of Environmental and Occupational Epidemiology, New York State Department of Health, 547 River Street, Room 200, Troy, NY 12180 (e-mail: sxl05{at}health.state.ny.us).
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.
asthma; environmental pollution; New York City; respiratory tract diseases; terrorism
Abbreviations: CI, confidence interval; CIR, cumulative incidence ratio; WTC, World Trade Center
Editor's note: An invited commentary on this article appears on page 508, and the authors' response appears on page 511.
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