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BACKGROUND: Asthma is a major health outcome associated with exposure to the 9/11/2001 World Trade Center disaster. Risk of new-onset asthma is highest among those who arrived earliest at the disaster site, those who worked the longest, and those who worked on the WTC pile on 9/11/2001. Asthma risk among those working on the Staten Island landfill and barges, where exposures may have differed significantly from those at the WTC site, has not been well studied. The purposes of this study were to evaluate whether 9/11-related landfill and barge work was associated with risk of new-onset asthma diagnosed between 2001-2004 and to determine whether specific landfill/barge job tasks may have been associated with new-onset asthma.
METHODS: We conducted a follow-up survey 8-9 years after 9/11/01 among World Trade Center Health Registry enrollees who reported working at the landfill/barges following the disaster. The survey content was based in part on a qualitative study of exposures reported among landfill and barge workers. We used survey data from Wave 1 (2003-4), Wave 2 (2006-7) and Wave 3 (2011-2012), including reported physician-diagnosed asthma or reactive airways dysfunction syndrome (RADS).A modified Delphi method was used to categorize job tasks according to likely asthma-inducing exposures, and logistic regression models adjusted for age, gender, education, and smoking were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for asthma.
RESULTS: The 1836 surveys received included 100 asthma cases (60 asthma and 40 RADS) reportedly diagnosed between 9/11/2001 and 12/31/2004. Significant associations were seen between asthma and female gender (aOR 2.1, 95% CI 1.2-3.7), work for the police department (aOR 2.2, 95% CI 1.3-3.7), high Staten Island / barge work exposure index (aOR 2.6, 95% CI 1.1-6.2) and probable PTSD at Wave 1 (aOR 2.7, 95% CI 1.6-4.8). Asthma was associated significantly with sifting by hand / digging / sanitation work / or welding/steel cutting (OR 2.7, 95% CI 1.6 – 4.5). Factors not significantly associated with asthma diagnosis included age, race/ethnicity, smoking status at Wave 1, number of work periods and whether individuals had also worked at Ground Zero
CONCLUSIONS: Work on the landfill / barges during the cleanup after the World Trade Center disaster is associated with new onset asthma, even after controlling for other risk factors. Future post-disaster cleanups need to consider additional protective measures to reduce the risk of asthma and other adverse health outcomes among workers.