Temporal Aspects of the Association between Exposure to the World Trade Center Disaster and Risk of Cutaneous Melanoma

Paolo Boffetta; 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; David J Prezant; Christopher R Dasaro; Andrew C Todd; Charles B Hall

doi:10.1016/j.xjidi.2021.100063

Temporal Aspects of the Association between Exposure to the World Trade Center Disaster and Risk of Cutaneous Melanoma

JID Innov. 2021 Oct 13;2(1):100063. doi: 10.1016/j.xjidi.2021.100063. eCollection 2022 Jan.

Authors

Paolo Boffetta^{1

2}, David G Goldfarb^{3

4

5}, Rachel Zeig-Owens^{3

4

6}, Dana Kristjansson^{7

8}, Jiehui Li⁹, Robert M Brackbill⁹, Mark R Farfel⁹, James E Cone⁹, Janette Yung⁹, Amy R Kahn¹⁰, Baozhen Qiao¹⁰, Maria J Schymura¹⁰, Mayris P Webber^{3

4}, David J Prezant^{3

4

6}, Christopher R Dasaro¹¹, Andrew C Todd¹¹, Charles B Hall⁶

Affiliations

¹ Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA.
² Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
³ Department of Medicine, Montefiore Medical Center, New York, New York, USA.
⁴ Fire Department of the City of New York (FDNY), Brooklyn, New York, USA.
⁵ Department of Environmental, Occupational and Geospatial Health Sciences, City University of New York Graduate School of Public Health & Health Policy, New York, New York, USA.
⁶ Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA.
⁷ Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, Oslo, Norway.
⁸ Center of Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
⁹ World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York, USA.
¹⁰ Bureau of Cancer Epidemiology, New York State Department of Health, Albany, New York, USA.
¹¹ Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Abstract

Rescue/recovery workers who responded to the World Trade Center (WTC) attacks were exposed to known/suspected carcinogens. Studies have identified a trend toward an elevated risk of cutaneous melanoma in this population; however, few found significant increases. Furthermore, temporal aspects of the association have not been investigated. A total of 44,540 non-Hispanic White workers from the WTC Combined Rescue/Recovery Cohort were studied between March 12, 2002 and December 31, 2015. Cancer data were obtained through linkages with 13 state registries. Poisson regression was used to estimate hazard ratios and 95% confidence intervals using the New York State population as the reference; change points in hazard ratios were estimated using profile likelihood. We observed 247 incident cases of melanoma. No increase in incidence was detected during 2002-2004. From 2005 to 2015, the hazard ratio was 1.34 (95% confidence interval = 1.18-1.52). A dose‒response relationship was observed by arrival time at the WTC site. Risk was elevated just over 3 years after the attacks. Whereas WTC-related exposures to UVR or other agents might have contributed to this result, exposures other than those at the WTC site, enhanced medical surveillance, and lack of a control group with a similar proportion of rescue/recovery workers cannot be discounted. Our results support continued study of this population for melanoma.

Keywords: 9/11, 11 September 2001; CI, confidence interval; FDNY, Fire Department of the City of New York; HR, hazard ratio; NYS, New York State; WTC, World Trade Center.

Abstract

Grants and funding