The destruction of the World Trade Center (WTC) on 11 September 2001 in New York City resulted in the massive release of pulverized dust and combustion products. The dust and smoke settled in the surrounding area, which encompassed a large residential community. We hypothesized that previously normal residents in the community surrounding the former WTC would have an increased incidence of persistent respiratory symptoms and abnormalities in screening spirometry. A hybrid cross-sectional and retrospective cohort study using a symptom-based questionnaire and onsite screening spirometry in residents in an exposed area and in a control area was performed 12 ± 4 months after the collapse. Surveys were analyzed from 2,812 residents. New-onset respiratory symptoms were described by 55.8% of residents in the exposed area, compared with 20.1% in the control area after the event. Persistent new-onset symptoms were identified in 26.4 versus 7.5% of residents in the exposed area versus control area, respectively. No differences in screening spirometry between the groups were detected. A small pilot study suggested the possibility of an increase in bronchial hyperresponsiveness in exposed participants with persistent symptoms. The data demonstrate an increased rate of new-onset and persistent respiratory health effects in residents near the former WTC compared with a control population.

Background: Industrial spills of volatile organic compounds (VOCs) in Endicott, New York (USA), have led to contamination of groundwater, soil, and soil gas. Previous studies have reported an increase in adverse birth outcomes among women exposed to VOCs in drinking water.Objective: We investigated the prevalence of adverse birth outcomes among mothers exposed to trichloroethylene (TCE) and tetrachloroethylene [or perchloroethylene (PCE)] in indoor air contaminated through soil vapor intrusion.Methods: We examined low birth weight (LBW), preterm birth, fetal growth restriction, and birth defects among births to women in Endicott who were exposed to VOCs, compared with births statewide. We used Poisson regression to analyze births and malformations to estimate the association between maternal exposure to VOCs adjusting for sex, mother’s age, race, education, parity, and prenatal care. Two exposure areas were identified based on environmental sampling data: one area was primarily contaminated with TCE, and the other with PCE.Results: In the TCE-contaminated area, adjusted rate ratios (RRs) were significantly elevated for LBW [RR = 1.36; 95% confidence interval (CI): 1.07, 1.73; n = 76], small for gestational age (RR = 1.23; 95% CI: 1.03, 1.48; n = 117), term LBW (RR = 1.68; 95% CI: 1.20, 2.34; n = 37), cardiac defects (RR = 2.15; 95% CI: 1.27, 3.62; n = 15), and conotruncal defects (RR = 4.91; 95% CI: 1.58, 15.24; n = 3). In the PCE-contaminated area, RRs for cardiac defects (five births) were elevated but not significantly. Residual socioeconomic confounding may have contributed to elevations of LBW outcomes.Conclusions: Maternal residence in both areas was associated with cardiac defects. Residence in the TCE area, but not the PCE area, was associated with LBW and fetal growth restriction.

The New York State Farm Family Health and Hazard Surveillance was conducted to assess the health status and safety practices among year-round adult farmers and farm residents in New York State and included a telephone interview survey of 1,727 persons from 552 farms. To determine the extent to which self-reported hearing loss is in agreement with audiometry, a subset of 376 participants who completed a hearing loss interview and pure-tone audiometry was analyzed. Thirty-six percent of the participants had self-reported hearing loss, defined as at least some difficulty hearing in one or both ears. The prevalence of audiometric hearing impairment, defined as a threshold average greater than 25 dB hearing level, was 9% for the binaural low-frequency average (500, 1000, and 2000 Hz), 29% for the binaural mid-frequency average (1000, 2000, 3000, and 4000 Hz), and 47% for the binaural high-frequency average (3000, 4000, 6000, and 8000 Hz). Agreement between self-report and audiometry was highest for the binaural mid-frequency average (kappa statistic 55%, sensitivity 77%, and specificity 82%). Self-reported hearing loss was found to be a moderately good measure of hearing impairment. We conclude that a simple questionnaire focusing on hearing difficulty is a useful and valid tool for conducting epidemiologic studies of farmers. Whenever possible, a substudy using audiometry should be conducted.

There needs to be continuing education of all farmers as to the risks of injury. However, when resources are limited, we recommend that injury education and interventions in this farming population should target younger farmers, those who work longer hours, owner/operators, farmers from higher grossing farms, with special attention to farmers who have physical impairments.

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.