| Respiratory and Other Health Effects Reported in Children Exposed to the World Trade Center Disaster of 11 September 2001 Pauline A. Thomas,1 Robert Brackbill,2 Lisa Thalji,3 Laura DiGrande,4 Sharon Campolucci,2 Lorna Thorpe,4 and Kelly Henning5 1New Jersey Medical School–University of Medicine and Dentistry of New Jersey, Newark, New Jersey, USA; 2Agency for Toxic Substances and Disease Registry, U.S. Department of Health and Human Services, Atlanta, Georgia, USA; 3RTI International, Chicago, Illinois, USA; 4New York City Department of Health and Mental Hygiene, New York City, New York, USA; 5Bloomberg Foundation, New York City, New York, USA Abstract
Background: Effects of the World Trade Center (WTC) disaster on children's respiratory health have not been definitively established. Objective: This report describes respiratory health findings among children who were < 18 years of age on 11 September 2001 (9/11) and examine associations between disaster-related exposures and respiratory health. Methods: Children recruited for the WTC Health Registry (WTCHR) included child residents and students (kindergarten through 12th grade) in Manhattan south of Canal Street, children who were south of Chambers Street on 9/11, and adolescent disaster-related workers or volunteers. We collected data via computer-assisted telephone interviews in 2003–2004, with interview by adult proxy for children still < 18 years of age at that time. We compared age-specific asthma prevalence with National Health Interview Survey estimates. Results: Among 3,184 children enrolled, 28% were < 5 years of age on 9/11 ; 34%, 5–11 years ; and 39%, 12–17 years. Forty-five percent had a report of dust cloud exposure on 9/11. Half (53%) reported at least one new or worsened respiratory symptom, and 5.7% reported new asthma diagnoses. Before 9/11, age-specific asthma prevalence in enrolled children was similar to national estimates, but prevalence at interview was elevated among enrollees < 5 years of age. Dust cloud exposure was associated with new asthma diagnosis (adjusted odds ratio = 2.3 ; 95% confidence interval, 1.5–3.5) . Conclusions: Asthma prevalence after 9/11 among WTCHR enrollees < 5 years of age was higher than national estimates, and new asthma diagnosis was associated with dust cloud exposure in all age groups. We will determine severity of asthma and persistence of other respiratory symptoms on follow-up surveys. Key words: air pollution, asthma, postdisaster health assessment in children, respiratory health, World Trade Center disaster. Environ Health Perspect 116: 1383–1390 (2008) . doi:10.1289/ehp.11205 available via http://dx.doi.org/ [Online 18 June 2008]
Address correspondence to P. Thomas, MSB F 506, New Jersey Medical School, 185 South Orange Ave., Newark, NJ 07103 USA. Telephone: (973) 972-9384. Fax: (973) 972-7625. E-mail thomasp1@umdnj.edu We thank the residents, parents, and educators of children and students of lower Manhattan, as well as the many staff members of RTI International and New York City Department of Health and Mental Hygiene who worked to encourage those exposed to join the World Trade Center Health Registry (WTCHR) . Several WTCHR staff provided assistance with the manuscript, including D. Wu, J. Chou, and A. Bucciarelli. We are especially grateful to S. Stellman for his wise and helpful editorial suggestions. This project was conducted by the New York City Department of Health and Mental Hygiene and funded by the Federal Emergency Management Agency through the Agency for Toxic Substances and Disease Registry. The authors declare they have no competing financial interests. Received 21 December 2007 ; accepted 16 June 2008.
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