Combining three cohorts of world trade center rescue/recovery workers for assessing cancer incidence and mortality

Robert M. Brackbill, Amy R. Kahn, Jiehui Li, Rachel Zeig-Owens, David G. Goldfarb, Molly Skerker, Mark R. Farfel, James E. Cone, Janette Yung, Deborah J. Walker, Adrienne Solomon, Baozhen Qiao, Maria J. Schymura, Christopher R. Dasaro, Dana Kristjansson, Mayris P. Webber, Roberto G. Lucchini, Andrew C. Todd, David J. Prezant, Paolo BoffettaCharles B. Hall

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Three cohorts including the Fire Department of the City of New York (FDNY), the World Trade Center Health Registry (WTCHR), and the General Responder Cohort (GRC), each funded by the World Trade Center Health Program have reported associations between WTC-exposures and cancer. Results have generally been consistent with effect estimates for excess incidence for all cancers ranging from 6 to 14% above background rates. Pooling would increase sample size and de-duplicate cases between the cohorts. However, pooling required time consuming steps: obtaining Institutional Review Board (IRB) approvals and legal agreements from entities involved; establish-ing an honest broker for managing the data; de-duplicating the pooled cohort files; applying to State Cancer Registries (SCRs) for matched cancer cases; and finalizing analysis data files. Obtaining SCR data use agreements ranged from 6.5 to 114.5 weeks with six states requiring >20 weeks. Records from FDNY (n = 16,221), WTCHR (n = 29,372), and GRC (n = 33,427) were combined de-duplicated resulting in 69,102 unique individuals. Overall, 7894 cancer tumors were matched to the pooled cohort, increasing the number cancers by as much as 58% compared to previous analyses. Pooling resulted in a coherent resource for future research for studies on rare cancers and mortality, with more representative of occupations and WTC-exposure.

Original languageEnglish (US)
Article number1386
Pages (from-to)1-17
Number of pages17
JournalInternational journal of environmental research and public health
Issue number4
StatePublished - Feb 2 2021


  • Cancer
  • Exposure
  • Pooling cohorts
  • Rescue and recovery workers
  • World Trade Center

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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