Respiratory Research

1. Persistent Hyperreactivity and Reactive Airway Dysfunction in Firefighters at the World Trade Center
   New York City Fire Department rescue workers experienced massive exposure to airborne particulates at the World Trade Center site. Aims of this longitudinal study were to (1) determine if bronchial hyperreactivity was present, persistent, and independently associated with exposure intensity, (2) identify objective measures shortly after the collapse that would predict persistent hyperreactivity and a diagnosis of reactive airways dysfunction 6 months post-collapse.
   
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2. Obstructive Airways Disease With Air Trapping Among Firefighters Exposed to World Trade Center Dust 
   Airways obstruction was the predominant physiologic finding underlying the reduction in lung function post-September 11, 2001, in FDNY WTC rescue workers presenting for pulmonary evaluation.
   
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3. World Trade Center ''Sarcoid-Like'' Granulomatous Pulmonary Disease in New York City Fire Department Rescue Workers
   Previous reports suggest that sarcoidosis occurs with abnormally high frequency in firefighters. We sought to determine whether exposure to World Trade Center (WTC) “dust” during the collapse and rescue/recovery effort increased the incidence of sarcoidosis or “sarcoid-like” granulomatous pulmonary disease (SLGPD).
   
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4. Pulmonary Function after Exposure to the World Trade Center Collapse in the New York City Fire Department
   On September 11, 2001, the World Trade Center collapse created an enormous urban disaster site with high levels of airborne pollutants. First responders, rescue and recovery workers, and residents have since reported respiratory symptoms and developed pulmonary function abnormalities.
   
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5. Lung Function in Rescue Workers at the World Trade Center after 7 Years
   We investigated the longer-term consequences of exposure to World Trade Center dust by characterizing trends in pulmonary function during the 7 years after 9/11, as assessed by repeated measures of forced expiratory volume in 1 second (FEV₁) among FDNY rescue workers.
   
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6. Symptoms, Respirator Use, and Pulmonary Function Changes Among New York City Firefighters Responding to the World Trade Center Disaster
   Objective was to determine whether arrival time at the WTC and other exposure variables (including respirator use) were associated with symptoms and changes in pulmonary function (after exposure - before exposure).
   
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7. Accelerated Spirometric Decline in New York City Firefighters Withα₁ -Antitrypsin Deficiency 
   On September 11, 2001, the World Trade Center (WTC) collapse caused massive air pollution, producing variable amounts of lung function reduction in the New York City Fire Department (FDNY) rescue workforce. a 1 -Antitrypsin (AAT) deficiency is a risk factor for obstructive airway disease.
   
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8. Emerging Exposures and Respiratory Health: World Trade Center Dust
   The attack on the World Trade Center (WTC) on 9/11/2001 produced a massive dust cloud with acute exposure, and the rubble pile burning over 3 months exposed more than 300,000 residents, rescue workers, and clean-up workers. Firefighters in the New York City Fire Department had significant respiratory symptoms characterized by cough, dyspnea, gastroesophageal reflux, and nasal stuffiness with a significant 1-year decline in FVC and FEV(1). Bronchial hyperreactivity measured by methacholine challenge correlated with bronchial wall thickening on CT scans.
   
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Mental Health Research

1. Trends of Elevated PTSD Risk in Firefighters Exposed to the World Trade Center Disaster: 2001–2005
   We identified trends in the prevalence of elevated posttraumatic stress disorder (PTSD) risk as determined by the Fire Department of the City of New York (FDNY)-modified PTSD Checklist in World Trade Center (WTC)-exposed firefighters. We also examined trends in relation to WTC exposure, social support, change in recreational activities, and functional health.
   
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2. Trends in Probable PTSD in Firefighters Exposed to the World Trade Center Disaster, 2001–2010
   We present the longest follow-up, to date, of probable posttraumatic stress disorder (PTSD) after the 2001 terrorist attacks on the World Trade Center (WTC) in New York City firefighters who participated in the rescue/recovery effort.
   
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3. Evaluating Risk Factors and Possible Mediation Effects in Posttraumatic Depression and Posttraumatic Stress Disorder Comorbidity
   On September 11, 2001 (9/11), attacks on the World Trade Center (WTC) killed 341 Fire Department of the City of New York (FDNY) firefighters and injured hundreds more. Previous WTC-related studies reported high rates of comorbid depression and posttraumatic stress disorder (PTSD), identifying disability retirement, alcohol use, and early arrival at the WTC site as correlates. However, those studies did not evaluate risk factors that could have mediated the observed comorbidity. We identified unique risk factors for each condition in an effort to better understand comorbidity.
   
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4. Performance characteristics of the PTSD Checklist in retired firefighters exposed to the World Trade Center disaster
   Since the World Trade Center (WTC) attacks on September 11, 2001, the Fire Department, City of New York Monitoring Program has provided physical and mental health screening services to rescue/recovery workers. This study evaluated performance of the self-report PTSD Checklist (PCL) as a screening tool for risk of posttraumatic stress disorder (PTSD) in firefighters who worked at Ground Zero, compared with the interviewer-administered Diagnostic Interview Schedule (DIS).
   
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Occupational Research

1. The Impact of the World Trade Center Attack on FDNY Firefighter Retirement, Disabilities, and Pension Benefits
   Our goal was to examine the effect of the World Trade Center (WTC) attack and subsequent New York City Fire Department (FDNY) rescue/recovery activities on firefighter retirements. We also analyzed the financial impact associated with the increased number and proportion of service-connected ‘‘accidental’’ disability retirements on the FDNY pension system.
   
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Autoimmune Research

1. Nested Case–Control Study of Selected Systemic Autoimmune Diseases in World Trade Center Rescue/Recovery Workers.
   Objective. To test the a priori hypothesis that acute and chronic work exposures to the World Trade Center (WTC) site on or after September 11, 2001 were associated with risk of new-onset systemic autoimmune diseases.
   
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