Linda G Kahn1, Xiaoxia Han2, Tony T Koshy3, Yongzhao Shao4, Dinh Binh Chu5, Kurunthachalam Kannan6, Leonardo Trasande7. 1. Department of Pediatrics, New York University School of Medicine, 403 East 34th Street, New York, NY 10016, USA. Electronic address: linda.kahn@nyumc.org. 2. Department of Population Health, New York University School of Medicine, 650 1st Avenue, New York, NY 10016, USA. Electronic address: xh414@nyu.edu. 3. Department of Pediatrics, New York University School of Medicine, 403 East 34th Street, New York, NY 10016, USA. Electronic address: tony.koshy@nyumc.org. 4. Department of Population Health, New York University School of Medicine, 650 1st Avenue, New York, NY 10016, USA; Department of Environmental Medicine, New York University School of Medicine, 650 1st Avenue, New York, NY 10016, USA. Electronic address: yongzhao.shao@nyumc.org. 5. Wadsworth Center, New York State Department of Health, Empire State Plaza, Albany, NY 12201, USA. Electronic address: binh.chudinh@hust.edu.vn. 6. Wadsworth Center, New York State Department of Health, Empire State Plaza, Albany, NY 12201, USA; Department of Environmental Health Sciences, University at Albany, State University of New York, Albany, NY 12201-0509, USA. Electronic address: kurunthachalam.kannan@health.ny.gov. 7. Department of Pediatrics, New York University School of Medicine, 403 East 34th Street, New York, NY 10016, USA; Department of Population Health, New York University School of Medicine, 650 1st Avenue, New York, NY 10016, USA; Department of Environmental Medicine, New York University School of Medicine, 650 1st Avenue, New York, NY 10016, USA; Department of Medicine, New York University School of Medicine, 550 1st Avenue, New York, NY 10016, USA; NYU Wagner School of Public Service, 295 Lafayette Street, New York, NY 10012, USA; NYU College of Global Public Health, 726 Broadway, New York, NY 10012, USA. Electronic address: leonardo.trasande@nyumc.org.
Abstract
BACKGROUND: The collapse of the World Trade Center (WTC) on September 11, 2001 released a dust cloud containing numerous environmental contaminants, including polychlorinated dibenzo-para-dioxins and polychlorinated dibenzofurans (PCDD/Fs). PCDD/Fs are toxic and are associated with numerous adverse health outcomes including cancer, diabetes, and impaired reproductive and immunologic function. Prior studies have found adults exposed to the WTC disaster to have elevated levels of PCDD/Fs. This is the first study to assess PCDD/F levels in WTC-exposed children. METHODS: This analysis includes 110 participants, a subset of the 2014-2016 WTC Adolescent Health Study, a group of both exposed youths who lived, attended school, or were present in lower Manhattan on 9/11 recruited from the WTC Health Registry (WTCHR) and unexposed youths frequency matched on age, sex, race, ethnicity, and income. Our sample was selected to maximize the contrast in their exposure to dust from the WTC collapse. Questionnaire data, including items about chronic home dust and acute dust cloud exposure, anthropometric measures, and biologic specimens were collected during a clinic visit. Serum PCDD/F concentrations were measured according to a standardized procedure at the New York State Department of Health Organic Analytical Laboratory. We used multivariable linear regression to assess differences in PCCD/Fs between WTCHR and non-WTCHR participants. We also compared mean and median PCDD/F and toxic equivalency (TEQ) concentrations in our cohort to 2003-4 National Health and Nutrition Examination Survey (NHANES) levels for youths age 12-19. RESULTS: Median PCDD/F levels were statistically significantly higher among WTCHR participants compared to non-WTCHR participants for 16 out of 17 congeners. Mean and median TEQ concentrations in WTCHR participants were >7 times those in non-WTCHR participants (72.5 vs. 10.1 and 25. 3 vs. 3.39pg/g lipid, respectively). Among WTCHR participants, median concentrations of several PCDD/Fs were higher than the NHANES 95th percentiles. After controlling for dust cloud exposure, home dust exposure was significantly associated with higher PCDD/F level. CONCLUSIONS: Adolescents in lower Manhattan on the day of the WTC attack and exposed to particulate contamination from the WTC collapse had significantly elevated PCDD/F levels >12years later compared to a matched comparison group, driven by chronic home dust exposure rather than acute dust cloud exposure. PCDD/F and TEQ levels substantially exceeded those in similar-aged NHANES participants. Future studies are warranted to explore associations of PCDD/Fs with health and developmental outcomes among individuals exposed to the WTC disaster as children.
BACKGROUND: The collapse of the World Trade Center (WTC) on September 11, 2001 released a dust cloud containing numerous environmental contaminants, including polychlorinated dibenzo-para-dioxins and polychlorinated dibenzofurans (PCDD/Fs). PCDD/Fs are toxic and are associated with numerous adverse health outcomes including cancer, diabetes, and impaired reproductive and immunologic function. Prior studies have found adults exposed to the WTC disaster to have elevated levels of PCDD/Fs. This is the first study to assess PCDD/F levels in WTC-exposed children. METHODS: This analysis includes 110 participants, a subset of the 2014-2016 WTC Adolescent Health Study, a group of both exposed youths who lived, attended school, or were present in lower Manhattan on 9/11 recruited from the WTC Health Registry (WTCHR) and unexposed youths frequency matched on age, sex, race, ethnicity, and income. Our sample was selected to maximize the contrast in their exposure to dust from the WTC collapse. Questionnaire data, including items about chronic home dust and acute dust cloud exposure, anthropometric measures, and biologic specimens were collected during a clinic visit. Serum PCDD/F concentrations were measured according to a standardized procedure at the New York State Department of Health Organic Analytical Laboratory. We used multivariable linear regression to assess differences in PCCD/Fs between WTCHR and non-WTCHR participants. We also compared mean and median PCDD/F and toxic equivalency (TEQ) concentrations in our cohort to 2003-4 National Health and Nutrition Examination Survey (NHANES) levels for youths age 12-19. RESULTS: Median PCDD/F levels were statistically significantly higher among WTCHR participants compared to non-WTCHR participants for 16 out of 17 congeners. Mean and median TEQ concentrations in WTCHR participants were >7 times those in non-WTCHR participants (72.5 vs. 10.1 and 25. 3 vs. 3.39pg/g lipid, respectively). Among WTCHR participants, median concentrations of several PCDD/Fs were higher than the NHANES 95th percentiles. After controlling for dust cloud exposure, home dust exposure was significantly associated with higher PCDD/F level. CONCLUSIONS: Adolescents in lower Manhattan on the day of the WTC attack and exposed to particulate contamination from the WTC collapse had significantly elevated PCDD/F levels >12years later compared to a matched comparison group, driven by chronic home dust exposure rather than acute dust cloud exposure. PCDD/F and TEQ levels substantially exceeded those in similar-aged NHANES participants. Future studies are warranted to explore associations of PCDD/Fs with health and developmental outcomes among individuals exposed to the WTC disaster as children.
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