Abstract

The terrorist attacks on 11 September 2001 placed nearly a half million people at increased risk of adverse health. Health effects research began shortly after and continues today, now mostly as a coordinated effort under the federally mandated World Trade Center (WTC) Health Program (WTCHP). Established in 2011, the WTCHP provides medical monitoring and treatment of covered health conditions for responders and survivors and maintains a research program aimed to improve the care and well-being of the affected population. By 2020, funds in excess of USD 127 M had been awarded for health effects research. This review describes research findings and provides an overview of the WTCHP and its future directions. The literature was systematically searched for relevant articles published from 11 September 2001 through 30 June 2020. Synthesis was limited to broad categories of mental health, cancer, respiratory disease, vulnerable populations, and emerging conditions. In total, 944 WTC articles were published, including peer-reviewed articles funded by the WTCHP (n = 291) and other sources. Research has focused on characterizing the burden and etiology of WTC-related health conditions. As the program moves forward, translational research that directly enhances the care of individuals with chronic mental and physical health conditions is needed.

Highlights

  • On the morning of 11 September 2001, two hijacked commercial airliners were deliberately crashed into towers One and Two of the World Trade Center in lower Manhattan, New York City (NYC)

  • The World Trade Center Health Program (WTCHP) provides medical monitoring and treatment for specific symptoms and health conditions that are presumed to be caused by exposure to the 9/11 attacks on the World Trade Center, the Pentagon, and Shanksville, Pennsylvania

  • The WTCHP solicits applications for scientifically rigorous research in three broad areas listed by the Zadroga Act: (1) research on physical and mental health conditions that may be related to the 11 September 2001, terrorist attacks; (2) research on diagnosing WTC-related health conditions of such individuals, in the case of conditions for which there has been diagnostic uncertainty; and (3) research on treating WTC-related health conditions of such individuals, in the case of conditions for which there has been treatment uncertainty

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Summary

Introduction

On the morning of 11 September 2001, two hijacked commercial airliners were deliberately crashed into towers One and Two of the World Trade Center in lower Manhattan, New York City (NYC). Federal funds were appropriated to support a variety of post-disaster activities, including the establishment of the World Trade Center Health Registry (Registry). On 2 January 2011, the James Zadroga 9/11 Health and Compensation Act of 2010 (Zadroga Act) was signed into law and the World Trade Center Health Program (WTCHP) was created to monitor and. Res. Public Health 2020, 17, 7290 treat responders and survivors with 9/11-related adverse health conditions. The WTCHP provides medical monitoring and treatment for specific symptoms and health conditions that are presumed to be caused by exposure to the 9/11 attacks on the World Trade Center, the Pentagon, and Shanksville, Pennsylvania. A responder refers to individuals involved in rescue, response, recovery, clean-up and related support activities following the attack. The WTCHP provides for health surveillance involving clinical data collection and analysis and research of health conditions, as described below. The WTCHP provides for outreach and maintenance of the Registry, including its research activities

WTCHP Data Centers and Clinical Centers of Excellence
WTCHP Research Populations
Environmental Exposure
Solicitation and Award
Stakeholder Involvement in Research Planning
Description of WTC Research
Approximately
Mental Health Conditions
Cancer
Vulnerable Populations
Emerging Conditions
Future Directions
Conclusions
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