World Trade Center Research Articles

The Evolution of Safety and Security Literature in Event Management

The evolution of safety and security literature has been notably accompanied with the rise of modern terrorism, above all after the attacks to World Trade Center in 2001. This was the first bloody incident where four commercial airplanes have been weaponized against the most powerful nation in the planet. Like the recent COVID-19 pandemic, 9/11 has changed not only geopolitics but travel behavior as never before. In this grim context, the present conceptual article focuses and examines the evolution of safety???security literature head by Event Management, as fertile ground in Event Management and Tourism studies, because of terrorism. We identify three academic schools that in different stages make a seminal contribution to the studied field.

DNA Methylation as a Molecular Mechanism of Carcinogenesis in World Trade Center Dust Exposure: Insights from a Structured Literature Review.

The collapse of the World Trade Center (WTC) buildings in New York City generated a large plume of dust and smoke. WTC dust contained human carcinogens including metals, asbestos, polycyclic aromatic hydrocarbons (PAHs), persistent organic pollutants (POPs, including polychlorinated biphenyls (PCBs) and dioxins), and benzene. Excess levels of many of these carcinogens have been detected in biological samples of WTC-exposed persons, for whom cancer risk is elevated. As confirmed in this structured literature review (n studies = 80), all carcinogens present in the settled WTC dust (metals, asbestos, benzene, PAHs, POPs) have previously been shown to be associated with DNA methylation dysregulation of key cancer-related genes and pathways. DNA methylation is, therefore, a likely molecular mechanism through which WTC exposures may influence the process of carcinogenesis.

P3.01F.02 Retrospective Characterization of Patients with Primary Lung Cancer Related to World Trade Center Disaster Exposure

P3.01F.02 Retrospective Characterization of Patients with Primary Lung Cancer Related to World Trade Center Disaster Exposure

Association of Depression and eGFR Decline in World Trade Center Responders

Association of Depression and eGFR Decline in World Trade Center Responders

Characteristics of survivors enrolled in the World Trade Center Health Program

The World Trade Center (WTC) Health Program is a limited federal health care program that provides medical monitoring and treatment for WTC-related health conditions to responders and survivors impacted by the terrorist attacks on September 11, 2001.This study described the characteristics of the Program survivor members (who lived, worked, went to school, daycare or adult daycare or present in the New York City Disaster Area of 9/11/2001) to stimulate innovative ideas for improving healthcare services, generate new research interest, and serve as a reference for future research on this population. Administrative and medical claims data collected from the Program start date (07/01/2011) through 2022 were used. As of 12/31/2022, there were 37,384 enrolled survivors: 5.0% were aged ≤21 years on 9/11/2001, 45.9% females, and 31.2% non-Hispanic Whites. A total of 24,148 (64.6%) were certified for at least one WTC-related condition, including neoplasms (36.0%), aerodigestive disorders (35.6%) and mental health conditions (18.6%); 22.9% were certified for more than one category. Certification rates of some WTC-related conditions differed by sex, age and race/ethnicity. WTC survivor population is diverse in sex, age and race/ethnicity, with a high proportion certified for certain WTC-related health conditions, providing great opportunities for research in various areas.

Managing cancer following the World Trade Center disaster.

Managing cancer following the World Trade Center disaster.

Cross-sectional association between posttraumatic stress and cognition is moderated by pulmonary functioning in world trade center responders.

Posttraumatic stress disorder (PTSD) symptomatology and poorer pulmonary function are highly prevalent psychiatric and medical conditions. In the present study, we tested for the individual, additive, and modifying associations of PTSD symptomatology and pulmonary function with cognitive performance. In this cross-sectional study, a total of 1,401 World Trade Center (WTC) responders (mean age = 53, SD = 8 years, 92% males) participated in the study. Cogstate assessment measured cognitive performance. PTSD symptomatology was measured using the trauma-specific version of the posttraumatic stress disorder checklist (PCL-17) adapted for the WTC attacks. The 1-second forced expiratory volume and forced vital capacity (FEV1/FVC) ratio was used to measure pulmonary function. Linear regressions with cognitive performance as the outcome were conducted to assess individual, additive, and moderating associations of PTSD symptomatology and pulmonary function. Higher PTSD symptomatology and poorer pulmonary function were negatively associated with cognitive performance. A 10% increase on the FEV1/FVC ratio moderated the association between PTSD symptomatology and cognition, whereby its association with cognition was stronger when PTSD symptomatology was higher (est. = 0.01, 95%CI = 0.004, 0.01, p < 0.001). When stratified by responder type, these associations persisted in trained (est. = 0.01, 95%CI = 0.01, 0.02, p < 0.001), but not in non-trained (est. = 0.004, 95% C.I. = -0.01, 0.02, p = 0.39) responders. In the presence of higher PTSD, better pulmonary functioning is associated with better cognitive performance. Early intervention efforts to mitigate preventable cognitive decline in high-risk populations should be studied, especially since intervention in one modality may have an impact on others.

Teaching the art of compassionate inquiry: involving survivors from 9/11 in social work education

ABSTRACT This paper reports findings from pedagogic research evaluating the impact of the involvement of survivors from the World Trade Center attacks in New York City in 2001 in trauma-specific social work education. A pedagogic approach to mental health education is discussed which aims to prepare students to develop trauma-informed assessment and intervention skills concurrent with their encounters with trauma survivors in field practice placements. The small-scale research involved surveying students’ evaluations at a university in New York, following exposure to first-hand accounts of survivors’ experiences. Across the three areas—confidence in knowledge of trauma, impact on learning, and preparation for field practice—the evaluation findings indicate that the students’ knowledge, gained from the involvement of 9/11 survivors, improved over time. This paper presents the background to this project, preparations involved, and findings from research evaluations with the students. The findings suggest that the involvement of those with direct and lived trauma experience in classroom teaching, whilst challenging, can yield positive impacts for students. The 9/11 survivors poignantly shared with students that their lives were changed forever in the aftermath of these events. The findings have potential global educational impact and resonance.

Exposure to the World Trade Center Particulate Matter Alters the Gut-Brain Axis in Early Onset Alzheimer's Disease Mice.

The September 11, 2001, catastrophe unleashed widespread destruction beyond the World Center (WTC), with fires and toxic gases leaving lasting impacts. First responders at Ground Zero faced prolonged exposure to hazardous particulate matter (PM), resulting in chronic health challenges. Among the multitude of health concerns, the potential association between the WTCPM and Alzheimer's disease (AD) has emerged as an area of intense inquiry, probing the intricate interplay between environmental factors and neurodegenerative diseases. We posit that a genetic predisposition to AD in mice results in dysregulation of the gut-brain axis following chronic exposure to WTCPM. This, in turn, may heighten the risk of AD-like symptoms in these individuals. 3xTg-AD and WT mice were intranasally administered with WTCPM collected at Ground Zero within 72 hours after the attacks. Working memory and learning and recognition memory were monitored for 4 months. Moreover, brain transcriptomic analysis and gut barrier permeability along with microbiome composition were examined. Our findings underscore the deleterious effects of WTCPM on cognitive function, as well as notable alterations in brain genes associated with synaptic plasticity, pro-survival, and inflammatory signaling pathways. Complementary, chronic exposure to the WTCPM led to increased gut permeability in AD mice and altered bacteria composition and expression of functional pathways in the gut. Our results hint at a complex interplay between gut and brain axis, suggesting potential mechanisms through which WTCPM exposure may exacerbate cognitive decline. Identifying these pathways offers opportunities for tailored interventions to alleviate neurological effects among first responders.

World Trade Center (wtc) related exposures and cardiometabolic risk among the wtc Health Program General Responder Cohort

World Trade Center (wtc) related exposures and cardiometabolic risk among the wtc Health Program General Responder Cohort

Long-term reorganization of structural and functional connectivity among World Trade Center responders with post-traumatic stress disorder: a data-driven multimodal approach

Long-term reorganization of structural and functional connectivity among World Trade Center responders with post-traumatic stress disorder: a data-driven multimodal approach

Biomarkers of Airway Disease, Barrett’s and Underdiagnosed Reflux Noninvasively (BAD-BURN) in World Trade Center exposed firefighters: a case–control observational study protocol

BackgroundParticulate matter exposure (PM) is a cause of aerodigestive disease globally. The destruction of the World Trade Center (WTC) exposed first responders and inhabitants of New York City to WTC-PM and caused obstructive airways disease (OAD), gastroesophageal reflux disease (GERD) and Barrett’s Esophagus (BE). GERD not only diminishes health-related quality of life but also gives rise to complications that extend beyond the scope of BE. GERD can incite or exacerbate allergies, sinusitis, bronchitis, and asthma. Disease features of the aerodigestive axis can overlap, often necessitating more invasive diagnostic testing and treatment modalities. This presents a need to develop novel non-invasive biomarkers of GERD, BE, airway hyperreactivity (AHR), treatment efficacy, and severity of symptoms.MethodsOur observational case-cohort study will leverage the longitudinally phenotyped Fire Department of New York (FDNY)-WTC exposed cohort to identify Biomarkers of Airway Disease, Barrett’s and Underdiagnosed Reflux Noninvasively (BAD-BURN). Our study population consists of n = 4,192 individuals from which we have randomly selected a sub-cohort control group (n = 837). We will then recruit subgroups of i. AHR only ii. GERD only iii. BE iv. GERD/BE and AHR overlap or v. No GERD or AHR, from the sub-cohort control group. We will then phenotype and examine non-invasive biomarkers of these subgroups to identify under-diagnosis and/or treatment efficacy. The findings may further contribute to the development of future biologically plausible therapies, ultimately enhance patient care and quality of life.DiscussionAlthough many studies have suggested interdependence between airway and digestive diseases, the causative factors and specific mechanisms remain unclear. The detection of the disease is further complicated by the invasiveness of conventional GERD diagnosis procedures and the limited availability of disease-specific biomarkers. The management of reflux is important, as it directly increases risk of cancer and negatively impacts quality of life. Therefore, it is vital to develop novel noninvasive disease markers that can effectively phenotype, facilitate early diagnosis of premalignant disease and identify potential therapeutic targets to improve patient care.Trial registrationName of Primary Registry: “Biomarkers of Airway Disease, Barrett's and Underdiagnosed Reflux Noninvasively (BADBURN)”. Trial Identifying Number: NCT05216133. Date of Registration: January 31, 2022.

Sleep disturbances across two weeks predict future mental healthcare utilization.

Insufficient sleep costs the U.S. economy over $411 billion per year. However, most studies investigating economic costs of sleep rely on one-time measures of sleep, which may be prone to recall bias and cannot capture variability in sleep. To address these gaps, we examined how sleep metrics captured from daily sleep diaries predicted medical expenditures. Participants were 391 World Trade Center responders enrolled in the World Trade Center Health Program (mean age = 54.97 years, 89% men). At baseline, participants completed 14 days of self-reported sleep and stress measures. Mean sleep, variability in sleep, and a novel measure of sleep reactivity (i.e., how much people's sleep changes in response to daily stress) were used to predict the subsequent year's medical expenditures, covarying for age, race/ethnicity, sex, medical diagnoses, and body mass index. Mean sleep efficiency did not predict mental healthcare utilization. However, greater sleep efficiency reactivity to stress (b=$191.75, p=.027), sleep duration reactivity to stress (b=$206.33, p=.040), variability in sleep efficiency (b=$339.33, p=.002), variability in sleep duration (b=$260.87, p=.004), and quadratic mean sleep duration (b=$182.37, p=.001) all predicted greater mental healthcare expenditures. Together, these sleep variables explained 12% of the unique variance in mental healthcare expenditures. No sleep variables were significantly associated with physical healthcare expenditures. People with more irregular sleep, more sleep reactivity, and either short or long sleep engage in more mental healthcare utilization. It may be important to address these individuals' sleep problems to improve mental health and reduce healthcare costs.

Prevalence of Mild and Severe Cognitive Impairment in World Trade Center Exposed Fire Department of the City of New York (FDNY) and General Emergency Responders.

The emergency personnel who responded to the World Trade Center (WTC) attacks endured severe occupational exposures, yet the prevalence of cognitive impairment remains unknown among WTC-exposed-FDNY-responders. The present study screened for mild and severe cognitive impairment in WTC-exposed FDNY responders using objective tests, compared prevalence rates to a cohort of non-FDNY WTC-exposed responders, and descriptively to meta-analytic estimates of MCI from global, community, and clinical populations. A sample of WTC-exposed-FDNY responders (n = 343) was recruited to complete an extensive battery of cognitive, psychological, and physical tests. The prevalences of domain-specific impairments were estimated based on the results of norm-referenced tests, and the Montreal Cognitive Assessment (MoCA), Jak/Bondi criteria, Petersen criteria, and the National Institute on Aging and Alzheimer's Association (NIA-AA) criteria were used to diagnose MCI. NIA-AA criteria were also used to diagnose severe cognitive impairment. Generalized linear models were used to compare prevalence estimates of cognitive impairment to a large sample of WTC-exposed-non-FDNY responders from the General Responder Cohort (GRC; n = 7102) who completed the MoCA during a similar time frame. Among FDNY responders under 65 years, the unadjusted prevalence of MCI varied from 52.57% to 71.37% depending on the operational definition of MCI, apart from using a conservative cut-off applied to MoCA total scores (18 < MoCA < 23), which yielded a markedly lower crude prevalence (24.31%) compared to alternative criteria. The prevalence of MCI was higher among WTC-exposed-FDNY-responders, compared to WTC-exposed-non-FDNY-GRC-responders (adjusted RR = 1.53, 95% C.I. = [1.24, 1.88], p < .001) and meta-analytic estimates from different global, community, and clinical populations. Following NIA-AA diagnostic guidelines, 4.96% of WTC-exposed-FDNY-responders met the criteria for severe impairments (95% CI = [2.91% to 7.82%]), a prevalence that remained largely unchanged after excluding responders over the age of 65 years. There is a high prevalence of mild and severe cognitive impairment among WTC-responders highlighting the putative role of occupational/environmental and disaster-related exposures in the etiology of accelerated cognitive decline.

Frontier Stories: Burnt Shadows and an Alternative Ethic of Narrativizing Violence

ABSTRACT The attack on the twin towers of the World Trade Centre on September 11, 2001 and its hyper-visual aftermath has led to a new paradigm in Euro-American collective consciousness. This new paradigm is marked by an almost obsessive reliance on the image of the moment and the image as the ultimate source of or rather the absence of meaning. Kamila Shamsie’s fiction Burnt Shadows exemplifies a point of departure from what has become an almost salient feature of Euro-American narrative on violence, its representation, and historicity. This paper explores how Shamsie forges an alternate interpretative apparatus that resolutely refuses to give in to the singularity of a moment (and its image) as a defining trope of terror and its representation. Instead, Shamsie’s novel weaves a complex pattern of other stories gleaned from across time and from the frontier spaces of present-day Afghanistan and Pakistan that have remained largely unrecognized in the Euro-American cultural landscape. Emphasizing the relevance of the vast topography of catastrophe and continual human wreckage woven in Burnt Shadows this paper considers Shamsie’s approach as a necessary and timely intervention that reformulates violence and its historicity beyond the delimiting scope of a singular, overarching trope.

Beyond the flames: understanding the impact of loss without body recovery or identification in fire-related mass disaster contexts

Abstract The World Trade Center attack (2001), the Black Saturday (2009), the Malaysia Airlines Flight 17 (2014), the wildfires of June and October in Portugal (2017), the California wildfires (2018)—these are a few examples of mass disaster events, specifically related to fire and high temperatures, which resulted in multiple casualties and several people unidentified and/or missing. Besides the physical destruction, the lost lives are one of the main consequences of these contexts. Dealing with the loss of a family member may not be an easy process, however, it is easier to accept when there is a body to bury. Conversely, not knowing the whereabouts of a person who might have been involved in a disaster makes mourning and returning to daily life harder. The family of the missing/unidentified lives in doubt and in a state termed as ‘ambiguous loss’. Forensic anthropologists face several challenges and obstacles when detecting and analysing burnt skeletal remains, which are increased in mass disaster contexts. However, the suffering experienced by the families of the victims of these contexts is far superior. Therefore, it is of utmost importance to employ all efforts to achieve the identity of these victims to allow the families to mourn, as well as to reassure society that no death is insignificant. Thus, the importance of identifying the victims of scenarios involving fire/heat is addressed in this paper through a brief description of some mass disaster events, emphasizing the challenges faced in identifying burnt remains and the psychological consequences families endure resulting from it.

Racial and ethnic disparities in mortality among World Trade Center Health Registry enrollees with post-9/11 cancer.

There are well-documented racial and ethnic disparities in mortality after cancer in the general population, but less is known about whether disparities also exist in disaster-exposed populations. We conducted a longitudinal cohort study of 4341 enrollees in the World Trade Center Health Registry (WTCHR) with a first-ever primary invasive cancer diagnosis after 9/11/2001 and followed through 2020. We examined associations of race and ethnicity with all-cause mortality risk and cause-specific mortality risk using multivariable Cox proportional hazards regression models and Fine and Gray's proportional sub-distribution hazards models, respectively. Models were adjusted for baseline characteristics and tumor characteristics. We also examined models further adjusted for socioeconomic status (SES), and we used inverse odds weighting to formally test for mediation by SES. Compared to non-Hispanic White enrollees with cancer, non-Hispanic Blacks had higher risks for all-cause mortality (adjusted hazard ratio (aHR) = 1.20, 95% CI = 1.02-1.41) and non-cancer mortality (aHR = 1.48, 95% CI = 1.09-2.01) in the full model. In the model without SES, Hispanic enrollees with cancer had higher risks for all-cause mortality (aHR = 1.32, 95% CI = 1.09-1.60) and cancer mortality (aHR = 1.31, 95% CI = 1.05-1.64) compared to non-Hispanic Whites; these associations became not statistically significant in the full model. In the inverse odds weighting analysis, SES explained 24% and 29% of the disparity in all-cause mortality risk observed in non-Hispanic Blacks and Hispanics, respectively, compared to non-Hispanic Whites. This study found that there are racial and ethnic disparities in mortality after cancer in the WTCHR. Additional studies are needed to further explore the factors mediating these disparities.

Landmarks to Lived experiences: A comparative study of Bahrain World Trade Center and Bahrain Bay Towers

The potential reverberation of urban development on the cityscape through its building functions and heightsgenerates a skyline, creating an aesthetic geographical pattern. Some have a tagline of being iconic, while others striveto attain it. The term 'iconic' is an emblem of expression, a mixture of traditional and contemporary design, and,foremost, the city's oldest superstructure. Bahrain has been fast progressing, exemplified by its wonderous skylinesand a blend from old to new. Bahrain World Trade Centre is one of its so-called 'iconic' and has won many awardsaround the globe for its sustainability aspect, while others are popping out of the datum, one of them is thecontemporary Bahrain Bay Towers, with a pride of being the tallest building in the skyline of Manama. This studyconducts pilot research comparing two superstructures, focusing on the perceptions and sensory experiences ofpeople living among them.

Penerapan Kompensasi Terhadap Korban Kejahatan Tindak Pidana Terorisme Studi Kasus Bom Bali

The bombing incident that occurred in Bali in 2002 was a tragedy that attracted world attention, with victims reaching 202 deaths and more than 200 people injured. This tragedy occurred after the hijacked plane crashed into the World Trade Center towers in America in 2001, which increasingly increased global attention to the issue of terrorism. The aim of this research is to examine compensation for victims of terrorist crimes. This research method uses a descriptive qualitative research method with a normative juridical approach using secondary data in the form of documents and books regarding the object of this research, then this research uses 3 types of legal materials in the form of primary legal materials, secondary legal materials and tertiary legal materials. The findings of this research show that in Law Number 31 of 2014 concerning Amendments to Law Number 13 of 2006 concerning Protection of Witnesses and Victims, victims of criminal acts of terrorism also receive protection for their personal security, family and property, and are free from threats. relating to testimony that will be, is being, or has been given and participating in the process of selecting and determining forms of security protection and support as well as providing information without pressure. Protection for victims of criminal acts of terrorism implemented in Indonesia is based on the 1945 Constitution of the Republic of Indonesia and Law Number 15 of 2003 concerning the Eradication of Criminal Acts of Terrorism. Bali bombing victims have the right to receive legal protection and compensation from the state for the acts of terrorism that occurred. They also receive protection for their personal security, family and property, and are free from threats related to the testimony they will, are giving, or have given.

Nasal resistance and inflammation: mechanisms for obstructive sleep apnea from chronic rhinosinusitis.

We have previously estimated that the prevalence of obstructive sleep apnea (OSA) among World Trade Center rescue and recovery workers is 75% and identified that having symptoms of chronic rhinosinusitis (CRS) is an independent risk factor for OSA in this population. Nasal inflammation and/or elevated awake nasal resistance that carried over into sleep could explain this association. To understand the mechanism(s) for the elevated risk of OSA observed in World Trade Center responders with CRS symptoms we examined if elevated awake supine nasal resistance was associated with OSA, CRS and/or nasal inflammatory biomarkers. A total of 601 individuals (83% male, average age 53 years, body mass index = 29.9 ± 5.5 kg/m2) enrolled in the World Trade Center Health Program and without significant snoring prior to September 11, 2001 underwent 2 nights of home sleep apnea testing, measurements of anterior rhinomanometry in the supine position, and nasal lavage. Awake supine nasal resistance was not associated with OSA; 74.8% and 74.4% of the participants with low and high nasal resistance respectively, had OSA. Patients with CRS had elevated nasal inflammatory markers (interleukin 6, interleukin 8, eosinophilic cationic protein, and neutrophil) but did not have high nasal resistance. Nasal inflammatory markers were not correlated with nasal resistance. As awake nasal resistance did not explain the relationship of CRS to OSA in this large and well characterized dataset, our findings suggest that either "sleep" nasal resistance or other factors such as increased supraglottic inflammation, perhaps through impairing upper airway reflex mechanisms, or systemic inflammation are involved in the pathophysiology of OSA in the World Trade Center population. Ayappa I, Laumbach R, Black K, etal. Nasal resistance and inflammation: mechanisms for obstructive sleep apnea from chronic rhinosinusitis. J Clin Sleep Med. 2024;20(10):1627-1636.