Amyotrophic Lateral Sclerosis (ALS)-Related Mortality Among World Trade Center-Exposed and Non-World Trade Center-Exposed Rescue and Recovery Workers

Ankura Singh, Rachel Zeig-Owens (), Madeline F. Cannon, Tyrone Moline, Theresa Schwartz and David J. Prezant
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Ankura Singh: Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA
Rachel Zeig-Owens: Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA
Madeline F. Cannon: Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA
Tyrone Moline: Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA
Theresa Schwartz: Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA
David J. Prezant: Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA

IJERPH, 2025, vol. 22, issue 11, 1-10

Abstract: Amyotrophic lateral sclerosis (ALS) is a rare but fatal neurodegenerative disease. Some occupational exposures are associated with ALS. This study evaluated ALS mortality rates in World Trade Center (WTC)-exposed and non-WTC-exposed rescue/recovery workers. Fire department workers who were 18–70 years old on 11 September 2001 (9/11) were included in the study ( N = 33,122). Follow-up began on the later of 9/11 or on their hire date, and ended at the earliest death date or 31 December 2023. Cause of death data were obtained from the National Death Index; ALS (specifically motor neuron disease)-related mortality was the primary outcome. Demographic data were obtained from the fire departments’ databases. We estimated standardized mortality ratios (SMRs) and 95% CIs for ALS-related mortality in WTC-exposed and non-WTC-exposed workers using US population rates as a reference. Multivariable-adjusted Poisson regression models estimated relative rates (RRs) and 95% CIs for ALS-related mortality in the WTC-exposed vs. non-WTC-exposed groups. Between 9/11 and 31 December 2023, five WTC-exposed and sixteen non-WTC-exposed participants died of ALS. ALS mortality rates were lower in WTC-exposed than in non-WTC-exposed rescue/recovery workers (RR = 0.54, 95% CI = 0.49–0.60). ALS-related mortality was not elevated in WTC-exposed (SMR = 0.44, 95% CI = 0.14–1.03) or non-WTC-exposed rescue/recovery workers (SMR = 1.06, 95% CI = 0.60–1.72) compared with the US general population. This initial evaluation of ALS in WTC-exposed workers indicates that the risk of ALS death is not increased in this population.

Keywords: amyotrophic lateral sclerosis; mortality; motor neuron disease; occupational health; firefighters (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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