# Long-term effects of WTC exposure on respiratory and cardiovascular diseases using automated CT image analysis

> **NIH ALLCDC R21** · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · 2021 · $249,626

## Abstract

Project Summary
Responders to the World Trade Center (WTC) site in the aftermath of the 9/11 attacks were exposed to
toxic dust, which has been linked to an increased risk of respiratory and cardiovascular disease. Many of
these diseases, such as lung cancer, mesothelioma, interstitial lung disease, and asbestosis, have long
latency periods of upwards of twenty years, which we are now approaching. While published studies
have linked WTC dust exposure to increased risk of various diseases, few have examined the relationship
of the amount of exposure to the extent and progression of disease. The respiratory and cardiovascular
effects of WTC dust exposure have been studied using pulmonary function tests and the number of
cardiovascular events, but computed tomography (CT) scans provide an opportunity to see the early
structural changes in the lungs and cardiovascular system before clinical symptoms appear. CT scans are
used in the screening and evaluation of respiratory diseases such as lung cancer, interstitial lung disease,
and chronic obstructive pulmonary disease, and to visualize coronary arteries and quantify the amount
of coronary artery calcifications; in fact, it is possible to detect multiple diseases from a single chest CT
scan. While manual evaluation by a radiologist is often the gold standard, automated image analysis
tools are able to quickly and accurately quantify these diseases.
We propose to apply automated image analysis tools to quantify four respiratory and cardiovascular
diseases thought to be related to toxic dust exposure: emphysema, pleural thickening, interstitial lung
disease, and coronary artery calcifications. We will apply these tools retrospectively to all available chest
CT scans of members of the WTC general responders cohort (GRC) and a propensity-matched cohort of
participants enrolled in a lung screening program. The comparison of the extent and progression of
diseases in these two cohorts will provide information on the long-term effects of WTC dust exposure.
We hypothesize that a higher frequency of these diseases can be found in WTC members and that they
will also have a more rapid disease course compared to non-WTC members. We can further analyze the
results of the WTC GRC to assess the relationship between WTC dust exposure, which we will estimate
using the arrival time to the WTC site, and the extent and progression of these diseases. The results of
this research will potentially improve the care of WTC GRC members through the early identification of
diseases and updating of screening guidelines.

## Key facts

- **NIH application ID:** 10314976
- **Project number:** 1R21OH012244-01
- **Recipient organization:** ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
- **Principal Investigator:** Artit Jirapatnakul
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2021
- **Award amount:** $249,626
- **Award type:** 1
- **Project period:** 2021-07-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10314976

## Citation

> US National Institutes of Health, RePORTER application 10314976, Long-term effects of WTC exposure on respiratory and cardiovascular diseases using automated CT image analysis (1R21OH012244-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10314976. Licensed CC0.

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