# Cancer Survival in WTC First Responders vs. Comparable Occupational Cohorts

> **NIH ALLCDC U01** · ALBERT EINSTEIN COLLEGE OF MEDICINE · 2024 · $496,631

## Abstract

Project Summary
We recently found that World Trade Center (WTC)-exposed rescue/recovery workers who participated in the
WTC Health Program (WTCHP) experienced improved survival post-cancer diagnosis compared with
demographically similar cancer patients from New York State. This survival benefit was observed in both all-
cause mortality and cancer-specific mortality. Further, we documented this benefit both in cancers with
elevated incidence and cancers with reduced incidence compared with the general population. As part of the
WTCHP, enrollees receive medical monitoring and cancer care, including treatment, at no cost to them. We
hypothesized that the observed survival benefit was due to the level of care that these rescue/recovery
workers receive as part of the WTCHP. We could not rule out however, the possibility that rescue/recovery
workers were healthier than the reference population of New York State cancer patients prior to cancer
diagnosis and therefore more likely to have a favorable cancer outcome (i.e., due to the healthy worker effect).
However, no survival benefit was observed for WTC-exposed rescue/recovery not enrolled in the WTCHP – a
fact that argues against the healthy worker effect as the sole factor. Now, we propose to address this
knowledge gap by identifying and quantifying the sources of the observed survival benefit using an
occupationally appropriate cohort as a comparison. The overall goal of the current proposal is to investigate
cancer survival and survival-related factors such as cancer-specific pathology and treatment initiation in
WTCHP responders (firefighters and police) and non-WTC-exposed responders (i.e., firefighters and police
who met similar health criteria for hiring as WTC-exposed responders), compared with each other, by
occupation, and with the general US population. Results from this proposal have the potential to elucidate the
impact of WTCHP medical monitoring and treatment on survival post-cancer diagnoses and to help inform
health care delivery systems. Further, while the project is focused on WTC responders, its results could have
broader implications for workers occupationally exposed to environmental contaminants.

## Key facts

- **NIH application ID:** 10903706
- **Project number:** 5U01OH012612-02
- **Recipient organization:** ALBERT EINSTEIN COLLEGE OF MEDICINE
- **Principal Investigator:** Charles B Hall
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2024
- **Award amount:** $496,631
- **Award type:** 5
- **Project period:** 2023-07-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10903706

## Citation

> US National Institutes of Health, RePORTER application 10903706, Cancer Survival in WTC First Responders vs. Comparable Occupational Cohorts (5U01OH012612-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10903706. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*