Disaster Epidemiology
World Trade Center (WTC) dust exposure and risk of breast cancer among female WTC survivors Ashley Geczik* Ashley Geczik Julia Sisti Mst Afroza Parvin James Cone Janna Metzler Jiehui Li
World Trade Center (WTC) dust from the 9/11 attacks contained many carcinogens, such as polycyclic aromatic hydrocarbons (PAHs), which have been reported to be associated with breast cancer risk. We examined associations between WTC dust exposure and first primary invasive breast cancer among WTC-exposed female survivors who lived, worked, attended school in the exposure area or who were passersby on 9/11, were enrolled in the WTC Health Registry in 2003-2004, and ever lived in New York State (NYS) since the exposure. Breast cancer cases were identified through linkage with the NYS Cancer Registry. WTC dust exposure was assessed with a composite score that accounted for location on 9/11, dust cloud exposure, and exposure to smoke and debris during clean-up. Follow-up began at study enrollment (2003-2004) and ended on the earliest date of first breast cancer diagnosis, death, or 12/31/2020. Multivariable Cox proportional hazards models adjusted for age, race/ethnicity, education, smoking history, and prior medical conditions were used to estimate HRs and 95% CI for associations of quartiles of WTC dust scores and breast cancer. Among 17,434 female survivors in our study sample, 554 were diagnosed with invasive breast cancer over an average of 16 years of follow-up. The median age on 9/11 was 42 years old. The associations between breast cancer and WTC dust exposure were not statistically significant (adjusted HR_Q2: 0.85, 95% CI: 0.64-1.13; HR_Q3: 0.95, 95% CI:0.72-1.26; HR_Q4 0.88, 95% CI:0.66-1.17) when compared to relatively lower level of exposure (Q1). Our findings do not support evidence for a link between WTC dust exposure and breast cancer among female survivors. Surveillance for this and other cancers among survivors is continuing.