Cancer study: 9/11 firefighters vulnerable

The first major cancer study of city firefighters who worked at the World Trade Center site after Sept. 11, 2001, found they were 19 percent more likely to have cancer than firefighters who didn't work at Ground Zero.

The findings likely will fuel the issue of whether the federal government should cover and compensate first responders with the disease.

The study, published Thursday in a special 9/11 issue of the medical journal The Lancet, looked at 9,853 male firefighters -- 8,927 exposed to the World Trade Center site and 926 not exposed -- from Sept. 11, 2001, to Sept. 11, 2008. It found that exposed firefighters had a 10 percent increased risk of cancer compared with the general population. But when compared with other firefighters -- generally a healthier group -- that percentage nearly doubled.

Dr. David Prezant, chief medical officer for the FDNY and an author of the study, would not say whether the findings should prompt the National Institute for Occupational Safety and Health, which administers the federal medical monitoring and treatment programs under the Zadroga Act, to consider covering cancer. Nor would he say whether the $2.75 billion compensation fund created by the act should include cancer patients.

The Zadroga Act, signed by President Barack Obama this year, provides monitoring and financial assistance to first responders to the 9/11 attacks. Cancer is not covered by Zadroga. "We can only say we studied firefighters. We have not studied non-FDNY responders or residents," he said at a news conference. "Although we found an increase in cancer it is not an epidemic."

But John Feal, head of the FealGood Foundation advocacy group, used just that word to describe cancers he's seen among first responders. "The onus is no longer on us to prove 9/11 got us sick; the onus is on them to prove it didn't get us sick."

Researchers found that among firefighters exposed to Ground Zero, 25 more than expected developed cancer. Among those not exposed, 26 fewer than expected did so.

The study erred on the side of being conservative and adjusted for "surveillance bias," that is, when people go for more tests and are thus diagnosed earlier. Without the adjustment, the increased risk of cancer among exposed firefighters was 32 percent.

No single cancer showed a significantly higher risk, but certain cancers showed a trend toward increased risk: stomach, colon, melanoma, prostate, thyroid, non-Hodgkin lymphoma, bladder, kidney, pancreas and esophagus. The researchers found a 58 percent lower rate of lung cancer among WTC-exposed firefighters compared with the general population.

The researchers said an association between WTC exposure and cancer was "biologically plausible" because of the array of known carcinogens found in dust at the site.

In July, NIOSH issued a report concluding there isn't enough evidence linking cancer with toxins to Ground Zero to justify covering it through the Zadroga Act. Agency spokesman Fred Blosser said Thursday a second review was likely to be done in early to mid-2012.

And that review is likely to determine whether Special Master Sheila Birnbaum will add cancer as a disease that will be compensated. In her final ruling issued Monday, she said she would "continue to rely on the medical judgment made by the WTC Health Program."

Findings in other 9/11-related studies

Several other 9/11-related studies were published Thursday in The Lancet:

• Nine years later, first responders continue to suffer from illnesses, one study found. Incidence rates of asthma were 28 percent; sinusitis, 42 percent; and gastroesophageal reflux disease, 39 percent. Among rescue and recovery workers, incidence rates of depression were 28 percent; post-traumatic stress disorder, 32 percent; and panic disorder, 21 percent.

• 9/11 World Trade Center survivors have a 43 percent lower death rate than a comparable group of New Yorkers. Researchers suggested that most survivors were employed and volunteered for the study; both are groups that tend to be healthier.

-- Ridgely Ochs