Original Investigation

Lung Cancer Incidence After September 11, 2001, Among World Trade Center Responders

JAMA Network Open 10.1001/jamanetworkopen.2025.36655

October 09, 2025 at 11:00 AM EDT

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Is there an association between occupational exposures while working at the World Trade Center (WTC) disaster sites and the incidence of lung cancer over a decade later?In this cohort study including 12 334 WTC responders aged 49.3 years at study inclusion, 118 developed incident lung cancer more than a decade after exposure. Compared with minimally exposed responders who reported low dust exposure, responders working on the WTC sites who reported more severe exposures had a nearly 3-fold higher incidence of lung cancer even after adjusting for demographic factors and smoking.This study suggests that, when compared with the lowest reported exposure levels, a higher level of reported exposure to more particulate dust or debris was significantly associated with an increased incidence of lung cancer.

Corresponding Author: Sean A. P. Clouston, PhD, Program in Public Health, 3-071 Health Sciences Center, Stony Brook University, Stony Brook, NY 11794 (sean.clouston@stonybrookmedicine.edu).

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