Responders received a clinical screening evaluation consisting of medical, mental health, and exposure-assessment questionnaires; a standardized physical examination; and pre- and postbronchodilator spirometry, complete blood count, blood chemistries, urinalysis, and chest radiograph. Participants received both immediate and final letters with examination results and a face-to-face physician consultation at the end of the examination day. Participants were provided referrals for evaluation and treatment for physical or mental health conditions identified in the screening examination.
A trained health care practitioner administered a medical questionnaire on selected diagnoses and prior upper and lower respiratory conditions (e.g., chronic sinusitis and asthma), occurrence of symptoms in the year before 11 September 2001, during the period the subject worked at the WTC site, for the month before the screening examination, and whether preexisting symptoms and diagnoses worsened during their WTC work. A questionnaire also asked about smoking history. Where possible, questions were adapted from standardized instruments (e.g., Burney et al. 1989 (link); European Community Respiratory Health Survey 1994 ; Miller et al. 2005 (link); National Center for Health Statistics 1996 ; NIOSH 2006 ; Piccirillo et al. 2002 (link)).
We used an interviewer-administered survey instrument to obtain pre- and post-September 11 occupational and environmental exposure histories, including dates that responders reported for first working or volunteering for September 11–related duties and, for those present on September 11, whether they were exposed to the cloud of dust from the building collapses. We constructed the ordinal date-related categories shown in the tables as a rough measure of relative dust exposures, and also categorized workers by location where they spent the majority of their time when first working at Ground Zero. We also obtained data on respirator type and use during the first week of the WTC recovery; those data will be reported in subsequent analyses.
Eligible responders were invited for clinical examinations irrespective of their willingness to provide consent to have data aggregated. Only data from responders providing institutional review board consent and HIPAA authorization (on or after 14 April 2003) are included in data analyses.
A trained health care practitioner administered a medical questionnaire on selected diagnoses and prior upper and lower respiratory conditions (e.g., chronic sinusitis and asthma), occurrence of symptoms in the year before 11 September 2001, during the period the subject worked at the WTC site, for the month before the screening examination, and whether preexisting symptoms and diagnoses worsened during their WTC work. A questionnaire also asked about smoking history. Where possible, questions were adapted from standardized instruments (e.g., Burney et al. 1989 (link); European Community Respiratory Health Survey 1994 ; Miller et al. 2005 (link); National Center for Health Statistics 1996 ; NIOSH 2006 ; Piccirillo et al. 2002 (link)).
We used an interviewer-administered survey instrument to obtain pre- and post-September 11 occupational and environmental exposure histories, including dates that responders reported for first working or volunteering for September 11–related duties and, for those present on September 11, whether they were exposed to the cloud of dust from the building collapses. We constructed the ordinal date-related categories shown in the tables as a rough measure of relative dust exposures, and also categorized workers by location where they spent the majority of their time when first working at Ground Zero. We also obtained data on respirator type and use during the first week of the WTC recovery; those data will be reported in subsequent analyses.
Eligible responders were invited for clinical examinations irrespective of their willingness to provide consent to have data aggregated. Only data from responders providing institutional review board consent and HIPAA authorization (on or after 14 April 2003) are included in data analyses.
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