• Jessica Weakley, Charles B Hall, Xiaoxue Liu, Rachel Zeig-Owens, Mayris P Webber, Theresa Schwartz, and David Prezant.
• Montefiore Medical Center, Bronx, New York, USA Fire Department of the City of New York, Bureau of Health Services, 9 Metrotech Center, Brooklyn, New York, USA.
• Occup Environ Med. 2016 Apr 1; 73 (4): 280-3.

ObjectiveTo assess how the effect of World Trade Center (WTC) exposure on physician-diagnosed chronic rhinosinusitis (CRS) in firefighters changed during the decade following the attack on 9/11 (11 September 2001 to 10 September 2011).MethodsWe examined temporal effects on the relation between WTC exposure and the incidence of physician diagnosed CRS in firefighters changed during the decade following the attack on 9/11 (11 September 2001 to 10 September 2011). Exposure was grouped by time of arrival at the WTC site as follows: (high) morning 11 September 2001 (n=1623); (moderate) afternoon 11 September 2001 or 12 September 2001 (n=7025); or (low) 13-24 September 2001 (n=1200). Piecewise exponential survival models were used to estimate incidences by exposure group, with change points in the relative incidences estimated by maximum likelihood.ResultsIncidences dramatically increased after 2007 due to a programmatic change that provided free medical treatment, but increases were similar in all exposure groups. For this reason, we observed no change point during the study period, meaning the relative incidence by exposure group (high vs moderate vs low) of CRS disease did not significantly change over the study period. The relative rate of developing CRS was 1.99 (95% CI=1.64 to 2.41) for high versus low exposure, and 1.52 (95% CI=1.28 to 1.80) for moderate versus low exposure during the 10-year follow-up period.ConclusionsThe risk of CRS in FDNY firefighters appears increased with WTC-exposure, and has not diminished by time since exposure.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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