The Air That We Breathed

9/11 Exposure Linked to Threefold Increase in Lung Cancer Risk

A new study from medical researchers based at the State University of New York (SUNY) at Stony Brook has established a link between exposure to toxic debris from the collapse of the World Trade Center towers and a near-tripling of rates of lung cancer. The analysis, “Lung Cancer Incidence After September 11, 2001, Among World Trade Center Responders,” was published in October by JAMA Network Open, a peer-reviewed journal from the American Medical Association.

While lung cancer is covered by both the World Trade Center Health Program and the Victim Compensation Fund, no previous study has succeeded in quantifying the level of increased risk. This task was made more complicated by two factors. First, the latency period for lung cancer is measured in decades, which means that many people who will eventually develop the disease as a result of September 11-related exposure are only now beginning to show symptoms. And second (somewhat counterintuitively), because smoking rates happen to be significantly lower among people exposed to toxins on September 11 than in the general population, the incidence of lung cancer among the first group should theoretically be (and for years, appeared to be) lower than that of the second. As the study notes, “these results might seem contradictory when compared with previous work, where the incidence of lung cancer was lower among World Trade Center responders than in the general population.”

But scientists affiliated with the World Trade Center Health and Wellness Program at SUNY Stony Brook University tracked 12,334 subjects between 2012 and 2023. During that period, this cohort reported 118 diagnoses of lung cancer. Among those with the most prolonged exposure to toxins (mainly rescue and recovery workers), the study found a likelihood of lung cancer to be 2.9 times higher than for a control group.

“We assessed activities-based exposure metrics and found that World Trade Center site exposures were associated with lung cancer incidence one to two decades after the attacks,” the authors write. “To our knowledge, this is the first study to characterize the association between World Trade Center site exposure based on a severity index and lung cancer among responders, to examine activity-specific risk factors for lung cancer within a World Trade Center site–exposed cohort, and to quantify the absolute and relative risk of lung cancer associated with World Trade Center site exposures after a minimum 10-year latency period.”