Gastroesophageal Reflux Disease in the World Trade Center Health Program General Responder Cohort
Abstract
Background: People participating in the rescue, recovery, and clean-up effort after the September 11, 2001 attack on the World Trade Center (WTC) were exposed to a complex mix of noxious substances and subsequently experienced elevated gastroesophageal reflux disease (GERD) incidence, the second-most-common WTC-related condition. Methods: Longitudinal WTC Health Program data, collected between July 2002 and December 2022, were used to describe the sample characteristics, diagnostic procedures, and treatment of consenting cohort members with self-reported GERD who reported incident GERD for a year or longer (n = 19,067). Cross-tabulations and binomial logistic regression, adjusted for confounders including comorbidities, assessed the associations with intermittent and resolved, compared with unresolved, GERD. Results: 12.6% of the study cohort reported intermittent GERD; 5.5% reported GERD resolution. Analyses indicated that most GERD resolution was reported by people of color and those with body mass index <25, and by cohort members who had longer postdiagnosis follow-up and implemented dietary modifications together with proton pump inhibitors or Program-approved antacids. GERD-certified members who underwent endoscopy, used medications without dietary modifications, or used bed head-elevation, and those with Barrett’s disease (5.8%) or esophageal cancer (0.1%) may have had more severe GERD and reported little resolution. Conclusions: The use of GERD services was consistent…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 19,067 participants or records.
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