World Trade Center First Responders have Increased Prevalence of Hepatic Steatosis

world trade center after 9/11
world trade center, 9/11, twin towers, WTC tower 1
First responders to the World Trade Center attacks appear to have a much higher prevalence of hepatic steatosis than the general population.

The following article is part of coverage from Digestive Disease Week (DDW 2020). Due to the global COVID-19 pandemic, the American Gastroenterology Association made the necessary decision to cancel the meeting originally scheduled for May 2–May 5, 2020, in Chicago. While live events will not proceed as planned, readers can click here catch up on the latest research intended to be presented at the meeting.

World Trade Center (WTC) first responders appear to have a much higher prevalence of hepatic steatosis than the general population, according to results intended to be presented at Digestive Disease Week (DDW) 2020.

The study comprised a retrospective chart review of WTC first responders who received medical benefits from the government-funded WTC Health Program. Research has linked a myriad of health concerns with toxin exposure resulting from the WTC attacks, but few data have indicated whether this exposure has increased first responders’ risk of fatty liver disease. Researchers included patients who were referred to a designated WTC responder center for gastrointestinal symptoms from January 2014 to August 2019 (N=243) in the analysis. The prevalence of hepatic steatosis, defined by the hepatic steatosis index (HIS), comprised the primary outcome.

Approximately 82.6% of patients in the cohort had an HIS score >36, indicative of hepatic steatosis. The researchers found a positive correlation between body mass index and hepatic steatosis (aOR, 3.26; 95% CI, 2.24-5.5). The presence of hepatic steatosis was associated with a greater likelihood of gastritis upon endoscopy (68.9% vs 50.0%), esophagitis (57.4% vs 56.2%), and duodenitis (14.9% vs 12.5%). The most common comorbidities included gastroesophageal reflux disease (70.4%), chronic rhinosinusitis (66.7%), obstructive sleep apnea (52.3%), hypertension (40.3%), and diabetes (10.3%).

A limitation of this study was the lack of generalizability across patients of other professions who have been exposed to occupational and industrial hazards. In spite of this, the study was focused on WTC first responders specifically, and the researchers concluded that additional “research is needed to understand mechanisms in this unique population.”

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Reja D, Sameera S, Patel R, et al. Prevalence of suspected toxic alcohol fatty liver disease (TAFLD) in World Trade Center first responders: Findings from the World Trade Center Health Program. Abstract intended to be presented at Digestive Disease Week 2020; May 2020 (canceled). Chicago, Illinois, United States of America.