Get access

Respiratory protective equipment, mask use, and respiratory outcomes among World Trade Center rescue and recovery workers


  • Disclaimer: This study was supported by Cooperative Agreement U50/ATU272750 from the Agency for Toxic Substances and Disease Registry (ATSDR), Centers for Disease Control and Prevention (CDC), which included support from the National Center for Environmental Health and by Cooperative Agreement U50/OH009739 from the National Institute for Occupational Safety and Health (NIOSH) and the New York City Department of Health and Mental Hygiene. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the ATSDR or CDC/NIOSH.

  • Disclosure Statement: The authors declare they have no competing financial interests.



Serious respiratory illnesses have been reported among rescue/recovery workers (RRW) following the World Trade Center (WTC) attacks.


We studied RRW enrolled in the WTC Health Registry to assess the effects of different respiratory protection equipment (RPE) types on respiratory outcomes, such as recurrent respiratory symptoms and diseases possibly associated with 9/11 exposures. We performed descriptive and multivariate analyses adjusting for demographics and exposure variables.


A total of 9,296 RRW met inclusion criteria. The strongest predictors of using adequate RPE were being affiliated with construction, utilities or environmental remediation organizations and having received RPE training. Workers who used respirators were less likely to report adverse respiratory outcomes compared to those who reported no/lower levels of respiratory protection.


Level of respiratory protection was associated with the odds of reporting respiratory symptoms and diseases. Training, selection, fit testing, and consistent use of RPE should be emphasized among emergency responders. Am. J. Ind. Med. 54:897–905, 2011. © 2011 Wiley Periodicals, Inc.