BACKGROUND: The @entity19628 , 2001 (9/11) World Trade @entity8462 has been associated with several subacute and chronic health effects, but whether excess mortality after 9/11 has occurred is unknown. We tested whether excess mortality has occurred in @entity1 exposed to the @entity4536 . METHODS: In this observational cohort study, @entity204 occurring in 2003-09 in WTC Health Registry @entity1 residing in New York City were identified through linkage to New York City vital records and the National Death Index. Eligible @entity1 were rescue and recovery workers and volunteers; lower Manhattan area residents, workers, school staff and students; and commuters and passers-by on 9/11. Study @entity1 were categorised as rescue and recovery workers (including volunteers), or non-rescue and non-recovery @entity1 . Standardised mortality ratios (SMR) were calculated with New York City rates from 2000-09 as the reference. Within the cohort, proportional hazards were used to examine the relation between a three-tiered WTC-related exposure level (high, intermediate, or low) and total mortality. FINDINGS: We identified 156 @entity204 in 13,337 rescue and recovery workers and 634 @entity204 in 28,593 non-rescue and non-recovery @entity1 . All-cause SMRs were significantly lower than that expected for rescue and recovery @entity1 (SMR 0  45, 95% CI 0  38-0  53) and non-rescue and non-recovery @entity1 (0  61, 0  56-0  66). No significantly increased SMRs for @entity17220 or heart, or for haematological @entity5 were found. In non-rescue and non-recovery @entity1 , both intermediate and high levels of WTC-related exposure were significantly associated with mortality when compared with low exposure (adjusted hazard ratio 1  22, 95% CI 1  01-1  48, for intermediate exposure and 1  56, 1  15-2  12, for high exposure). High levels of exposure in non-rescue and non-recovery individuals, when compared with low exposed non-rescue and non-recovery individuals, were associated with @entity299 -related mortality (adjusted hazard ratio 2  06, 1  10-3  86). In rescue and recovery @entity1 , level of WTC-related exposure was not significantly associated with all-cause mortality (adjusted hazard ratio 1  25, 95% CI 0  56-2  78, for high exposure and 1  03, 0  52-2  06, for intermediate exposure when compared with low exposure). INTERPRETATION: This exploratory study of mortality in a well defined cohort of 9/11 survivors provides a baseline for continued surveillance. Additional follow-up is needed to establish whether these associations persist and whether a similar association over time will occur in rescue and recovery @entity1 . FUNDING: US Centers for Disease Control and Prevention (National Institute for Occupational Safety and Health, Agency for Toxic Substances and Disease Registry, and National Center for Environmental Health); New York City Department of Health and Mental Hygiene.

Mortality among survivors of the @entity19628 , 2001, World Trade XXXX : results from the World Trade Center Health Registry cohort.

@entity1 :: ('9606', 'Species') :: ['participants', 'people'] @entity5 :: ('MESH:D009369', 'Disease') :: ['malignancies'] @entity17220 :: ('MESH:D015619', 'Disease') :: ['diseases of the respiratory system'] @entity4536 :: ('MESH:D016773', 'Disease') :: ['WTC disaster'] @entity8462 :: ('MESH:D008224', 'Disease') :: ['Center (WTC) disaster'] @entity299 :: ('MESH:D006331', 'Disease') :: ['heart-disease'] @entity19628 :: ('55752', 'Gene') :: ['Sept 11'] @entity204 :: ('MESH:D003643', 'Disease') :: ['deaths']
@entity8462 :: (MESH:D008224,Disease) :: ['Center disaster']
