{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T09:21:10Z","timestamp":1763025670175,"version":"3.45.0"},"reference-count":32,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T00:00:00Z","timestamp":1762992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000125","name":"National Institute for Occupational Safety and Health","doi-asserted-by":"publisher","award":["U01 OH011309","U01 OH011934","200-2011-39383","200-2011-39378","200-2017-93426","200-2017-93326","75D301-22-P-15204","75D301-22-R-72142","75D301-22-R-72244"],"award-info":[{"award-number":["U01 OH011309","U01 OH011934","200-2011-39383","200-2011-39378","200-2017-93426","200-2017-93326","75D301-22-P-15204","75D301-22-R-72142","75D301-22-R-72244"]}],"id":[{"id":"10.13039\/100000125","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Amyotrophic lateral sclerosis (ALS) is a rare but fatal neurodegenerative disease. Some occupational exposures are associated with ALS. This study evaluated ALS mortality rates in World Trade Center (WTC)-exposed and non-WTC-exposed rescue\/recovery workers. Fire department workers who were 18\u201370 years old on 11 September 2001 (9\/11) were included in the study (N = 33,122). Follow-up began on the later of 9\/11 or on their hire date, and ended at the earliest death date or 31 December 2023. Cause of death data were obtained from the National Death Index; ALS (specifically motor neuron disease)-related mortality was the primary outcome. Demographic data were obtained from the fire departments\u2019 databases. We estimated standardized mortality ratios (SMRs) and 95% CIs for ALS-related mortality in WTC-exposed and non-WTC-exposed workers using US population rates as a reference. Multivariable-adjusted Poisson regression models estimated relative rates (RRs) and 95% CIs for ALS-related mortality in the WTC-exposed vs. non-WTC-exposed groups. Between 9\/11 and 31 December 2023, five WTC-exposed and sixteen non-WTC-exposed participants died of ALS. ALS mortality rates were lower in WTC-exposed than in non-WTC-exposed rescue\/recovery workers (RR = 0.54, 95% CI = 0.49\u20130.60). ALS-related mortality was not elevated in WTC-exposed (SMR = 0.44, 95% CI = 0.14\u20131.03) or non-WTC-exposed rescue\/recovery workers (SMR = 1.06, 95% CI = 0.60\u20131.72) compared with the US general population. This initial evaluation of ALS in WTC-exposed workers indicates that the risk of ALS death is not increased in this population.<\/jats:p>","DOI":"10.3390\/ijerph22111712","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T09:10:45Z","timestamp":1763025045000},"page":"1712","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Amyotrophic Lateral Sclerosis (ALS)-Related Mortality Among World Trade Center-Exposed and Non-World Trade Center-Exposed Rescue and Recovery Workers"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8495-4850","authenticated-orcid":false,"given":"Ankura","family":"Singh","sequence":"first","affiliation":[{"name":"Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA"},{"name":"Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8679-2306","authenticated-orcid":false,"given":"Rachel","family":"Zeig-Owens","sequence":"additional","affiliation":[{"name":"Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA"},{"name":"Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA"},{"name":"Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3753-6044","authenticated-orcid":false,"given":"Madeline F.","family":"Cannon","sequence":"additional","affiliation":[{"name":"Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA"},{"name":"Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyrone","family":"Moline","sequence":"additional","affiliation":[{"name":"Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA"},{"name":"Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA"},{"name":"Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9562-0330","authenticated-orcid":false,"given":"David J.","family":"Prezant","sequence":"additional","affiliation":[{"name":"Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, NY 11201, USA"},{"name":"Division of Pulmonary Medicine, Department of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA"},{"name":"Division of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1016\/S0140-6736(22)01272-7","article-title":"Amyotrophic lateral sclerosis","volume":"400","author":"Feldman","year":"2022","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/S1474-4422(21)00465-8","article-title":"Recent advances in the diagnosis and prognosis of amyotrophic lateral sclerosis","volume":"21","author":"Goutman","year":"2022","journal-title":"Lancet Neurol."},{"key":"ref_3","first-page":"181","article-title":"Risk factors for amyotrophic lateral sclerosis","volume":"7","author":"Ingre","year":"2015","journal-title":"Clin. 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