Surveillance for World Trade Center disaster health effects among survivors of collapsed and damaged buildings.

Problem/condition: Survivors of collapsed or damaged buildings from the attack on the World Trade Center (WTC) were among those most exposed to injury hazards, air pollution, and traumatic events.

Reporting Period: This report summarizes data from health outcomes collected during interviews conducted from September 5, 2003, to the close of the World Trade Center Health Registry (WTCHR) enrollment on November 20, 2004.

Description Of System: WTCHR will be used to monitor periodically the mental and physical health of 71,437 enrollees for 20 years.

Ethical issues in occupational disease outbreak investigations.

Occupational disease outbreak investigations usually involve rapid, small-scale analysis of reports of diseases with a suspected occupational etiology, usually in a single workplace or among workers of a single employer. Ethical issues are similar to those encountered in epidemiologic studies in the workplace, with the added constraints of the need to respond rapidly, limited numbers of subjects, low statistical power, and the mandate to issue results even when the ability to generalize them is limited. Informed consent, voluntary participation, fairness, and confidentiality are major ethical issues in workplace outbreak investigations.