Roberto Lucchini, MD – Post-9/11 Cancer Among WTC General Responders Consortium – Research to Care

Roberto Lucchini, MD – Post-9/11 Cancer Among WTC General Responders Consortium – Research to Care

-Thank you, Jackie.
Thank you. I would like to thank
everybody for inviting me. This is a great opportunity. Thank you, Max,
for putting it together, Tania and Dr. Howard and all these
excellent, great colleagues. It’s a pleasure for me
to be here. So when we talk
about cancer, of course we have to focus
on carcinogens, so this is why we’re here and this is why
we’re talking about cancer. So talking about the carcinogens is the most important point here that we have to focus on, all right? So we have a list of them and this is information
that we have because of measurement that had
been done on the settled dust. The settled dust is the dust
that deposits after whatever happens, so you can collect this dust and you can do
a lot of analysis, and that analysis is extremely,
extremely important for our knowledge. This is the first, always,
exposure assessment, it’s called, exposure sciences, this is a very important
field for us in occupational and
environmental health because we are dealing
with exposure constantly, so we need to know very well,
as much as we can, what are we dealing with? So in terms of exposure, in terms of the analysis
in the deposited dust, we have chrysotile asbestos,
everybody knows about asbestos, and so I don’t need to talk
about this further, because it’s a very
powerful carcinogen. Unfortunately it was present
in the buildings. When the building collapsed, a huge amount of asbestos came out and that became the exposure. Then we had– well, lead is another carcinogen
according to IARC nowadays, then PCBs, polychlorinated biphenyls, and benzene, benzene is
another important carcinogen we have known for many
years in occupational health. And the list goes on
with dioxin and diesel. So this is a mix of carcinogens
that is unprecedented, so I think this is an important
knowledge for us to maintain. Of course we are exposed
to carcinogens, unfortunately, every day. We breathe carcinogens,
we are exposed to them, but that was a particular story. That was a special moment
where the people, the responders, the workers,
and the survivors, and the community were exposed
to a high mix of carcinogens, and not only that, our knowledge about
these carcinogens is based on the exposure
to each one of them, right? So here we have a mixture, a co-exposure
to different carcinogens, so the knowledge that exists
about this co-exposure to a mix of carcinogens is not exactly the knowledge that we have based
on each one of them. This is an important
point to maintain. Before coming to this
program in 2012, you can tell by my accent, I have been working for
20 years in Northern Italy in the area of Milan. In that area, in the Seventies,
there was an outbreak of dioxin because of the first episode
of a toxic cloud; it was an industrial accident. And in that case,
it was the exposure to dioxin, just one chemical that happened
to be a carcinogen too, and research in that case
was very, very important. Even now, many years later,
research is still going on, and it’s very important
also as an example of this kind of relationship
with the community where it’s important
to maintain feedback between the researchers and
the members of the programs. So it’s important, this knowledge
about the exposure, and it’s important for us to study about the health effects. It’s not easy. It’s an important challenge. We have to collect data and we need to match data
with registries, registries for many states, because we have to collect the numbers of all these cases
of these cancers, so this is a very, very
important challenge and it’s a very important activity that is ongoing, basically. What we know, and actually
I would say that, as Dr. Moline just said, the importance of this is
there is a latency period before these cancers
are actually identifiable. So before waiting
for the latency period, it was very, very important
for the program to recognize that cancer can be certified
and treated by the program. So this is very, very important. It’s important to continue
with the research because we need
to know the details, we need to know whether there
are other emerging problems, but it’s important that
the program actually has this opportunity to treat
cancers that are affecting the responders
and the community. The first studies,
I think three important studies came out in 2012, 2013. These are the first studies
that came out from the firefighters, the Registry, and the General Consortium. These three studies
were actually done in more or less the same time, but the data were updated to 2008, so now we need to update
all this information, but already there, in 2008,
it was already clear that there was an excess
of all types of cancer, and especially of thyroid, prostate, but also some other cancers
like melanoma not restricted to the skin
and non-Hodgkin’s lymphoma and multiple myeloma. So this was the first evidence
that came out in those years, and now we are continuing
to update these results, and it’s going to be important
to understand what’s going to happen
in the future. There is an important new study
which has actually been funded and this study will be
actually one merged cohort and this is going to be
a cohort of FDNY, the General Responder
Cohort, and the Registry. This is going to be
a very powerful new study because the three cohorts
will be merged into one, so this is going to be
a better statistical power, kind of more uniform access
to the cases, and a better scientific
approach, in a way, than before because it’s going to be
everything in one only study. And we are just starting
now to collect data and to work on all
the procedures, IRBs, and all the complicated,
I would say, process that will make this happen. So I will stop here, so hopefully this is enough for now. And an important point
I will say one more time, it’s important that this program has cancer as a certifiable
condition already, and it’s also important
that research is continuing to clarify and to give us more
information and updates on what’s going on
in the long term. Thank you for your attention. [APPLAUSE]

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