Respiratory Conditions and Health Care Use Among World Trade Center Health Program Members, 2011 to 2024

The World Trade Center (WTC) Health Program (hereinafter, Program) provides medical monitoring and treatment for WTC-related health conditions to eligible individuals affected by 9/11. We identified Program members with a respiratory disease (RD) certification and described their characteristics, certifications, and related health care use during 2011-2024.

We analyzed administrative data on member enrollment, certifications, and medical claims from July 2011 through December 2024. We identified members certified for RD, including WTC-related health conditions within the corresponding care suites of obstructive airway disease, upper respiratory disease, and interstitial lung disease, and we examined related claims to assess health care use and cost.

Of 139 970 enrolled Program members, 90 529 (65%) received certification for ≥1 WTC-related health condition, and 53 444 (38%) received certification for RD. Of 39 058 RD-certified responder members, upper respiratory disease was the most common RD certification (82%), while of 14 386 RD-certified survivor members, obstructive airway disease was the most common RD certification (65%). More than 80% of RD-certified members were also certified for other non-RD WTC-related conditions. Since 2016, about 58% of RD-certified members had Program-paid diagnosis or treatment services annually, and 38% to 49% had RD-related diagnosis or treatment services during 2013-2024. Annual overall health care costs increased more rapidly than RD-related health care costs among RD-certified members.

Comorbidity prevalence and health care costs increased among this population of responders and survivors with RD certifications. Ongoing medical monitoring and data collection will help guide policies and interventions.