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Enrolling by invitationNCT03295279Updated May 6, 2026

WTC Chest CT Imaging Archive

An observational study in Chronic Airway Disease, Interstitial Lung Disease and Lung Cancer, sponsored by Icahn School of Medicine at Mount Sinai. Enrolling by invitation at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-05-06.

Sponsored by Icahn School of Medicine at Mount Sinai · Observational

Study type
Observational
Model
Cohort
Time perspective
Retrospective
Enrollment
2,122
Ages
18 Years and older
Sex
All
01

Study summary

Dr. Rafael E de la Hoz and colleagues have performed standardized and computer-assisted readings of all chest CT scans received by WTC workers and volunteers at the Mount Sinai Medical Center between 2003 and 2016. The clinical team sought to assess all findings suggestive of airway, interstitial, and neoplastic disease in a systematic way, and correlate those findings with clinical, functional, and exposure indicators. The study team's research will also involve analyses of longitudinal imaging and functional trends, and characterization of the WTC related lower airway diseases and their risk factors, with a focus on obesity-related imaging markers. The study team also plans to characterize the transitions into chronic obstructive pulmonary disease (COPD) among these workers.

The researchers also propose to test the use of added respiratory surveillance tools and explore functional markers of disease progression, explore alternate methods to investigate longitudinal functional trajectories, and novel spirometry calibration methods that might facilitate the implementation of spirometry in nonspecialized settings.

Read the detailed description

The goal of this proposal is to characterize WTC-related lower airway disorders, and use novel imaging approaches to the investigation of obesity, one of their most important risk factors for poor clinical outcome and chronicity. To that end, the clinical team will utilize the WTC Pulmonary Evaluation Unit Chest CT Imaging Archive, an already established large imaging database, linked to extensive related databases that include disease symptoms, both pre-WTC and WTC-related occupational exposures, detailed pulmonary function and longitudinal spirometry measurements, visual imaging classification and grading, and quantitative computer assisted method (QCAM) measurements of airway, pulmonary parenchymal, pleural, and cardiovascular abnormalities. During the course of the proposed research project, the clinical team will continue to enrich most sources of data with periodic updates, in order to accrue information on the trajectories of the different clinical, functional, and imaging abnormalities observed in this population, and investigate the role of key adverse risk factors directly, and in collaboration with other investigators. In a related project, the research team will focus on COPD, classifying its severity, investigating its diagnostic stability, progression, and transitions, characterize structural abnormalities as assessed by chest CT imaging, and examine the interaction of WTC-related exposure levels with tobacco smoking on increasing the risk of for the disease.

Grant U01 OH010401 was renewed to 6/30/2026.

Grant U01 OH011697 proposes (1) to establish the quantitative computed tomography (QCT) characteristics that may differentiate WTC-related from non-WTC-related COPD, (2) investigate characteristics and longitudinal lung function trajectories of WTC patients with pre-COPD, and (3) investigate lung mechanical strain (LMS) as an early QCT marker of lung injury associated with chronic disease and accelerated longitudinal lung function decline.

Grant U01 OH012782-01-00 proposes (1) to test the use of added respiratory surveillance tools (diffusion capacity and forced oscillometry) and explore functional markers of disease progression, (2) explore alternate methods to investigate longitudinal functional trajectories, and (3) novel spirometry calibration methods that might facilitate the implementation of spirometry in nonspecialized settings.

02

Conditions studied

  • Chronic Airway Disease
  • Interstitial Lung Disease
  • Lung Cancer

Keywords

  • World Trade Center
  • Quantitative computerized tomography
  • Qualitative computerized tomography of the chest
  • Chronic airway disease
  • Interstitial lung disease
  • Occupational pulmonology
  • Spirometry
  • Forced Oscillometry
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

All subjects will be participants in the screening/monitoring (SMP) and treatment program (TP) sides of the WTC Health Plan Clinical Center Excellence at Mount Sinai Medical Center, the major site, by far of the NY/NJ consortium of this program.

Inclusion criteria

  • All subjects will be participants in the screening/monitoring (SMP) and treatment program (TP) sides of the WTC Health Plan Clinical Center Excellence at Mount Sinai Medical Center, the major site, by far of the NY/NJ consortium of this program.

Exclusion criteria

Exclusion Criteria:

  • Special vulnerable populations, such as fetuses, neonates, pregnant women, children, prisoners, institutionalized individuals, will not be involved in this research study.
04

Study design

Observational model
Cohort
Time perspective
Retrospective
Enrollment
2,122 participants (estimated)
Patient registry
No
05

What researchers measure

Primary outcomes

  1. Accelerated longitudinal FEV1 decline

    The clinical team selects spirometries of acceptable quality, and subjects with at least 3 spirometries spanning at least 5 years, to calculate FEV1 slope, which can then be modeled quantitatively. For categorical analyses, the clinical team defines rapid FEV1 decliners and contrast them to normal-and-stable FEV1 subjects, defined as those having an FEV1 above the lower limit of normal at baseline, no bronchodilator response, and FEV1 not changing by more than 25 ml/year on average in either direction.

    Time frame: 5 years

Secondary outcomes

  1. Number of physician diagnosis of incident asthma

    Physician diagnosis of asthma with onset after WTC occupational exposures.

    Time frame: 5 years

06

Study locations

1 site
  • Icahn School of Medicine at Mount Sinai
    New York, New York 10029, United States
07

References and documents

Publications

  • de la Hoz RE, Shohet MR, Chasan R, Bienenfeld LA, Afilaka AA, Levin SM, Herbert R. Occupational toxicant inhalation injury: the World Trade Center (WTC) experience. Int Arch Occup Environ Health. 2008 Feb;81(4):479-85. doi: 10.1007/s00420-007-0240-x. Epub 2007 Sep 5. PubMed 17786467 ↗
  • Mendelson DS, Roggeveen M, Levin SM, Herbert R, de la Hoz RE. Air trapping detected on end-expiratory high-resolution computed tomography in symptomatic World Trade Center rescue and recovery workers. J Occup Environ Med. 2007 Aug;49(8):840-5. doi: 10.1097/JOM.0b013e3180d09e87. PubMed 17693781 ↗
  • de la Hoz RE, Liu X, Doucette JT, Reeves AP, Bienenfeld LA, Wisnivesky JP, Celedon JC, Lynch DA, San Jose Estepar R. Increased Airway Wall Thickness is Associated with Adverse Longitudinal First-Second Forced Expiratory Volume Trajectories of Former World Trade Center workers. Lung. 2018 Aug;196(4):481-489. doi: 10.1007/s00408-018-0125-7. Epub 2018 May 24. PubMed 29797069 ↗
  • Weber J, Reeves AP, Doucette JT, Jeon Y, Sood A, San Jose Estepar R, Celedon JC, de la Hoz RE. Quantitative CT Evidence of Airway Inflammation in WTC Workers and Volunteers with Low FVC Spirometric Pattern. Lung. 2020 Jun;198(3):555-563. doi: 10.1007/s00408-020-00350-5. Epub 2020 Apr 1. PubMed 32239319 ↗
  • Liu X, Reeves AP, Antoniak K, San Jose Estepar R, Doucette JT, Jeon Y, Weber J, Xu D, Celedon JC, de la Hoz RE. Association of quantitative CT lung density measurements and lung function decline in World Trade Center workers. Clin Respir J. 2021 Jun;15(6):613-621. doi: 10.1111/crj.13313. Epub 2020 Dec 29. PubMed 33244876 ↗
  • de la Hoz RE, Shapiro M, Nolan A, Sood A, Lucchini RG, Cone JE, Celedon JC. Association of World Trade Center (WTC) Occupational Exposure Intensity with Chronic Obstructive Pulmonary Disease (COPD) and Asthma COPD Overlap (ACO). Lung. 2023 Aug;201(4):325-334. doi: 10.1007/s00408-023-00636-4. Epub 2023 Jul 19. PubMed 37468611 ↗
  • de la Hoz RE, Jeon Y, Doucette JT, Reeves AP, San Jose Estepar R, Celedon JC. Cluster Analysis of World Trade Center Related Lower Airway Diseases. J Occup Environ Med. 2024 Feb 1;66(2):179-184. doi: 10.1097/JOM.0000000000003023. Epub 2023 Nov 29. PubMed 38305727 ↗
  • Weber J, Zhang Z, Doucette JT, Sood A, Celedon JC, de la Hoz RE. Spirometric pattern transitions in a World Trade Center occupational cohort on longitudinal surveillance. Respir Med. 2025 Aug;244:108170. doi: 10.1016/j.rmed.2025.108170. Epub 2025 May 21. PubMed 40409739 ↗
  • Zhang Z, San Jose Estepar R, Doucette JT, Weber J, Ross JC, Celedon JC, de la Hoz RE. Quantitative CT metrics of injury patterns among WTC workers on different longitudinal FEV1 trajectory groups. Respir Med. 2026 May;256:108810. doi: 10.1016/j.rmed.2026.108810. Epub 2026 Apr 7. PubMed 41956171 ↗
  • Napier CO, Mbadugha O, Bienenfeld LA, Doucette JT, Lucchini R, Luna-Sanchez S, de la Hoz RE. Obesity and weight gain among former World Trade Center workers and volunteers. Arch Environ Occup Health. 2017 Mar 4;72(2):106-110. doi: 10.1080/19338244.2016.1197174. Epub 2016 Jun 7. PubMed 27268046 ↗
  • de la Hoz RE, Jeon Y, Miller GE, Wisnivesky JP, Celedon JC. Post-traumatic Stress Disorder, Bronchodilator Response, and Incident Asthma in World Trade Center Rescue and Recovery Workers. Am J Respir Crit Care Med. 2016 Dec 1;194(11):1383-1391. doi: 10.1164/rccm.201605-1067OC. PubMed 27548615 ↗
  • de la Hoz RE, Weber J, Xu D, Doucette JT, Liu X, Carson DA, Celedon JC. Chest CT scan findings in World Trade Center workers. Arch Environ Occup Health. 2019;74(5):263-270. doi: 10.1080/19338244.2018.1452712. Epub 2018 May 9. PubMed 29543564 ↗
  • de la Hoz RE, Jeon Y, Reeves AP, San Jose Estepar R, Liu X, Doucette JT, Celedon JC, Nolan A. Increased pulmonary artery diameter is associated with reduced FEV1 in former World Trade Center workers. Clin Respir J. 2019 Oct;13(10):614-623. doi: 10.1111/crj.13067. Epub 2019 Aug 19. PubMed 31347281 ↗
  • de la Hoz RE, Liu X, Celedon JC, Doucette JT, Jeon Y, Reeves AP, San Jose Estepar R. Association of Obesity with Quantitative Chest CT Measured Airway Wall Thickness in WTC Workers with Lower Airway Disease. Lung. 2019 Aug;197(4):517-522. doi: 10.1007/s00408-019-00246-z. Epub 2019 Jun 28. PubMed 31254057 ↗
  • de la Hoz RE. Occupational lower airway disease in relation to World Trade Center inhalation exposure. Curr Opin Allergy Clin Immunol. 2011 Apr;11(2):97-102. doi: 10.1097/ACI.0b013e3283449063. PubMed 21325944 ↗
  • Sigel KM, Xu D, Weber J, Wisnivesky JP, Celedon JC, de la Hoz RE. Prevalence of Pulmonary Nodules Detected by Computed Tomography in World Trade Center Rescue and Recovery Workers. Ann Am Thorac Soc. 2020 Jan;17(1):125-128. doi: 10.1513/AnnalsATS.201907-517RL. No abstract available. PubMed 31499008 ↗
  • de la Hoz RE, Shapiro M, Nolan A, Celedon JC, Szeinuk J, Lucchini RG. Association of low FVC spirometric pattern with WTC occupational exposures. Respir Med. 2020 Aug-Sep;170:106058. doi: 10.1016/j.rmed.2020.106058. Epub 2020 Jun 7. PubMed 32843177 ↗
  • Sigel K, de la Hoz RE, Markowitz SB, Kong CY, Stone K, Todd AC, Wisnivesky JP. Lung cancer incidence among world trade center rescue and recovery workers. Cancer Med. 2022 Aug;11(16):3136-3144. doi: 10.1002/cam4.4672. Epub 2022 Mar 28. PubMed 35343066 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03295279
Lead sponsor
Icahn School of Medicine at Mount Sinai
Collaborators
University of Pittsburgh, Brigham and Women's Hospital, National Jewish Health
Responsible party
Rafael E. de la Hoz (Professor, Icahn School of Medicine at Mount Sinai) — Principal investigator
First posted
Sep 27, 2017
Start date
Sep 1, 2012
Primary completion
Aug 2027 (estimated)
Completion
Aug 2027 (estimated)
Last update
May 6, 2026

Study contacts

Rafael E. de la Hoz, MD, MPH, MSc
principal investigator · Icahn School of Medicine at Mount Sinai

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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