Gastroesophageal reflux symptoms and comorbid asthma and posttraumatic stress disorder following the 9/11 terrorist attacks on World Trade Center in New York City

Details

• Personal Author:
  Brackbill RM ; Cone, James E. ; Farfel MR ; Friedman S ; Li J ; Miller-Archie SA ; Stellman SD ; Thorpe LE ; Walker DJ
• Description:
  OBJECTIVES: Excess gastroesophageal reflux disease (GERD) was reported in several populations exposed to the September 11 2001 (9/11) terrorist attacks on the World Trade Center (WTC). We examined new onset gastroesophageal reflux symptoms (GERS) since 9/11 and persisting up to 5-6 years in relation to 9/11-related exposures among the WTC Health Registry enrollees, and potential associations with comorbid asthma and posttraumatic stress disorder (PTSD). METHODS: This is a retrospective analysis of 37,118 adult enrollees (i.e., rescue/recovery workers, local residents, area workers, and passersby in lower Manhattan on 9/11) who reported no pre-9/11 GERS and who participated in two Registry surveys 2-3 and 5-6 years after 9/11. Post-9/11 GERS (new onset since 9/11) reported at first survey, and persistent GERS (post-9/11 GERS reported at both surveys) were analyzed using log-binomial regression. RESULTS: Cumulative incidence was 20 percent for post-9/11 GERS and 13 percent for persistent GERS. Persistent GERS occurred more often among those with comorbid PTSD (24 percent), asthma (13 percent), or both (36 percent) compared with neither of the comorbid conditions (8 percent). Among enrollees with neither asthma nor PTSD, the adjusted risk ratio (aRR) for persistent GERS was elevated among: workers arriving at the WTC pile on 9/11 (aRR = 1.6; 95 percent confidence interval (CI) 1.3 - 2.1) or working at the WTC site greater than 90 days (aRR = 1.6; 1.4 - 2.0); residents exposed to the intense dust cloud on 9/11 (aRR = 1.5; 1.0 - 2.3), or who did not evacuate their homes (aRR = 1.7; 1.2 - 2.3); and area workers exposed to the intense dust cloud (aRR = 1.5; 1.2 - 1.8). CONCLUSIONS: Disaster-related environmental exposures may contribute to the development of GERS. GERS may be accentuated in the presence of asthma or PTSD. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Digestive System Digestive System Diseases Dust Emergencies Emergency Responders Environmental Exposure Epidemiology Health Care Facilities Workforce And Services Mental Disorders Mental Health Morbidity Occupational Health Respiratory Tract Diseases Risk Assessment Risk Factors Safety Stress, Psychological Surveys And Questionnaires

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• Keywords:
  Bronchial-asthma Dust-exposure Dusts Emergency-responders Emergency-response Employee-health Environmental-exposure Health-surveys Job-stress Medical-monitoring Medical-surveys Membrane-dysfunction Mental-stress Morbidity-rates Psychological-disorders Psychological-stress Rescue-workers Respiratory-system-disorders Risk-analysis Risk-factors Statistical-analysis Stomach-disorders Stress Surveillance-programs

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• ISSN:
  0002-9270
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  106
• Issue:
  11
• NIOSHTIC Number:
  nn:20039584
• Citation:
  Am J Gastroenterol 2011 Nov; 106(11):1933-1941
• Contact Point Address:
  Jiehui Li, MBBS, MSc, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Long Island City, NY 11101, USA
• Email:
  jli3@health.nyc.gov
• Federal Fiscal Year:
  2012
• Performing Organization:
  New York City Health/Mental Hygiene
• Peer Reviewed:
  True
• Start Date:
  20090430
• Source Full Name:
  American Journal of Gastroenterology
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:0618269d3b1fcf5ab3bb1e80a94ce134209509e178d6a891d9eb713c6391cb3e40a7a03b81c4e90486ed30d244017835556ab5193e7d0f53a59c992e96fc71dd
• Download URL:
  https://stacks.cdc.gov/view/cdc/192775/cdc_192775_DS1.pdf
• File Type:
  [PDF - 209.54 KB ]