Cardiovascular disease hospitalizations in relation to exposure to the September 11, 2001 World Trade Center disaster and posttraumatic stress disorder

Details

• Personal Author:
  Alper H ; Brackbill RM ; Cone, James E. ; Jordan HT ; Laskaris Z ; Miller-Archie SA ; Morabia A ; Stellman SD
• Description:
  Background: A cohort study found that 9/11-related environmental exposures and posttraumatic stress disorder increased self-reported cardiovascular disease risk. We attempted to replicate these findings using objectively defined cardiovascular disease hospitalizations in the same cohort. Methods and Results: Data for adult World Trade Center Health Registry enrollees residing in New York State on enrollment and no cardiovascular disease history (n=46 346) were linked to a New York State hospital discharge-reporting system. Follow-up began at Registry enrollment (2003-2004) and ended at the first cerebrovascular or heart disease (HD) hospitalization, death, or December 31, 2010, whichever was earliest. We used proportional hazards models to estimate adjusted hazard ratios (AHRs) for HD (n=1151) and cerebrovascular disease (n=284) hospitalization during 302 742 person-years of observation (mean follow-up, 6.5 years per person), accounting for other factors including age, race/ethnicity, smoking, and diabetes. An elevated risk of HD hospitalization was observed among women (AHR 1.32, 95% CI 1.01 to 1.71) but not men (AHR 1.16, 95% CI 0.97 to 1.40) with posttraumatic stress disorder at enrollment. A high overall level of World Trade Center rescue and recovery-related exposure was associated with an elevated HD hospitalization risk in men (AHR 1.82, 95% CI 1.06 to 3.13; P for trend=0.05), but findings in women were inconclusive (AHR 3.29, 95% CI 0.85 to 12.69; P for trend=0.09). Similar associations were observed specifically with coronary artery disease hospitalization. Posttraumatic stress disorder increased the cerebrovascular disease hospitalization risk in men but not in women. Conclusions: 9/11-related exposures and posttraumatic stress disorder appeared to increase the risk of subsequent hospitalization for HD and cerebrovascular disease. This is consistent with findings based on self-reported outcomes. [Description provided by NIOSH]
• Subjects:
  Cardiovascular Diseases Cardiovascular System Environmental Exposure Epidemiology Men Nervous System Nervous System Diseases Occupational Health Risk Assessment Risk Factors Safety Women

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• Keywords:
  Author Keywords: 9/11 World Trade Center Disaster Cardiovascular-disease Cardiovascular-system-disease Cardiovascular-system-disorders Cardiovascular Diseases Cerebrovascular-system Cerebrovascular-system-disorders Environmental-exposure Exposure-levels Hazards Humans Risk-factors Risk Factors Statistical-analysis Stress

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• ISSN:
  2047-9980
• 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:
  2
• Issue:
  5
• NIOSHTIC Number:
  nn:20043353
• Citation:
  J Am Heart Assoc 2013 Oct; 2(5):e000431
• Contact Point Address:
  Hannah T. Jordan, MD, MPH, World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, 42-09 28th Street, 7th floor, Long Island City, NY 11101
• Email:
  hjordan1@health.nyc.gov
• Federal Fiscal Year:
  2014
• Performing Organization:
  New York City Health/Mental Hygiene
• Peer Reviewed:
  True
• Start Date:
  20090430
• Source Full Name:
  Journal of the American Heart Association
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:1d29426102d66d8fe532a2026237d1990dd75106fd79f49eda073f59fd20d67c5110b8132ec7747795ed2f72adfe3629430cd993182cc139834bc126bc5122f3
• Download URL:
  https://stacks.cdc.gov/view/cdc/195271/cdc_195271_DS1.pdf
• File Type:
  [PDF - 232.79 KB ]