Longitudinal study of lower respiratory symptoms, pulmonary function, and PTSD among lower Manhattan area community members exposed to the 9/11/2001 World Trade Center terrorist attacks

Details

• Personal Author:
  Alper H ; Berger KI ; Cone, James E. ; Farfel MR ; Friedman SM ; Goldring MR ; Jordan HT ; Legha J ; Miller-Archie SA ; Ortega F ; Reibman J
• Description:
  Background: New-onset lower respiratory symptoms (LRS) and posttraumatic stress disorder (PTSD) were common among lower Manhattan community members who were exposed to the 9/11/2001 World Trade Center (WTC) terrorist attacks (9/11). However, little is known about longer-term LRS and pulmonary function in this group, or about the relationship between LRS and PTSD. Methods: Non-smoking WTC Health Registry enrollees who lived or worked in lower Manhattan on 9/11 and reported either post-9/11-onset LRS (cough, dyspnea, and/or wheezing) on 2 consecutive self-administered questionnaires (2003-04 and 2006-07) or LRS on neither questionnaire were recruited for two exams (2008-10 and 2013-14). LRS, spirometry and impulse oscillometry were assessed for 530 participants in both exams. Participants with LRS at all 4 assessments were considered to have persistent LRS; those with LRS on the initial questionnaires who became asymptomatic by exam 1 or 2 were considered to have resolved LRS; and those who were initially asymptomatic but reported LRS at exam 1 and/or 2 had late-onset LRS. Probable PTSD was defined as a PTSD checklist score >44 on the 2006-07 questionnaire. Logistic regression was used to examine factors associated with LRS persistence, accounting for potential confounders including socio-demographic characteristics. Results: Participants were 59% female and 67% non-Hispanic white; the mean age on 9/11 was 40.4 years. Median FEV1 and FVC values increased between exam 1 and 2 (1.6 and 2.6 ml/year, respectively). Among participants, 301 (57%) were asymptomatic at all assessments, 104 (20%) had resolved LRS, 70 (13%) had persistent LRS, 42 (8%) had late-onset LRS, and 13 (2%) had LRS at all assessments except exam 1. Of 187 with initial LRS, 104 (56%) became asymptomatic by exam 2. At exam 2, a higher proportion of participants with persistent LRS had abnormal spirometry (17% vs. 8%, p=0.03), R5 (57% vs. 21%, p<0.001), or R5-20 (47% vs. 7% p<0.001) compared to participants who were asymptomatic at all assessments. Among 174 participants with either persistent or resolved LRS, abnormal exam 1 spirometry (adjusted odds ratio 2.6, 95% CI 1.1-6.2) and PTSD (adjusted odds ratio 2.4, 95% CI 1.2-4.8) were associated with persistent LRS. Conclusions: Most participants with post-9/11 LRS experienced symptom resolution; few developed late-onset LRS. Spirometry results showed general improvement between exams. Oscillometry abnormalities among those with persistent LRS suggest small airways dysfunction as a possible underlying etiology. PTSD may also play a role in symptom persistence. [Description provided by NIOSH]
• Subjects:
  Dust Hazardous Substances Health Care Facilities Workforce And Services Lung Men Occupational Health Respiratory Function Tests Respiratory System Respiratory Tract Diseases Safety September 11 Terrorist Attacks Surveys And Questionnaires Women

  More +
• Keywords:
  Airway Obstruction Analytical Processes Clinical Symptoms Dust Exposure Etiology Exposure Assessment Health Surveys Humans Long Term Study Medical Monitoring Medical Screening Oscillography Post-traumatic Stress Disorder PTSD Pulmonary Function Questionnaires Regression Analysis Respiratory Function Respiratory System Disorders Spirometry Surveillance Terrorism Response Toxic Materials World Trade Center WTC

  More +
• ISSN:
  1073-449X
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Abstract or Summary
• 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:
  191
• NIOSHTIC Number:
  nn:20048581
• Citation:
  Am J Respir Crit Care Med 2015 May; 191(Abstract Issue):A2589
• Contact Point Address:
  H. T. Jordan, NYC Department of Health and Mental Hygiene, Queens, NY
• Email:
  hjordan1@health.nyc.gov
• Federal Fiscal Year:
  2015
• Performing Organization:
  New York City Health/Mental Hygiene
• Peer Reviewed:
  False
• Start Date:
  20090430
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Supplement:
  Abstract Issue
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:f788353cff6c5429fca44ffbff239734887e3fb9994902ff08c1cea630c24b04b0682f5bf3992bdcac2aa1dd898620430938ed9ec66fcb2dfdc3712ba8985cc3
• Download URL:
  https://stacks.cdc.gov/view/cdc/203303/cdc_203303_DS1.pdf
• File Type:
  [PDF - 24.56 KB ]