Post-traumatic stress disorder dimensions and asthma morbidity in World Trade Center rescue and recovery workers

Details

• Personal Author:
  Crawford G ; Crowley LE ; de la Hoz RE ; Goodman E ; James S ; Katz C ; Keller K ; Markowitz S ; Mindlis I ; Morales-Raveendran E ; Vila-Castelar C ; Wisnivesky JP ; Xu K
• Description:
  Objective: Using data from a cohort of World Trade Center (WTC) rescue and recovery workers with asthma, we assessed whether meeting criteria for post-traumatic stress disorder (PTSD), sub- PTSD and for specific PTSD symptom dimensions are associated with increased asthma morbidity. Methods: Participants underwent a Structured Clinical Interview for Diagnostic and Statistical Manual to assess presence of PTSD following DSM-IV criteria during in-person interviews between December 2013 and April 2015. We defined sub-threshold PTSD as meeting criteria for two of three symptom dimensions: re-experiencing, avoidance, or hyper-arousal. Asthma control, acute asthma-related healthcare utilization, and asthma-related quality of life data was collected using validated scales. Unadjusted and multiple regression analyses were performed to assess the relationship between sub-threshold PTSD and PTSD symptom domains with asthma morbidity measures. Results: Of the 181 WTC workers with asthma recruited into the study, 28% had PTSD, and 25% had sub-threshold PTSD. Patients with PTSD showed worse asthma control, higher rates of inpatient healthcare utilization, and poorer asthma quality of life than those with sub-threshold or no PTSD. After adjusting for potential confounders, among patients not meeting criteria for full PTSD, those presenting symptoms of re-experiencing exhibited poorer quality of life (p=0.003). Avoidance was associated with increased acute healthcare use (p=0.05). Sub-threshold PTSD was not associated with asthma morbidity (p>0.05 for all comparisons). Conclusions: There may be benefit in assessing asthma control in patients with sub-threshold PTSD symptoms as well as those with full PTSD to more effectively identify ongoing asthma symptoms and target management strategies. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Diagnosis Emergency Responders Health Care Facilities Workforce And Services Men Morbidity Occupational Health Respiratory System Respiratory Tract Diseases Safety September 11 Terrorist Attacks Surveys And Questionnaires Women

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• Keywords:
  9/11 Asthma Management Asthma Morbidity Asthma Outcomes Author Keywords: PTSD Bronchial Asthma Clinical Diagnosis Clinical Symptoms Disease Control Emergency Responders Health Surveys Humans Medical Monitoring Morbidity Rates Post-traumatic Stress Disorder PTSD Quality Of Life Regression Analysis Rescue Workers Statistical Analysis Stress Sub-threshold PTSD Surveillance Trauma World Trade Center WTC

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• ISSN:
  0277-0903
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Contract
• 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:
  54
• Issue:
  7
• NIOSHTIC Number:
  nn:20048990
• Citation:
  J Asthma 2017 Sep; 54(7):723-731
• Contact Point Address:
  Irina Mindlis, One Gustave Levy Place, Box 1087, New York, NY 10029
• Email:
  irina.mindlis@mssm.edu
• Federal Fiscal Year:
  2017
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  True
• Start Date:
  20120901
• Source Full Name:
  Journal of Asthma
• End Date:
  20170831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a4224d5c2aa8ee07e8d8f19c158c4139f7dd741f6b3d0e09e8803e3c7c92f5fc88abd448f33afadd51f7a7475bb6fa05158784c126b1e71099329980c1b11d2d
• Download URL:
  https://stacks.cdc.gov/view/cdc/203594/cdc_203594_DS1.pdf
• File Type:
  [PDF - 1.07 MB ]