Hospitalizations for Asthma Among Adults Exposed to the September 11, 2001 World Trade Center Terrorist Attack

Details

• Personal Author:
  Alper H ; Brackbill RM ; Cone, James E. ; Friedman SM ; Jordan HT ; Miller-Archie SA ; Wisnivesky JP
• Description:
  Objective: We described the patterns of asthma hospitalization among persons exposed to the 2001 World Trade Center (WTC) attacks, and assessed whether 9/11-related exposures or comorbidities, including posttraumatic stress disorder (PTSD) and gastroesophageal reflux symptoms (GERS), were associated with an increased rate of hospitalization. Methods: Data for adult enrollees in the WTC Health Registry, a prospective cohort study, with self-reported physician-diagnosed asthma who resided in New York State on 9/11 were linked to administrative hospitalization data to identify asthma hospitalizations during September 11, 2001-December 31, 2010. Multivariable zero-inflated Poisson regression was used to examine associations among 9/11 exposures, comorbid conditions, and asthma hospitalizations. Results: Of 11,471 enrollees with asthma, 406 (3.5%) had >/=1 asthma hospitalization during the study period (721 total hospitalizations). Among enrollees diagnosed before 9/11 (n = 6,319), those with PTSD or GERS had over twice the rate of hospitalization (adjusted rate ratio (ARR) = 2.5, 95% CI = 1.4-4.1; ARR = 2.1, 95% CI = 1.3-3.2, respectively) compared to those without. This association was not statistically significant in enrollees diagnosed after 9/11. Compared to higher educational attainment, completing less than college was associated with an increased hospitalization rate among participants with both pre-9/11- and post-9/11-onset asthma (ARR = 1.9, 95% CI = 1.2-2.9; ARR = 2.6, 95% CI = 1.6-4.1, respectively). Sinus symptoms, exposure to the dust cloud, and having been a WTC responder were not associated with asthma hospitalization. Conclusions: Among enrollees with pre- 9/11 asthma, comorbid PTSD and GERS were associated with an increase in asthma hospitalizations. Management of these comorbidities may be an important factor in preventing hospitalization. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Cohort Studies Delivery Of Health Care Diagnosis Digestive System Digestive System Diseases Dust Environmental Exposure Health Care Facilities Workforce And Services Lung Lung Diseases Morbidity Occupational Health Particulate Matter Respiratory System Respiratory Tract Diseases Safety September 11 Terrorist Attacks

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• Keywords:
  Author Keywords: Asthma Hospitalization Clinical Diagnosis Clinical Symptoms Cohort Studies Cohort Study Comorbidity Dust Exposure Dust Particles Environmental Exposure Gastroesophageal Reflux Gastroesophageal Reflux Disease Gastrointestinal System Disorders GERD Information Retrieval Systems Medical Care Medical Facilities Medical Services Medical Treatment Morbidity Rates Post-traumatic Stress Disorder Posttraumatic Stress Disorder PTSD Pulmonary Disorders Pulmonary System Disorders Regression Analysis Respiratory Irritants Respiratory System Disorders Statistical Analysis Terrorism World Trade Center WTC

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• ISSN:
  0277-0903
• 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
• Pages in Document:
  354-363
• Volume:
  55
• Issue:
  4
• NIOSHTIC Number:
  nn:20050258
• Citation:
  J Asthma 2018 Apr; 55(4):354-363
• Contact Point Address:
  Sara A. Miller-Archie, World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, 125 Worth Street, New York, NY 10013, USA
• Email:
  smilleÆ̍f@health.nyc.gov
• Federal Fiscal Year:
  2018
• Performing Organization:
  New York City Health/Mental Hygiene
• Peer Reviewed:
  True
• Start Date:
  20090430
• Source Full Name:
  Journal of Asthma
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:527d31a4c63c45927854f4a825ac1a1baecec4c6b1376fd4b91a6e73c78bff856d625cefd3d0f1240240b2c8d6a9c5aef3b65e8650176c73bdfe403761b2abe6
• Download URL:
  https://stacks.cdc.gov/view/cdc/210680/cdc_210680_DS1.pdf
• File Type:
  [PDF - 864.13 KB ]