Persistent Mental and Physical Health Impact of Exposure to the September 11, 2001 World Trade Center Terrorist Attacks

Details

• Personal Author:
  Brackbill RM ; Cone, James E. ; Farfel MR ; Friedman SM ; Gwynn C ; Jordan HT ; Li J ; Mok HK ; Osahan S ; Stein CR
• Description:
  Background: Asthma, gastroesophageal reflux disease (GERD), posttraumatic stress disorder (PTSD) and depression have each been linked to exposure to the September 11, 2001 World Trade Center (WTC) terrorist attacks (9/11). We described the prevalence and patterns of these conditions and associated health-related quality of life (HRQOL) fifteen years after the attacks. Methods: We studied 36,897 participants in the WTC Health Registry, a cohort of exposed rescue/recovery workers and community members, who completed baseline (2003-2004) and follow-up (2015-16) questionnaires. Lower respiratory symptoms (LRS; cough, dyspnea, or wheeze), gastroesophageal reflux symptoms (GERS) and selfreported clinician-diagnosed asthma and GERD history were obtained from surveys. PTSD was defined as a score > 44 on the PTSD checklist, and depression as a score > 10 on the Patient Health Questionnaire (PHQ). Poor HRQOL was defined as reporting limited usual daily activities for > 14 days during the month preceding the survey. Results: In 2015-16, 47.8% of participants had .1 of the conditions studied. Among participants without preexisting asthma, 15.4% reported asthma diagnosed after 9/11; of these, 76.5% had LRS at follow up. Among those without pre-9/11 GERD, 22.3% reported being diagnosed with GERD after 9/11; 72.2% had GERS at follow-up. The prevalence of PTSD was 14.2%, and of depression was 15.3%. HRQOL declined as the number of comorbidities increased, and was particularly low among participants with mental health conditions. Over one quarter of participants with PTSD or depression reported unmet need for mental health care in the preceding year. Conclusions: Nearly half of participants reported having developed at least one of the physical or mental health conditions studied by 2015-2016; comorbidity among conditions was common. Poor HRQOL and unmet need for health were frequently reported, particularly among those with post-9/11 PTSD or depression. Comprehensive physical and mental health care are essential for survivors of complex environmental disasters, and continued efforts to connect 9/11-exposed persons to needed resources are critical. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Emergency Responders Epidemiology Health Care Facilities Workforce And Services Men Mental Health Nervous System Occupational Health Respiratory System Respiratory Tract Diseases Safety September 11 Terrorist Attacks Surveys And Questionnaires Women

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• Keywords:
  Author Keywords: September 11 Terrorist Attacks Bronchial Asthma Depression First Responders Gastroesophageal Reflux Gastroesophageal Reflux Disease GERD Health Effects Health Services Health Surveys Humans Mental Health Physical Reactions Physiological Effects Post-traumatic Stress Disorder Posttraumatic PTSD Quality Of Life Questionnaires Registries Rescue Workers Respiratory System Disorders Statistical Analysis Stress Disorders Terrorism World Trade Center WTC

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• ISSN:
  1476-069X
• 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:
  12
• Volume:
  18
• NIOSHTIC Number:
  nn:20054717
• Citation:
  Environ Health 2019 Feb; 18:12
• Contact Point Address:
  Hannah T. Jordan, World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, New York, NY
• Email:
  hjordan1@health.nyc.gov
• Federal Fiscal Year:
  2019
• Performing Organization:
  New York City Health/Mental Hygiene
• Peer Reviewed:
  True
• Start Date:
  20090430
• Source Full Name:
  Environmental Health: A Global Access Science Source
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:6f08e0abf4a06e4d7b4975af34f58a1945630f3b3e92a8539be63f6d4ea45e91c326b71e3318bd8d1d548664b6018d72f1737322a97807da3061680d5742c45f
• Download URL:
  https://stacks.cdc.gov/view/cdc/217167/cdc_217167_DS1.pdf
• File Type:
  [PDF - 931.38 KB ]