The Relationship Between Post-Traumatic Stress Disorder and Self-Management Behaviors in World Trade Center Workers with Asthma

Details

• Personal Author:
  Ankam J ; Becker JH ; Busse P ; Crowley L ; Dickens B ; Doernberg M ; Federman A ; Gonzalez A ; Katz C ; Markowitz SB ; Weiss JJ ; Wisnivesky JP
• Description:
  Background: Comorbid posttraumatic stress disorder (PTSD) is highly prevalent and associated with increased morbidity among World Trade Center (WTC) rescue and recovery workers with asthma. However, the potential behavioral pathways underlying this relationship remain unclear. Objective: To evaluate whether PTSD is associated with lower adherence to asthma self-management behaviors among WTC workers with asthma. Methods: We used data from a prospective cohort of WTC workers with a physician diagnosis of asthma who were prescribed controller medications. Presence of comorbid PTSD was determined based on structured clinical interviews. Asthma self-management behaviors included medication adherence, inhaler technique, use of action plans, and trigger avoidance. We conducted unadjusted and multiple regression analyses to evaluate the association of PTSD with asthma self-management. Results: Overall, 30% of 276 WTC workers with asthma had comorbid PTSD. Posttraumatic stress disorder was associated with worse asthma control and poorer quality of life. However, PTSD was not significantly associated with medication adherence (odds ratio [OR] -0.15; 95% confidence interval [CI] -0.5 to 0.2), inhaler technique (OR -0.12; 95% CI -0.7 to 0.5), use of action plans (OR 0.8; 95% CI 0.4 to 1.8), or trigger avoidance (OR 0.9; 95% CI 0.4 to 1.8). Conclusions: We did not find significant differences in key asthma self-management behaviors between WTC workers with and without PTSD. These results suggest that other mechanisms, such as differences in symptom perception or inflammatory pathways, may explain the association between PTSD and increased asthma morbidity. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Health Promotion Morbidity Occupational Health Safety September 11 Terrorist Attacks Surveys And Questionnaires
• Keywords:
  9/11 Author Keywords: PTSD Health Programs Morbidity Rates Post-traumatic Stress Disorder PTSD Quality Of Life Questionnaires Self-management World Trade Center WTC

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• ISSN:
  2213-2198
• 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
• Pages in Document:
  242-249
• Volume:
  10
• Issue:
  1
• NIOSHTIC Number:
  nn:20064544
• Citation:
  J Allergy Clin Immunol Pract 2022 Jan; 10(1):242-249
• Contact Point Address:
  Juan P. Wisnivesky, MD, PhD, Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Pl., Box 1087, New York, NY 10029
• Email:
  juan.wisnivesky@mssm.edu
• Federal Fiscal Year:
  2022
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  True
• Start Date:
  20160901
• Source Full Name:
  Journal of Allergy and Clinical Immunology: In Practice
• End Date:
  20210831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:5be599c791e56fe3c7de8f7286879087987cd4071776bfddb1bade5a0176285cf7ad786d5126b8298386b088cbfbdb0f10f3b3b9326061e27a3c4426fc74a43e
• Download URL:
  https://stacks.cdc.gov/view/cdc/222988/cdc_222988_DS1.pdf
• File Type:
  [PDF - 230.52 KB ]