PTSD and Depressive Symptoms as Potential Mediators of the Association Between World Trade Center Exposure and Subjective Cognitive Concerns in Rescue/Recovery Workers

Details

• Personal Author:
  Appel D ; Hall CB ; Prezant DJ ; Rabin L ; Schwartz T ; Singh A ; Webber MP ; Zeig-Owens R
• Description:
  We observed that World Trade Center (WTC) exposure, post-traumatic stress disorder (PTSD) symptoms and depressive symptoms were associated with subjective cognitive concerns in Fire Department of the City of New York (FDNY) rescue/recovery workers. This follow-up study examined whether PTSD symptoms and/or depressive symptoms mediate the observed association between WTC exposure and subjective cognitive concerns. We included WTC-exposed FDNY workers who completed the Cognitive Function Instrument (CFI), measuring self-perceived cognitive decline (N = 9516). PTSD symptoms and depressive symptoms were assessed using the PCL-S and CES-D, respectively. Multivariable linear regression estimated the association between WTC exposure and CFI score, adjusting for confounders. Mediation analyses followed the methods of Vanderweele (2014). Participants' average age at CFI assessment was 56.6 +/- 7.6 years. Higher-intensity WTC exposure was associated with worse CFI score, an effect that was entirely mediated by PTSD symptoms (%mediated: 110.9%; 95%CI: 83.1-138.9). When substituting depressive symptoms for PTSD symptoms, the WTC exposure-CFI association was largely mediated (%mediated: 82.1%; 95%CI: 60.6-103.7). Our findings that PTSD symptoms and depressive symptoms mediate the association between WTC exposure and subjective cognitive concerns indicate that in the absence of these symptoms, WTC exposure in rescue/recovery workers would not be associated with subjective cognition. Interventions targeting PTSD and depression may have additional value in mitigating cognitive decline in WTC-exposed populations. [Description provided by NIOSH]
• Subjects:
  Emergency Responders Epidemiology Firefighters Mental Health Nervous System Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: Occupational Exposure Cognitive Dysfunction Cognitive Function Emergency Responders Epidemiological Studies Fire Fighters Mental Health Post-traumatic Post-traumatic Stress Disorder PTSD Rescue Workers Stress-related Illnesses Stress Disorders World Trade Center WTC

  More +
• ISSN:
  1660-4601
• Document Type:
  Text
• Funding:
  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:
  17
• Issue:
  16
• NIOSHTIC Number:
  nn:20060629
• Citation:
  Int J Environ Res Public Health 2020 Aug; 17(16):5683
• Contact Point Address:
  Charles B. Hall, Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York 10461, USA
• Email:
  charles.hall@einsteinmed.org
• Federal Fiscal Year:
  2020
• Performing Organization:
  New York City Fire Department
• Peer Reviewed:
  True
• Start Date:
  20140701
• Source Full Name:
  International Journal of Environmental Research and Public Health
• End Date:
  20170630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:d8612fb7468ef64e008f158a299362f653277300e71a4b4dbb037bf1f7cb6c9c37eeaf14edf2e83ee6547029644314349d08e26d8f576c399e15a5328521073c
• Download URL:
  https://stacks.cdc.gov/view/cdc/224481/cdc_224481_DS1.pdf
• File Type:
  [PDF - 596.61 KB ]