Hospitalizations Among Persons Under 18 Years of Age When Exposed to the September 11, 2001 World Trade Center Terrorist Attack

Details

• Personal Author:
  Alper H ; Backbill RM ; Gargano LM
• Description:
  Purpose: Much of the literature on hospitalizations post-September 11, 2001 (9/11) focuses on adults. These studies reported that 9/11-exposures and 9/11 post-traumatic stress disorder (PTSD) were associated with increased risk of hospitalization for heart disease, asthma, and drug or alcohol abuse. Previous research among children exposed to 9/11 found that exposures such as being caught in the dust cloud, witnessing horrific events, or having PTSD were associated with asthma, behavior problems, school-functioning, and substance use. The objectives of this study were to describe the patterns of hospitalizations among enrollees in the World Trade Center Health Registry (WTCHR) who were under 18 years of age on 9/11 and to assess whether 9/11-related exposures or PTSD were associated with increased odds of hospitalization. Methods: Data for enrollees who were under 18 years of age on 9/11 in the WTCHR, a prospective cohort study, were linked to New York State administrative hospitalization data to identify hospitalizations from enrollment (2003-2004) to December 31, 2016. PTSD was defined as parent report of the child having at least six of eight 9/11-specific stress symptoms. Exposure to the dust cloud was defined has parent report of the child being caught in the dust and debris cloud resulting from collapsing buildings. Logistic regression, controlling for age, race/ethnicity, and sex, was used to analyze the associations between hospitalization, 9/11-related exposure, and PTSD. Cochran-Armitage Trend Test was used to examine trends between number of PTSD symptoms and hospitalization. Results: Of 3,248 total enrollees under 18 years of age there were 457 enrollees with one or more hospitalizations (14.1%). There were 326 (71.3%) enrollees who had at more than 1 hospitalization. Among the 2,194 hospitalizations, 188 (8.6%) were for respiratory conditions, including asthma, sinusitis, and laryngitis, and 212 (9.7%) were for mental health or substance use conditions. Exposure to the dust cloud was associated with hospitalization for respiratory conditions (adjusted odds ratio (AOR): 1.5, 95% confidence interval (CI): 1.0-2.2). PTSD was significantly associated with hospitalization for mental health or substance use conditions (AOR: 2.8, 95% CI: 1.1-7.1). There was a significant trend in the relationship between number of PTSD symptoms and respiratory conditions (p=0.0001) and mental health/substance use (p=0.0003) hospitalizations. Conclusions: Dust cloud exposure on 9/11 and PTSD are potentially associated with respiratory and mental health/substance use hospitalizations among those exposed to 9/11 as children. Continued monitoring of this population will be important to understanding the long-term effects of 9/11-exposure. [Description provided by NIOSH]
• Subjects:
  Adolescent Behavior Cohort Studies Dust Mental Health Nervous System Occupational Health Respiratory System Respiratory Tract Diseases Safety September 11 Terrorist Attacks

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• Keywords:
  Adolescents Children Cohort Studies Dust Exposure Mental Health Post-traumatic Stress Disorder PTSD Respiratory Diseases World Trade Center WTC
• ISSN:
  1054-139X
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Abstract or Summary
• 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:
  64
• Issue:
  2
• NIOSHTIC Number:
  nn:20062472
• Citation:
  J Adolesc Health 2019 Feb; 64(2)(Suppl):S32-S33
• Federal Fiscal Year:
  2019
• Performing Organization:
  New York City Health/Mental Hygiene
• Peer Reviewed:
  False
• Start Date:
  20090430
• Source Full Name:
  Journal of Adolescent Health
• Supplement:
  Supplement
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:f849516b85d547a3c5a63c437e2e0709e71951fdd1187065d65ea0257c13fdd9da5afebfb99f79e83025af0ecd029bc194166a1a792c955902d3266bf9550520
• Download URL:
  https://stacks.cdc.gov/view/cdc/225715/cdc_225715_DS1.pdf
• File Type:
  [PDF - 67.90 KB ]