Stroke Hospitalizations, Posttraumatic Stress Disorder, and 9/11-Related Dust Exposure: Results from the World Trade Center Health Registry

Details

• Personal Author:
  Alper HE ; Brackbill RM ; Maqsood J ; Nguyen A-M ; Yu S
• Description:
  Background: Few studies have examined the association between disaster-related factors and stroke by subtype or number. We investigated the association between 9/11-related posttraumatic stress disorder (PTSD), dust exposure, and stroke subtype as well as recurrent strokes. Methods: The study included 29,012 individuals enrolled in the World Trade Center Health Registry. Stroke cases were obtained by matching Registry enrollees to the New York State Department of Health's discharge records for inpatient visits between 2000 and 2016. Cox proportional hazards regression models were performed to examine the association between 9/11-related risk factors and stroke by subtype. Multinomial logistic regression models were conducted to assess the associations between the same risk factors and the number of stroke hospitalizations. Results: Having PTSD significantly increased the risk of developing ischemic and hemorrhagic stroke, with adjusted hazards ratios (AHRs) of 1.64 (95% confidence interval [CI]: 1.28-2.10) and 1.73 (95% CI: 1.10-2.71), respectively. The point estimate for dust cloud exposure, although not significant statistically, suggested an increased risk of ischemic stroke (AHR = 1.20, 95% CI: 0.96-1.50). PTSD was significantly associated with recurrent strokes with an adjusted odds ratio of 1.79 (95% CI: 1.09-2.95). Conclusions: PTSD is a risk factor for both ischemic and hemorrhagic stroke and is associated with recurrent strokes. Dust exposure on 9/11 is a possible risk factor for ischemic stroke but not for hemorrhagic stroke, and was not associated with recurrent strokes. Our findings warrant additional research on stroke-morbidity and mortality associated with 9/11-related PTSD and dust exposure. [Description provided by NIOSH]
• Subjects:
  Cardiovascular Diseases Cardiovascular System Dust Emergency Responders Hazardous Substances Health Care Facilities Workforce And Services Health Promotion Occupational Health Risk Assessment Risk Factors Safety September 11 Terrorist Attacks

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• Keywords:
  Author Keywords: 9/11 Disaster Cardiovascular System Disorders Dust Exposure Emergency Responders First Responders Health Programs Heart Heart Disease Hemorrhagic Stroke Humans Ischemic Stroke Medical Monitoring Medical Records Post-traumatic Stress Disorder PTSD Recurrent Stroke Regression Analysis Risk Factors Toxic Materials World Trade Center WTC

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• ISSN:
  0271-3586
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  California ; New York ; OSHA Region 2 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  64
• Issue:
  10
• NIOSHTIC Number:
  nn:20063145
• Citation:
  Am J Ind Med 2021 Oct; 64(10):827-836
• Contact Point Address:
  Shengchao Yu, PhD, MA, World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, 30-30 47th Ave, Suite 414, Long Island City, NY 11101, USA
• Email:
  syu@health.nyc.gov
• Federal Fiscal Year:
  2022
• Performing Organization:
  New York City Health/Mental Hygiene
• Peer Reviewed:
  True
• Start Date:
  20090430
• Source Full Name:
  American Journal of Industrial Medicine
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:8c3e45ca1b93c964ee623e46526f5578dfda843ec0c65557eeb3279579cc3073cd32defeb34a402463f145667fde50e935bef4ac31db11a738e21ffecce0534f
• Download URL:
  https://stacks.cdc.gov/view/cdc/226262/cdc_226262_DS1.pdf
• File Type:
  [PDF - 548.78 KB ]