Mental Health Mediators of Subjective Cognitive Concerns Among World Trade Center Responders

Details

• Personal Author:
  Bender HA ; Cooney ML ; Frank B ; Lucchini RG ; Stein CR ; Winkel G
• Description:
  Decline in cognitive functioning among rescue and recovery workers who responded in the aftermath of the September 11, 2001, World Trade Center (WTC) attacks is of emerging interest. Responders are vulnerable to cognitive decline from exposure to airborne toxins present at the WTC site, as well as from WTC-related mental and physical health conditions. To better understand the relationship between occupational WTC exposure, mental health, physical health and subjective cognitive functioning, we examined the mediating role of health status in the association between exposure and subjective cognitive concerns in a multi-site, longitudinal investigation of the WTC General Responder cohort (n = 16,380 responders; n = 58,575 visits) for the period 2002-2015. Through latent class analyses, we identified a four-level marker of cognitive concerns based on information from a Self-Administered Mental Health Questionnaire. Using generalized linear mixed models with random intercepts, we observed that a higher intensity WTC exposure composite was associated with greater cognitive concerns, and that this association was operating almost entirely through mental health comorbidities, not physical health comorbidities. In fully adjusted models, the inclusion of probable depression, anxiety, PTSD and use of psychotropic medications attenuated the association between highest WTC exposure and greatest cognitive concerns. Physical health did not appear to be on the pathway between WTC exposure and cognitive concerns. Understanding the underlying sources of cognitive concerns may help identify vulnerable members of the General Responder cohort and potentially aid clinical decision-making, such as treatment choice and enhanced screening options. Earlier diagnosis and symptom treatment may help preserve functional independence. [Description provided by NIOSH]
• Subjects:
  Air Pollutants, Occupational Dust Emergency Responders Environmental Exposure Epidemiology Hazardous Substances Mental Health Nervous System Occupational Health Risk Assessment Risk Factors Safety September 11 Terrorist Attacks Surveys And Questionnaires

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• Keywords:
  Airborne Dusts Author Keywords: September 11 Terrorist Attacks Cognitive Dysfunction Cognitive Function Exposure Levels First Responders Health Effects Medicinal Chemicals Mental Health Models Occupational Health Physiological Factors Post-traumatic Stress Disorder Psychological Effects PTSD Questionnaires Rescue Workers Risk Factors Toxins Workers World Trade Center WTC

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• ISSN:
  0022-3956
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Florida ; New York ; OSHA Region 2 ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  187-196
• Volume:
  140
• NIOSHTIC Number:
  nn:20063220
• Citation:
  J Psychiatr Res 2021 Aug; 140:187-196
• Contact Point Address:
  Cheryl R.Stein, Hassenfeld Children's Hospital at NYU Langone, Department of Child and Adolescent Psychiatry, Child Study Center, One Park Avenue 7th Floor, New York, NY, 10016
• Email:
  cheryl.stein@nyulangone.org
• Federal Fiscal Year:
  2021
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  True
• Start Date:
  20150701
• Source Full Name:
  Journal of Psychiatric Research
• End Date:
  20171031
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:2fa5124cce91bba7d04cc75f5322bdcb3d4d9bffd8fb9bbfbf2c39eab6f3f4d7b2379a01834a0a4ddd81d525157b092ff184247f98df89500dcac3294ddb996d
• Download URL:
  https://stacks.cdc.gov/view/cdc/226321/cdc_226321_DS1.pdf
• File Type:
  [PDF - 2.56 MB ]