World Trade Center Workers with Asthma and Post-Traumatic Stress Disorder Perceive Airflow Limitation More Accurately

Details

• Personal Author:
  Agrawal N ; Ankam J ; Busse P ; Federman A ; Feldrman J ; Gonzalez A ; Lin J ; Markowitz SB ; Weiss JJ ; Wisnivesky JP
• Description:
  Background: Post-traumatic stress disorder (PTSD) is a major risk factor for increased asthma morbidity among World Trade Center (WTC) workers. Objective: To investigate whether differences in perception of airflow limitation mediate the association of PTSD with worse asthma control in WTC workers. Methods: We collected data from WTC workers on asthma control (Asthma Control Questionnaire and Asthma Quality of Life Questionnaire) and daily peak expiratory flow (PEF) measures over 6 weeks. Perception of airway limitation was assessed by comparing guessed vs actual PEF values. Post-traumatic stress disorder was diagnosed using the Structured Clinical Interview. We used unadjusted and adjusted models to compare PEF and perception measures in WTC workers with PTSD with those of workers without PTSD. Results: Overall, 25% of 224 participants had PTSD. Post-traumatic stress disorder was associated with worse Asthma Control Questionnaire (2.2 +/- 0.8 vs 1.1 +/- 0.9, P < .001) and Asthma Quality of Life Questionnaire (3.9 +/- 1.1 vs 5.4 +/- 1.1, P < .001) scores. Adjusted analyses showed no significant differences in PEF between WTC workers with (351.9 +/- 143.3 L/min) and those without PTSD (364.6 +/- 131.6 L/min, P = .55). World Trade Center workers with PTSD vs those without PTSD had increased proportion of accurate perception (67.0 +/- 37.2% vs 53.5 +/- 38.1%, P = .01) and decreased underperception (23.3.0 +/- 32.1% vs 38.9 +/- 37.5%, P = .004) of airflow limitation during periods of limitation. Similar results were obtained in adjusted analyses. Conclusion: This study indicates that differences in perception of airflow limitation may mediate the relationship of PTSD and increased asthma symptoms, given WTC workers with PTSD have worse self-reported asthma control, an increased proportion of accurate perception, and decreased underperception, despite no differences in daily PEF measures. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Cohort Studies Mental Health Morbidity Nervous System Occupational Health Safety September 11 Terrorist Attacks Surveys And Questionnaires
• Keywords:
  Cohort Studies Disease Control Mental Health Morbidity Rates Post-traumatic Stress Disorder PTSD Quality Of Life Questionnaires World Trade Center WTC
• ISSN:
  1081-1206
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• 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:
  62-68
• Volume:
  132
• Issue:
  1
• NIOSHTIC Number:
  nn:20068413
• Citation:
  Ann Allergy Asthma Immunol 2024 Jan; 132(1):62-68
• Contact Point Address:
  Juan P. Wisnivesky, MD, DrPH, One Gustave L. Levy Place, Box 1087, New York, NY 10029
• Email:
  juan.wisnivesky@mssm.edu
• Federal Fiscal Year:
  2024
• Performing Organization:
  Icahn School of Medicine at Mount Sinai, New York
• Peer Reviewed:
  True
• Start Date:
  20160901
• Source Full Name:
  Annals of Allergy, Asthma and Immunology
• End Date:
  20210831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:8cf1f991dcba0407c1b65328b3594a1f6215266443e2e98a8bfb6c3c960f46ad378485fa40f187cfd44f707846ba07878528219d7c1a13eed3d33164bbe3faa3
• Download URL:
  https://stacks.cdc.gov/view/cdc/230571/cdc_230571_DS1.pdf
• File Type:
  [PDF - 688.47 KB ]