The relationship between 9/11 exposure, systemic autoimmune disease, and post-traumatic stress disorder: a mediational analysis.

Details

• Personal Author:
  Brite J ; Cone, James E. ; Miller-Archie SA
• Description:
  The relationship between 9/11 exposure, systemic autoimmune disease (SAD) and mental health remains poorly understood. This report builds on a prior analysis of World Trade Center Health Registry data to determine whether 9/11 exposure is associated with higher risk of SAD, and if so, whether post-traumatic stress disorder (PTSD) is a mediating factor and whether the association varies by responder/community member status. The final analytic sample comprised 41,656 enrollees with 123 cases of SAD diagnosed post 9/11 through November 2017. SAD diagnosis was ascertained from survey responses and confirmed by medical record review or physician survey. Logistic regression models were constructed to determine the relationship between 9/11 exposure and PTSD and SAD. Causal mediation analysis was used to determine the mediational effect of PTSD. Each analysis was stratified by 9/11 responder/community member status. Rheumatoid arthritis (n = 75) was the most frequent SAD, followed by Sjögren's syndrome (n = 23), systemic lupus erythematosus (n = 20), myositis (n = 9), mixed connective tissue disease (n = 7), and scleroderma (n = 4). In the pooled cohort, those with 9/11-related PTSD had 1.85 times the odds (95% CI: 1.21-2.78) of SAD. Among responders, those with dust cloud exposure had almost twice the odds of SAD, while among community members, those with 9/11-related PTSD had 2.5 times the odds of SAD (95% CI: 1.39, 4.39). PTSD was not a significant mediator. Although emerging evidence suggests 9/11 exposure may be associated with SAD, more research is needed, particularly using pooled data sources from other 9/11-exposed cohorts, to fully characterize this relationship. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Emergency Responders Mental Health Nervous System Occupational Health Safety September 11 Terrorist Attacks
• Keywords:
  Author Keywords: Systemic Autoimmune Disease; Mediation Analysis; Post-traumatic Stress Disorder WTC; World Trade Center; Emergency Responders; Autoimmune Diseases; Mental Health; Post-traumatic Stress Disorder; PTSD; Rheumatoid Disorders; Lupus; Cohort Studies;
• ISSN:
  1660-4601
• 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
• Volume:
  19
• Issue:
  11
• NIOSHTIC Number:
  nn:20065385
• Citation:
  Int J Environ Res Public Health 2022 Jun; 19(11):6514
• Contact Point Address:
  Jennifer Brite, New York City Department of Health and Mental Hygiene, New York, NY 11101, USA
• Email:
  jbrite@york.cuny.edu
• Federal Fiscal Year:
  2022
• Performing Organization:
  New York City Health/Mental Hygiene
• Peer Reviewed:
  True
• Start Date:
  20090430
• Source Full Name:
  International Journal of Environmental Research and Public Health
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:e2651ac2d579bebaec91cdb46772a51cb1d1fd3ad4057c1cffcf90974e634697b5bf478381a8b2e5f6aab22d08f80e7a3b9bcea14ffc0cb405380cbb24d20652
• Download URL:
  https://stacks.cdc.gov/view/cdc/249421/cdc_249421_DS1.pdf
• File Type:
  [PDF - 320.21 KB ]