Exposure, probable PTSD and lower respiratory illness among World Trade Center rescue, recovery and clean-up workers

Details

• Alternative Title:
  Psychol Med
• Personal Author:
  Luft, B. J. ; Schechter, C. ; Kotov, R. ; Broihier, J. ; Reissman, D. ; Guerrera, K. ; Udasin, I. ; Moline, J. ; Harrison, D. ; Friedman-Jimenez, G. ; Pietrzak, R. H. ; Southwick, S. M. ; Bromet, E. J.
• Description:
  Background
  
  Thousands of rescue and recovery workers descended on the World Trade Center (WTC) in the wake of the terrorist attack of September 11, 2001 (9/11). Recent studies show that respiratory illness and post-traumatic stress disorder (PTSD) are the hallmark health problems, but relationships between them are poorly understood. The current study examined this link and evaluated contributions of WTC exposures.
  
  Method
  
  Participants were 8508 police and 12 333 non-traditional responders examined at the WTC Medical Monitoring and Treatment Program (WTC-MMTP), a clinic network in the New York area established by the National Institute for Occupational Safety and Health (NIOSH). We used structural equation modeling (SEM) to explore patterns of association among exposures, other risk factors, probable WTC-related PTSD [based on the PTSD Checklist (PCL)], physician-assessed respiratory symptoms arising after 9/11 and present at examination, and abnormal pulmonary functioning defined by low forced vital capacity (FVC).
  
  Results
  
  Fewer police than non-traditional responders had probable PTSD (5.9% v. 23.0%) and respiratory symptoms (22.5% v. 28.4%), whereas pulmonary function was similar. PTSD and respiratory symptoms were moderately correlated (r=0.28 for police and 0.27 for non-traditional responders). Exposure was more strongly associated with respiratory symptoms than with PTSD or lung function. The SEM model that best fit the data in both groups suggested that PTSD statistically mediated the association of exposure with respiratory symptoms.
  
  Conclusions
  
  Although longitudinal data are needed to confirm the mediation hypothesis, the link between PTSD and respiratory symptoms is noteworthy and calls for further investigation. The findings also support the value of integrated medical and psychiatric treatment for disaster responders.
  
  
• Subjects:
  Adult Cohort Studies Comorbidity Dust Female Humans Male Occupational Exposure Police Rescue Work Respiratory Function Tests Respiratory Tract Diseases Risk Factors September 11 Terrorist Attacks Stress Disorders, Post-Traumatic Vital Capacity

  More +
• Source:
  Psychol Med. 2011; 42(5):1069-1079
• Pubmed ID:
  22459506
• Pubmed Central ID:
  PMC3315774
• Document Type:
  Journal Article
• Funding:
  U10 OH008239/OH/NIOSH CDC HHSUnited States/ ; U10 OH008275/OH/NIOSH CDC HHSUnited States/ ; U10 OH008223/OH/NIOSH CDC HHSUnited States/ ; 5U1O 0H008232/PHS HHSUnited States/ ; U10 OH008216/OH/NIOSH CDC HHSUnited States/ ; 200-2002-0038/PHS HHSUnited States/ ; U10 OH008225/OH/NIOSH CDC HHSUnited States/
• Name as Subject:
  National Institute for Occupational Safety and Health. ; World Trade Center
• Place as Subject:
  New York ; United States
• Volume:
  42
• Issue:
  5
• NIOSHTIC Number:
  nn:20040691
• Collection(s):
  CDC Public Access National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:01927d2a6345dd0a1c9d356a9a9d9dd16337f3c9f5fe0e82aca007770f67f210b4978bca04d457c3c1b7c15f84ccbb9d685964b5250b0a4ad50d28afdcd3cab3
• Download URL:
  https://stacks.cdc.gov/view/cdc/8206/cdc_8206_DS1.pdf
• File Type:
  [PDF - 137.14 KB ]