Determinants of asthma morbidity in World Trade Center rescue and recovery workers

Xu, Kevin Y; Goodman, Elliot R.; Goswami, Ritobrata; Crane, Michael; Crowley, Laura; Busse, Paula J.; Katz, Craig L.; Markowitz, Steven; Hoz, Rafael E. de la; Jordan, Hannah; Skloot, Gwen; Wisnivesky, Juan P.

doi:10.1016/j.anai.2016.08.033

Cited by 12 publications

(17 citation statements)

References 12 publications

(13 reference statements)

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“…In keeping with literature indicating a close association with regards to comorbidity and reciprocal enhancement of symptom severity 17,18 , our crossdisease comparisons found the greatest transcriptomic level similarities between severe asthma and PTSD.…”

Section: Validation Of Differentially Expressed Genes In Independent Transcriptomic Datasetssupporting

confidence: 89%

Severe, But Not Moderate Asthmatics Share Blood Transcriptomic Changes With Post-Traumatic Stress Disorder And Depression.

Haas‐Neill

Dvorkin‐Gheva

Forsythe

2021

Preprint

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Asthma, an inflammatory disorder of the airways, is one of the most common chronic illnesses worldwide and is associated with significant morbidity. There is growing recognition of an association between asthma and mood disorders including post-traumatic stress disorder (PTSD) and major depressive disorder (MDD). Although there are several hypotheses regarding the relationship between asthma and mental health, there is little understanding of underlying mechanisms and causality. In the current study we utilized publicly available datasets of human blood mRNA collected from patients with severe and moderate asthma, MDD, and PTSD. We performed differential expression (DE) analysis and Gene Set Enrichment Analysis (GSEA) on diseased subjects against the healthy subjects from their respective datasets, compared the results between diseases, and validated DE genes and gene sets with 4 more independent datasets. Our analysis revealed that commonalities in blood transcriptomic changes were only found between the severe form of asthma and mood disorders. Gene expression commonly regulated in PTSD and severe asthma, included ORMDL3 a gene known to be associated with asthma risk and STX8, which is involved in TrkA signalling. We also identified several pathways commonly regulated to both MDD and severe asthma. This study reveals gene and pathway regulation that potentially drives the comorbidity between severe asthma, PTSD, and MDD and may serve as foci for future research aimed at gaining a better understanding of both the relationship between asthma and PTSD, and the pathophysiology of the individual disorders.

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Section: Validation Of Differentially Expressed Genes In Independent Transcriptomic Datasetssupporting

confidence: 89%

Severe, But Not Moderate Asthmatics Share Blood Transcriptomic Changes With Post-Traumatic Stress Disorder And Depression.

Haas‐Neill

Dvorkin‐Gheva

Forsythe

2021

Preprint

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“…Asthma is known to be associated with poor quality of life, in both community and WTC populations [14,30,31]. Similarly in this study, the ACT change tracked a clinically significant change in quality of life measures.…”

Section: Discussionsupporting

confidence: 67%

“…Previous studies have demonstrated an association between mental health conditions and incident asthma or poor asthma control [11,13,14]. The current study goes further to demonstrate that clinically meaningful change in these mental health indicators is associated with concomitant change in asthma symptom control.…”

Section: Discussionsupporting

confidence: 67%

Change in Asthma Is Associated with Change in PTSD in World Trade Center Health Registrants, 2011 to 2016

Friedman

Alper

Hoz

et al. 2022

IJERPH

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The WTC Health Registry (WTCHR) is a closed, longitudinal cohort of rescue/recovery workers and survivors exposed to the 11 September 2001 disaster. WTCHR enrollees diagnosed with asthma after 11 September, 2001 continued to experience poor control despite treatment. Asthma is associated with mental problems, although their bidirectional movement has not been studied. This study tested whether a clinical change in mental problems was associated with a difference in asthma control, and whether a change in asthma control varied with a change in quality of life (QoL). Difference in the Asthma Control Test (ACT) on the WTCHR from 2011–12 to 2015–16 was compared with the change in the Post-traumatic Stress Disorder Checklist (PCL-17), the Patient Health Questionnaire depression scale, self-reported heartburn, and change of physical and mental QoL over this period. In adjusted multinomial multivariable logistic regression, improved PCL-17 was associated with a better ACT score, odds ratio (OR) = 1.42 (95% C.I. 1.01, 1.99), and a worsened PCL-17 score was associated with a worsened ACT score, OR = 1.77 (95% C.I. 1.26, 2.50). Decreased ACT was associated with poor physical QoL, OR = 1.97 (95% C.I. 1.48, 2.62). Change in mental health measures tracked with change in asthma control, which correlated with a change in QoL. Careful follow-up and treatment of all three are indicated to improve these inter-related issues.

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“…The frequently studied health outcomes linked to 9/11 include physical health conditions such as asthma, autoimmune diseases, cardiovascular diseases, and cancer, [1][2][3][4][5][6] mental health conditions such as posttraumatic stress disorder (PTSD) and depression, [7][8][9][10] and physical and mental health comorbidities. 11 Many studies have reported significant associations between these health outcomes and 9/11-related dust exposure, [1][2][3][4][5][6] with some studies also noting the temporal associations between mental health problems, particularly 9/11-related PTSD, and physical health outcomes. [12][13][14][15][16][17] A number of studies have observed an association between heart disease and 9/11 exposures including PTSD and dust/debris cloud and injury.…”

Section: Introductionmentioning

confidence: 99%

“…The long-term health effects of the World Trade Center (WTC) terrorist attacks on September 11, 2001 (9/11) have been acknowledged in recent literature. The frequently studied health outcomes linked to 9/11 include physical health conditions such as asthma, autoimmune diseases, cardiovascular diseases, and cancer, [1][2][3][4][5][6] mental health conditions such as posttraumatic stress disorder (PTSD) and depression, [7][8][9][10] and physical and mental health comorbidities. 11 Many studies have reported significant associations between these health outcomes and 9/11-related dust exposure, [1][2][3][4][5][6] with some studies also noting the temporal associations between mental health problems, particularly 9/11-related PTSD, and physical health outcomes.…”

Section: Introductionmentioning

confidence: 99%

Stroke hospitalizations, posttraumatic stress disorder, and 9/11‐related dust exposure: Results from the World Trade Center Health Registry

Alper

Nguyen

et al. 2021

American J Industrial Med

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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.

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Determinants of asthma morbidity in World Trade Center rescue and recovery workers

Cited by 12 publications

References 12 publications

Severe, But Not Moderate Asthmatics Share Blood Transcriptomic Changes With Post-Traumatic Stress Disorder And Depression.

Severe, But Not Moderate Asthmatics Share Blood Transcriptomic Changes With Post-Traumatic Stress Disorder And Depression.

Change in Asthma Is Associated with Change in PTSD in World Trade Center Health Registrants, 2011 to 2016

Stroke hospitalizations, posttraumatic stress disorder, and 9/11‐related dust exposure: Results from the World Trade Center Health Registry

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