Comorbid persistent lower respiratory symptoms and posttraumatic stress disorder 5–6 years post‐9/11 in responders enrolled in the World Trade Center Health Registry

Friedman, Samuel; Farfel, Mark R.; Maslow, Carey B.; Cone, James E.; Brackbill, Robert M.; Stellman, Steven D.

doi:10.1002/ajim.22217

Cited by 41 publications

(46 citation statements)

References 32 publications

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“…Half of the enrollees with persistent LRS also had at least one mental health condition. Comorbid LRS and mental illness have been reported in rescue/recovery workers by other WTC disaster investigators10 14 16 18 and in Registry surveys from 2003–2004 and 2006–2007 among workers and residents 4 15 17 27. This study extends those findings to demonstrate that the co-occurrence of respiratory and mental health illness has continued for at least 10 years after the disaster and that reported persistent LRS were highly associated with probable GAD, depression and PTSD separately and in combination.…”

Section: Discussionsupporting

confidence: 76%

“…Comorbid LRS and mental illness have been associated with greater decreased QoL than LRS alone in rescue/recovery workers, local area workers and residents 15 17 19. Reported persistent LRS in this study were significantly associated with ≥14 days of poor physical and with ≥14 days of poor mental health, even while controlling for the number of coexisting mental health conditions.…”

Section: Discussionmentioning

confidence: 56%

“…LRS, especially in combination with PTSD, have been associated with indicators of poor quality of life (QoL) in WTCHR rescue/recovery workers, local area workers, residents and passersby 15 17. Reduced QoL in firefighters and EMS workers has been attributed to physical conditions (including lower respiratory disease) and mental health conditions (including PTSD, depression and GAD) 19…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for and consequences of persistent lower respiratory symptoms among World Trade Center Health Registrants 10 years after the disaster

et al. 2016

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 99%

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Risk factors for and consequences of persistent lower respiratory symptoms among World Trade Center Health Registrants 10 years after the disaster

et al. 2016

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“…Prior Registry studies have identified relationships between PTSD and other mental health conditions and both persistent and more frequent lower respiratory symptoms and poorly controlled asthma [6,30,31]. Potential pathways that link mental health conditions to increased asthma morbidity may be biological as well as behavioral.…”

Section: Discussionmentioning

confidence: 99%

Hospitalizations for asthma among adults exposed to the September 11, 2001 World Trade Center terrorist attack

et al. 2017

Self Cite

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Objective: We described the patterns of asthma hospitalization among persons exposed to the 2001 World Trade Center (WTC) attacks, and assessed whether 9/11-related exposures or comorbidities, including posttraumatic stress disorder (PTSD) and gastroesophageal reflux symptoms (GERS), were associated with an increased rate of hospitalization. Methods: Data for adult enrollees in the WTC Health Registry, a prospective cohort study, with self-reported physician-diagnosed asthma who resided in New York State on 9/11 were linked to administrative hospitalization data to identify asthma hospitalizations during September 11, 2001-December 31, 2010. Multivariable zero-inflated Poisson regression was used to examine associations among 9/11 exposures, comorbid conditions, and asthma hospitalizations. Results: Of 11 471 enrollees with asthma, 406 (3.5%) had ࣙ1 asthma hospitalization during the study period (721 total hospitalizations). Among enrollees diagnosed before 9/11 (n = 6319), those with PTSD or GERS had over twice the rate of hospitalization (adjusted rate ratio (ARR) = 2.5, 95% CI = 1.4-4.1; ARR = 2.1, 95% CI = 1.3-3.2, respectively) compared to those without. This association was not statistically significant in enrollees diagnosed after 9/11. Compared to higher educational attainment, completing less than college was associated with an increased hospitalization rate among participants with both pre-9/11-and post-9/11-onset asthma (ARR = 1.9, 95% CI = 1.2-2.9; ARR = 2.6, 95% CI = 1.6-4.1, respectively). Sinus symptoms, exposure to the dust cloud, and having been a WTC responder were not associated with asthma hospitalization. Conclusions: Among enrollees with pre-9/11 asthma, comorbid PTSD and GERS were associated with an increase in asthma hospitalizations. Management of these comorbidities may be an important factor in preventing hospitalization.

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“…We now understand that postdisaster mental health issues in adults and children were common and, importantly, also often chronic, including symptoms of posttraumatic stress disorder, anxiety, and depression related not only to the immediate trauma, but also to the longerterm recovery and rebuilding efforts and medical illnesses (16,(37)(38)(39)(40)(41)(42)(43). Comorbidity of mental and physical health issues compounds complexity of diagnosis and management.…”

Section: Special Article What We Have Learned About Health Effectsmentioning

confidence: 99%

Destruction of the World Trade Center Towers. Lessons Learned from an Environmental Health Disaster

Reibman¹,

Levy‐Carrick

Miles

et al. 2016

Annals ATS

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The assault and subsequent collapse of the World Trade Center towers in New York City on September 11, 2001 (9/11), released more than a million tons of debris and dust into the surrounding area, engulfing rescue workers as they rushed to aid those who worked in the towers, and the thousands of nearby civilians and children who were forced to flee. In December 2015, almost 15 years after the attack, and 5 years after first enactment, Congress reauthorized the James Zadroga 9/11 Health and Compensation Act, a law designed to respond to the adverse health effects of the disaster. This reauthorization affords an opportunity to review human inhalation exposure science in relation to the World Trade Center collapse. In this Special Article, we compile observations regarding the collective medical response to the environmental health disaster with a focus on efforts to address the adverse health effects experienced by nearby community members including local residents and workers. We also analyze approaches to understanding the potential for health risk, characterization of hazardous materials, identification of populations at risk, and shortfalls in the medical response on behalf of the local community. Our overarching goal is to communicate lessons learned from the World Trade Center experience that may be applicable to communities affected by future environmental health disasters. The World Trade Center story demonstrates that communities lacking advocacy and preexisting health infrastructures are uniquely vulnerable to health disasters. Medical and public health personnel need to compensate for these vulnerabilities to mitigate long-term illness and suffering.

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Comorbid persistent lower respiratory symptoms and posttraumatic stress disorder 5–6 years post‐9/11 in responders enrolled in the World Trade Center Health Registry

Abstract: Outcomes in comorbid responders were similar to or more severe than in comorbid survivors. Health care and disaster relief providers must suspect comorbid illness when evaluating responders' respiratory or mental illnesses and consider treatment for both.

Cited by 41 publications

References 32 publications

Risk factors for and consequences of persistent lower respiratory symptoms among World Trade Center Health Registrants 10 years after the disaster

Risk factors for and consequences of persistent lower respiratory symptoms among World Trade Center Health Registrants 10 years after the disaster

Hospitalizations for asthma among adults exposed to the September 11, 2001 World Trade Center terrorist attack

Destruction of the World Trade Center Towers. Lessons Learned from an Environmental Health Disaster

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