Comparison of health outcomes among affiliated and lay disaster volunteers enrolled in the World Trade Center Health Registry

Debchoudhury, Indira; Welch, Alice; Fairclough, Monique A.; Cone, James E.; Brackbill, Robert M.; Stellman, Steven D.; Farfel, Mark R.

doi:10.1016/j.ypmed.2011.08.034

Cited by 29 publications

(27 citation statements)

References 17 publications

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“…Thus caution must be taken in drawing inferences for the subgroup summaries based on these small numbers. Second, we only estimated crude ORs for the WTC exposure variables without adjusting for other factors, such as age, sex, socioeconomic status, and co-morbidity, which have been shown to affect PTSD outcomes [31] [32] [36] [37]. While changes in the summary ORs may be limited, as the significant associations were still present after adjusting for relevant covariates in most studies included in this meta-analysis, influences of these potential moderators and others that were not considered in the current study deserve further attention by ongoing WTC studies.…”

Section: Discussionmentioning

confidence: 99%

World Trade Center Disaster Exposure-Related Probable Posttraumatic Stress Disorder among Responders and Civilians: A Meta-Analysis

et al. 2014

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The World Trade Center (WTC) disaster on September 11, 2001 was an unprecedented traumatic event with long-lasting health consequences among the affected populations in the New York metropolitan area. This meta-analysis aimed to estimate the risk of probable posttraumatic stress disorder (PTSD) associated with specific types of WTC exposures. Meta-analytical findings from 10 studies of 3,271 to 20,294 participants yielded 37 relevant associations. The pooled summary odds ratio (OR) was 2.05 (95% confidence interval (CI): 1.82, 2.32), with substantial heterogeneity linked to exposure classification, cohort type, data source, PTSD assessment instrument/criteria, and lapse time since 9/11. In general, responders (e.g. police, firefighters, rescue/recovery workers and volunteers) had a lower probable PTSD risk (OR = 1.61; 95% CI: 1.39, 1.87) compared to civilians (e.g. residents, office workers, and passersby; OR = 2.71, 95% CI: 2.35, 3.12). The differences in ORs between responders and civilians were larger for physical compared to psychosocial exposure types. We also found that injury, lost someone, and witnessed horror were the three (out of six) most pernicious exposures. These findings suggest that these three exposures should be a particular focus in psychological evaluation and treatment programs in WTC intervention and future emergency preparedness efforts.

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Section: Discussionmentioning

confidence: 99%

World Trade Center Disaster Exposure-Related Probable Posttraumatic Stress Disorder among Responders and Civilians: A Meta-Analysis

et al. 2014

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“…Psychometric properties of the PCL used in this manner in other settings and with other traumatized populations have reported sensitivity ranging from 0.94 to 0.97, specificity from 0.86 to 0.99, positive predictive value from 0.70 to 0.97, and diagnostic efficiency from 0.83 to 0.96 (Blanchard et al, 1996; Ruggiero et al, 2003; Ventureyra et al, 2002; Weathers et al, 1993). Because studies have shown that the diagnostic efficiency of the PCL is improved when using a cut-off of 44 as opposed to 50 (Blanchard et al, 1996), in this study, as well as previous Registry studies (Brackbill et al, 2009; Debchoudhury et al, 2011; Farfel et al, 2008; Li et al, 2011), enrollees with a PCL score of44 or greater at Wave 2 were considered to have probable PTSD (hereafter referred to as PTSD).…”

Section: Methodsmentioning

confidence: 98%

Frequent binge drinking five to six years after exposure to 9/11: Findings from the World Trade Center Health Registry

Welch

Caramanica

Maslow

et al. 2014

Drug and Alcohol Dependence

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Background Exposure to 9/11 may have considerable long-term impact on health behaviors, including increased alcohol consumption. We examined the association between frequent binge drinking, posttraumatic stress disorder (PTSD), and number of 9/11-specific experiences among World Trade Center Health Registry (Registry) enrollees five-to-six years after 9/11. Methods Participants included 41,284 lower Manhattan residents, workers, passers-by, and rescue/recovery workers aged 18 or older without a pre-9/11 PTSD diagnosis who completed Wave 1 (2003–2004) and Wave 2 (2006–2007) interviews. Frequent binge drinking was defined as consuming five or more drinks on five or more occasions in the prior 30 days at Wave 2. Probable PTSD was defined as scoring 44 or greater on the PTSD Checklist. 9/11 exposure was measured as the sum of 12 experiences and grouped as none/low (0–1), medium (2–3), high (4–5) and very high (6+). Results Frequent binge drinking was significantly associated with increasing 9/11 exposure and PTSD. Those with very high and high exposures had a higher prevalence of frequent binge drinking (13.7% and 9.8%, respectively) than those with medium and low exposures (7.5% and 4.4%, respectively). Upon stratification, very high and high exposures were associated with frequent binge drinking in both the PTSD and no PTSD subgroups. Conclusions Our findings suggest that 9/11 exposure had an impact on frequent binge drinking five-to-six years later among Registry enrollees. Understanding the effects of traumatic exposure on alcohol use is important to identify risk factors for post-disaster alcohol misuse, inform policy, and improve post-disaster psychological and alcohol screening and counseling.

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“…Perrin et al (2007) found that the overall prevalence of PTSD among rescue/recovery workers was 12.4%, ranging from 6.2% for trained police to 21.2% for untrained and unaffiliated volunteers 17) . Debchoudhury et al (2011) confirmed these findings and found that unaffiliated volunteers had greater risk of early mental health diagnosis, chronic PTSD, and lateonset PTSD 18) . Li et al (2011) found the incidence of postSeptember 11 GERS to be higher in individuals with asthma or PTSD than in those without either condition, and highest in those with both comorbid conditions 8) .…”

Section: The Importance Of Worker Training In Preventing Ptsdmentioning

confidence: 66%

The Lessons of September 11

Crane¹,

Milek²,

Globina³

et al. 2011

Ind Health

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Comparison of health outcomes among affiliated and lay disaster volunteers enrolled in the World Trade Center Health Registry

Abstract: Lay volunteers' poorer health outcomes reflect earlier, more intense exposure to and lack of protection from physical and psychological hazards. There is a need to limit volunteers' exposures during and after disasters, as well as to provide timely screening and health care post-disaster.

Cited by 29 publications

References 17 publications

World Trade Center Disaster Exposure-Related Probable Posttraumatic Stress Disorder among Responders and Civilians: A Meta-Analysis

World Trade Center Disaster Exposure-Related Probable Posttraumatic Stress Disorder among Responders and Civilians: A Meta-Analysis

Frequent binge drinking five to six years after exposure to 9/11: Findings from the World Trade Center Health Registry

The Lessons of September 11

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