Determinants of Counseling for Children in Manhattan After the September 11 Attacks

Stuber, Jennifer; Fairbrother, Gerry; Galea, Sandro; Pfefferbaum, Betty; Wilson‐Genderson, Maureen; Vlahov, David

doi:10.1176/appi.ps.53.7.815

Cited by 141 publications

(109 citation statements)

References 31 publications

(28 reference statements)

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“…Our findings complement earlier reports describing the acute physical consequences of the disaster (CDC 2002;Prezant et al 2002) and its psychological impacts (Boscarino et al 2002;Fairbrother et al 2003;Galea et al 2002aGalea et al , 2002bStuber et al 2002;Vlahov et al 2002aVlahov et al , 2002b.…”

Section: Discussionsupporting

confidence: 91%

“…The prevalence of those symptoms was related to intensity and duration of smoke and dust exposure. Studies of the mental health consequences of the disaster have documented a high prevalence of posttraumatic stress disorder (PTSD) Fairbrother et al 2003) and other psychological sequelae, including increased rates of drug and alcohol abuse (Boscarino et al 2002;Galea et al 2002a;Stuber et al 2002;Vlahov et al 2002aVlahov et al , 2002b.…”

mentioning

confidence: 99%

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Health and environmental consequences of the world trade center disaster.

Landrigan

Lioy

Thurston

et al. 2004

Environ Health Perspect

335

329

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The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyses of outdoor and indoor settled dust; high-altitude imaging and modeling of the atmospheric plume; inhalation studies of WTC dust in mice; and clinical examinations, community surveys, and prospective epidemiologic studies of exposed populations. WTC dust was found to consist predominantly (95%) of coarse particles and contained pulverized cement, glass fibers, asbestos, lead, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polychlorinated furans and dioxins. Airborne particulate levels were highest immediately after the attack and declined thereafter. Particulate levels decreased sharply with distance from the WTC. Dust pH was highly alkaline (pH 9.0-11.0). Mice exposed to WTC dust showed only moderate pulmonary inflammation but marked bronchial hyperreactivity. Evaluation of 10,116 firefighters showed exposure-related increases in cough and bronchial hyperreactivity. Evaluation of 183 cleanup workers showed new-onset cough (33%), wheeze (18%), and phlegm production (24%). Increased frequency of new-onset cough, wheeze, and shortness of breath were also observed in community residents. Follow-up of 182 pregnant women who were either inside or near the WTC on 11 September showed a 2-fold increase in small-for-gestational-age (SGA) infants. In summary, environmental exposures after the WTC disaster were associated with significant adverse effects on health. The high alkalinity of WTC dust produced bronchial hyperreactivity, persistent cough, and increased risk of asthma. Plausible causes of the observed increase in SGA infants include maternal exposures to PAH and particulates. Future risk of mesothelioma may be increased, particularly among workers and volunteers exposed occupationally to asbestos. Continuing follow-up of all exposed populations is required to document the long-term consequences of the disaster.

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

Health and environmental consequences of the world trade center disaster.

Landrigan

Lioy

Thurston

et al. 2004

Environ Health Perspect

335

329

View full text Add to dashboard Cite

show abstract

“…Some were affected directly by losing a parent or family member, being displaced from their home or school, or witnessing the attacks. 13 Still hundreds of thousands more were touched indirectly by viewing the horrific images that consumed the media for weeks after the attacks or observing initial and ongoing responses of public figures and trusted adults. Certainly, a child's personal experience related to September 11th can be predictive of that child's response.…”

Section: Nature Of Disastersmentioning

confidence: 99%

“…In the Manhattan area, 22% of children from the community-at-large received some form of counseling after the attacks, which was a much greater rate of counseling than seen with similar tragedies such as the Oklahoma City bombing. 13,17 However, most of this counseling was received in schools. In the Washington area, the total number of children's visits to behavioral health clinics at military treatment facilities did not increase; however, there was a significant increase in the percentage of visits for anxiety disorders and acute stress reactions.…”

Section: Effects On Childrenmentioning

confidence: 99%

Psychosocial Implications of Disaster or Terrorism on Children: A Guide for the Pediatrician

Hagan¹

2005

Pediatrics

108

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ABSTRACT. During and after disasters, pediatricians can assist parents and community leaders not only by accommodating the unique needs of children but also by being cognizant of the psychological responses of children to reduce the possibility of long-term psychological morbidity. The effects of disaster on children are mediated by many factors including personal experience, parental reaction, developmental competency, gender, and the stage of disaster response. Pediatricians can be effective advocates for the child and family and at the community level and can affect national policy in support of families. In this report, specific children's responses are delineated, risk factors for adverse reactions are discussed, and advice is given for pediatricians to ameliorate the effects of disaster on children. Pediatrics 2005; 116:787-795; terrorism, disaster preparedness, posttraumatic stress disorder, anxiety.

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“…Unfortunately, the rigor in establishing diagnoses in this study is unclear as is the temporal relationship of disorders to the attacks. Other studies have used parent report, notable for underestimating distress in their children (Earls et al, 1988;Handford et al, 1986), to describe children's reactions to the September 11 attacks (Schlenger et al, 2002;Schuster et al, 2001;Stuber et al, 2002). Thus studies of children's reactions to terrorism are even more problematic than those of adults.…”

Section: Studies Of Children and Terrorismmentioning

confidence: 99%