Neurological disease in the aftermath of terrorism: a review

Cauwer, Harald De; Somville, Francis

doi:10.1007/s13760-018-0924-x

Cited by 6 publications

(3 citation statements)

References 59 publications

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“…Such research has been started by Stecker et al’s 2014 study on rat sciatic nerves [32], which provided biological plausibility for the effect of WTC exposure mediated by a methanol-soluble element in WTC dust, leading to an increased risk of neuropathy. Furthermore, recent studies of neurodegeneration, in the military and populations exposed to terrorist attacks other than the WTC, have begun to stress the relevance of toxic neuropathy [33,34,35]. In conclusion, our study suggests that WTC exposure may result in an increased risk of peripheral neuropathy in rescue/recovery workers, especially those who were most highly exposed to the dust cloud.…”

Section: Discussionmentioning

confidence: 50%

Post-9/11 Peripheral Neuropathy Symptoms among World Trade Center-Exposed Firefighters and Emergency Medical Service Workers

Colbeth

Zeig‐Owens

Webber

et al. 2019

IJERPH

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Peripheral neuropathy can result from numerous conditions including metabolic disorders, inflammatory disease, or exposure to environmental or biological toxins. We analyzed questionnaire data from 9239 Fire Department of the City of New York (FDNY) World Trade Center (WTC)-exposed firefighters and emergency medical service workers (EMS) to evaluate the association between work at the WTC site and subsequent peripheral neuropathy symptoms using the validated Diabetic Neuropathy Symptom (DNS) score. We grouped the population into an “Indicated” group with conditions known to be associated with paresthesia (N = 2059) and a “Non-Indicated” group without conditions known to be associated (N = 7180). The level of WTC exposure was categorized by time of arrival to the WTC. Overall, 25% of workers aged 40 and older reported peripheral neuropathy symptoms: 30.6% in the Indicated and 23.8% in the Non-Indicated groups, respectively. Multivariable logistic models performed on the Non-Indicated group, and on the Non-Indicated in comparison with non-WTC exposed National Health and Nutrition Examination Survey (NHANES), found that the highest level of WTC-exposure was significantly associated with DNS positive outcomes, after controlling for potential confounders. In conclusion, this study suggests that symptoms of peripheral neuropathy and paresthesias are common and are associated with WTC-exposure intensity.

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Section: Discussionmentioning

confidence: 50%

Post-9/11 Peripheral Neuropathy Symptoms among World Trade Center-Exposed Firefighters and Emergency Medical Service Workers

Colbeth

Zeig‐Owens

Webber

et al. 2019

IJERPH

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“…Our hazard function plots of survival times paresthesia-free suggest a long-term and continuing risk 17 years or more after the WTC disaster of paresthesia. Few instances of exposure to a time-limited event, including environmental disasters with neurotoxic consequences, have been reported and most exposures to neurotoxins result in symptoms within weeks or months [3,17,18]. In some instances, it is difficult to untangle whether a latency period precedes symptom expression of neuropathy or if a certain level of dose must be accumulated.…”

Section: Discussionmentioning

confidence: 99%

Time to Onset of Paresthesia Among Community Members Exposed to the World Trade Center Disaster

Thawani

Wang

Shao

et al. 2019

IJERPH

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We examined whether time to onset of paresthesia was associated with indicators of severity of World Trade Center (WTC) exposure. We analyzed data from 3411 patients from the Bellevue Hospital—WTC Environmental Health Center. Paresthesia was defined as present if the symptom occurred in the lower extremities with frequency “often” or “almost continuous.” We plotted hazard functions and used the log-rank test to compare time to onset of paresthesia between different exposure groups. We also used Cox regression analysis to examine risk factors for time-to-paresthesia after 9/11/2001 and calculate hazard ratios adjusted for potential confounders. We found significantly elevated hazard ratios for paresthesia for (a) working in a job that required cleaning of WTC dust in the workplace; and (b) being heavily exposed to WTC dust on September 11, 2001, after adjusting for age, race/ethnicity, depression, anxiety, post-traumatic stress disorder, and body mass index. These observational data are consistent with the hypothesis that exposure to WTC dust or some other aspect of cleaning WTC dust in the workplace, is associated with neuropathy and paresthesia. Further neurological evaluations of this and other WTC-exposed populations is warranted.

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“…People who have been exposed to a terrorist attack, their relatives, and the bereaved are at risk of developing mental health disorders such as posttraumatic stress disorder (PTSD), anxiety, depression, and suicide risk. 1,2 Five weeks and 12 weeks after the terrorist attacks in Madrid, Spain on March 11, 2004, 44.1% of respondents presented PTSD, 31.5% major depression, and 13.4% generalized anxiety disorder. 3 In addition to the symptoms experienced, a mental health disorder can also lead to difficulties at work, 4 changes in social and family relationships 5 or in quality of life, 6 and poor physical health.…”

Section: Introductionmentioning

confidence: 99%

Short-Term Psychological Support for Civilians Exposed to the January 2015 Terrorist Attacks in France

Vuillermoz

Prieto²,

Pirard³

et al. 2022

Prehosp. Disaster med.

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Introduction:Following a terrorist attack, responses to a psychosocial disaster range from low-intensity initiatives to high-intensity treatment. Some studies described post-disaster psychosocial services and planning across Europe. However, little is known about the psychosocial support (PS) actually delivered after terrorist attacks.Study Objective:This study assesses prevalence and the factors associated with not receiving short-term PS among terror-exposed people with probable mental health disorders following the January 2015 terrorist attacks in France.Methods:This study used data from the first wave of a longitudinal survey conducted six months after the attacks. Prevalence and factors associated with not receiving PS were described in the immediate period (48 hours), the early post-immediate period (48 hours-one week), and the medium-term (over one week) using a robust Poisson regression for each of the three periods.Results:Nearly one-half of the participants (N = 189) did not receive PS in any period (46.6% in the immediate period, 45.5% in the early post-immediate period, and 54.5% in the medium-term). In each period, not receiving PS was associated with not being very close to the attack sites. Not receiving PS in the immediate period was also associated with being a direct witness (DW) rather than being directly threatened (DT) and not having support in daily life; in the early post-immediate period, not receiving PS was associated with not having a peri-traumatic dissociation experience and being followed for a psychological problem before the attacks; and in the medium-term period, it was associated with perceived social isolation.Conclusion:The characteristics of the terror exposure and social support seemed to influence presence or absence of PS after the terrorist attack and highlight the need for strategies to reach out to people regardless of the type of exposure.

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Neurological disease in the aftermath of terrorism: a review

Cited by 6 publications

References 59 publications

Post-9/11 Peripheral Neuropathy Symptoms among World Trade Center-Exposed Firefighters and Emergency Medical Service Workers

Post-9/11 Peripheral Neuropathy Symptoms among World Trade Center-Exposed Firefighters and Emergency Medical Service Workers

Time to Onset of Paresthesia Among Community Members Exposed to the World Trade Center Disaster

Short-Term Psychological Support for Civilians Exposed to the January 2015 Terrorist Attacks in France

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