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Environ Health. 2019 Feb 12;18(1):12. doi: 10.1186/s12940-019-0449-7.

Persistent mental and physical health impact of exposure to the September 11, 2001 World Trade Center terrorist attacks.

Author information

1
World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, New York, NY, USA. hjordan1@health.nyc.gov.
2
Present Address: Bureau of Tuberculosis Control, New York City Department of Health and Mental Hygiene, 42-09 28th St., CN-72B, Long Island City, Queens, NY, 11101, USA. hjordan1@health.nyc.gov.
3
World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, New York, NY, USA.
4
Department of Child and Adolescent Psychiatry, Hassenfeld Children's Hospital at NYU Langone, One Park Avenue, room 7-314, New York, NY, USA.
5
Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, NY, USA.

Abstract

BACKGROUND:

Asthma, gastroesophageal reflux disease (GERD), posttraumatic stress disorder (PTSD) and depression have each been linked to exposure to the September 11, 2001 World Trade Center (WTC) terrorist attacks (9/11). We described the prevalence and patterns of these conditions and associated health-related quality of life (HRQOL) fifteen years after the attacks.

METHODS:

We studied 36,897 participants in the WTC Health Registry, a cohort of exposed rescue/recovery workers and community members, who completed baseline (2003-2004) and follow-up (2015-16) questionnaires. Lower respiratory symptoms (LRS; cough, dyspnea, or wheeze), gastroesophageal reflux symptoms (GERS) and self-reported clinician-diagnosed asthma and GERD history were obtained from surveys. PTSD was defined as a score > 44 on the PTSD checklist, and depression as a score > 10 on the Patient Health Questionnaire (PHQ). Poor HRQOL was defined as reporting limited usual daily activities for > 14 days during the month preceding the survey.

RESULTS:

In 2015-16, 47.8% of participants had ≥1 of the conditions studied. Among participants without pre-existing asthma, 15.4% reported asthma diagnosed after 9/11; of these, 76.5% had LRS at follow up. Among those without pre-9/11 GERD, 22.3% reported being diagnosed with GERD after 9/11; 72.2% had GERS at follow-up. The prevalence of PTSD was 14.2%, and of depression was 15.3%. HRQOL declined as the number of comorbidities increased, and was particularly low among participants with mental health conditions. Over one quarter of participants with PTSD or depression reported unmet need for mental health care in the preceding year.

CONCLUSIONS:

Nearly half of participants reported having developed at least one of the physical or mental health conditions studied by 2015-2016; comorbidity among conditions was common. Poor HRQOL and unmet need for health were frequently reported, particularly among those with post-9/11 PTSD or depression. Comprehensive physical and mental health care are essential for survivors of complex environmental disasters, and continued efforts to connect 9/11-exposed persons to needed resources are critical.

KEYWORDS:

Asthma; Depression; Epidemiology; Gastroesophageal reflux; Health services; Health surveys; Quality of life; Registries; September 11 terrorist attacks; Stress disorders, post-traumatic

PMID:
30755198
PMCID:
PMC6373081
DOI:
10.1186/s12940-019-0449-7
[Indexed for MEDLINE]
Free PMC Article

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