Persistent mental and physical health impact of exposure to the September 11, 2001 World Trade Center terrorist attacks
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 asso...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-02-01
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| Series: | Environmental Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12940-019-0449-7 |
| _version_ | 1828871824845307904 |
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| author | Hannah T. Jordan Sukhminder Osahan Jiehui Li Cheryl R. Stein Stephen M. Friedman Robert M. Brackbill James E. Cone Charon Gwynn Ho Ki Mok Mark R. Farfel |
| author_facet | Hannah T. Jordan Sukhminder Osahan Jiehui Li Cheryl R. Stein Stephen M. Friedman Robert M. Brackbill James E. Cone Charon Gwynn Ho Ki Mok Mark R. Farfel |
| author_sort | Hannah T. Jordan |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-13T06:41:22Z |
| format | Article |
| id | doaj.art-88eca15048ad48108e7b571dd2421030 |
| institution | Directory Open Access Journal |
| issn | 1476-069X |
| language | English |
| last_indexed | 2024-12-13T06:41:22Z |
| publishDate | 2019-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Environmental Health |
| spelling | doaj.art-88eca15048ad48108e7b571dd24210302022-12-21T23:56:25ZengBMCEnvironmental Health1476-069X2019-02-0118111610.1186/s12940-019-0449-7Persistent mental and physical health impact of exposure to the September 11, 2001 World Trade Center terrorist attacksHannah T. Jordan0Sukhminder Osahan1Jiehui Li2Cheryl R. Stein3Stephen M. Friedman4Robert M. Brackbill5James E. Cone6Charon Gwynn7Ho Ki Mok8Mark R. Farfel9World Trade Center Health Registry, New York City Department of Health and Mental HygieneWorld Trade Center Health Registry, New York City Department of Health and Mental HygieneWorld Trade Center Health Registry, New York City Department of Health and Mental HygieneDepartment of Child and Adolescent Psychiatry, Hassenfeld Children’s Hospital at NYU LangoneWorld Trade Center Health Registry, New York City Department of Health and Mental HygieneWorld Trade Center Health Registry, New York City Department of Health and Mental HygieneWorld Trade Center Health Registry, New York City Department of Health and Mental HygieneDivision of Epidemiology, New York City Department of Health and Mental HygieneWorld Trade Center Health Registry, New York City Department of Health and Mental HygieneWorld Trade Center Health Registry, New York City Department of Health and Mental HygieneAbstract 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.http://link.springer.com/article/10.1186/s12940-019-0449-7September 11 terrorist attacksEpidemiologyQuality of lifeAsthmaDepressionStress disorders, post-traumatic |
| spellingShingle | Hannah T. Jordan Sukhminder Osahan Jiehui Li Cheryl R. Stein Stephen M. Friedman Robert M. Brackbill James E. Cone Charon Gwynn Ho Ki Mok Mark R. Farfel Persistent mental and physical health impact of exposure to the September 11, 2001 World Trade Center terrorist attacks Environmental Health September 11 terrorist attacks Epidemiology Quality of life Asthma Depression Stress disorders, post-traumatic |
| title | Persistent mental and physical health impact of exposure to the September 11, 2001 World Trade Center terrorist attacks |
| title_full | Persistent mental and physical health impact of exposure to the September 11, 2001 World Trade Center terrorist attacks |
| title_fullStr | Persistent mental and physical health impact of exposure to the September 11, 2001 World Trade Center terrorist attacks |
| title_full_unstemmed | Persistent mental and physical health impact of exposure to the September 11, 2001 World Trade Center terrorist attacks |
| title_short | Persistent mental and physical health impact of exposure to the September 11, 2001 World Trade Center terrorist attacks |
| title_sort | persistent mental and physical health impact of exposure to the september 11 2001 world trade center terrorist attacks |
| topic | September 11 terrorist attacks Epidemiology Quality of life Asthma Depression Stress disorders, post-traumatic |
| url | http://link.springer.com/article/10.1186/s12940-019-0449-7 |
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