Exposure, probable PTSD and lower respiratory illness among World Trade Center rescue, recovery and clean-up workers

B. J. Luft, Clyde B. Schechter, R. Kotov, J. Broihier, D. Reissman, K. Guerrera, I. Udasin, J. Moline, D. Harrison, G. Friedman-Jimenez, R. H. Pietrzak, S. M. Southwick, E. J. Bromet

Research output: Contribution to journalArticle

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Abstract

Background Thousands of rescue and recovery workers descended on the World Trade Center (WTC) in the wake of the terrorist attack of September 11, 2001 (9/11). Recent studies show that respiratory illness and post-traumatic stress disorder (PTSD) are the hallmark health problems, but relationships between them are poorly understood. The current study examined this link and evaluated contributions of WTC exposures.Method Participants were 8508 police and 12 333 non-traditional responders examined at the WTC Medical Monitoring and Treatment Program (WTC-MMTP), a clinic network in the New York area established by the National Institute for Occupational Safety and Health (NIOSH). We used structural equation modeling (SEM) to explore patterns of association among exposures, other risk factors, probable WTC-related PTSD [based on the PTSD Checklist (PCL)], physician-assessed respiratory symptoms arising after 9/11 and present at examination, and abnormal pulmonary functioning defined by low forced vital capacity (FVC).Results Fewer police than non-traditional responders had probable PTSD (5.9% v. 23.0%) and respiratory symptoms (22.5% v. 28.4%), whereas pulmonary function was similar. PTSD and respiratory symptoms were moderately correlated (r=0.28 for police and 0.27 for non-traditional responders). Exposure was more strongly associated with respiratory symptoms than with PTSD or lung function. The SEM model that best fit the data in both groups suggested that PTSD statistically mediated the association of exposure with respiratory symptoms.Conclusions Although longitudinal data are needed to confirm the mediation hypothesis, the link between PTSD and respiratory symptoms is noteworthy and calls for further investigation. The findings also support the value of integrated medical and psychiatric treatment for disaster responders.

Original languageEnglish (US)
Pages (from-to)1069-1079
Number of pages11
JournalPsychological Medicine
Volume42
Issue number5
DOIs
StatePublished - May 2012

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Post-Traumatic Stress Disorders
Police
Lung
September 11 Terrorist Attacks
National Institute for Occupational Safety and Health (U.S.)
Vital Capacity
Disasters
Checklist
Psychiatry
Physicians
Health
Therapeutics

Keywords

  • 9/11
  • disaster responders
  • exposure
  • mediate
  • post-traumatic stress disorder
  • respiratory conditions
  • risk factors
  • World Trade Center

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Applied Psychology

Cite this

Exposure, probable PTSD and lower respiratory illness among World Trade Center rescue, recovery and clean-up workers. / Luft, B. J.; Schechter, Clyde B.; Kotov, R.; Broihier, J.; Reissman, D.; Guerrera, K.; Udasin, I.; Moline, J.; Harrison, D.; Friedman-Jimenez, G.; Pietrzak, R. H.; Southwick, S. M.; Bromet, E. J.

In: Psychological Medicine, Vol. 42, No. 5, 05.2012, p. 1069-1079.

Research output: Contribution to journalArticle

Luft, BJ, Schechter, CB, Kotov, R, Broihier, J, Reissman, D, Guerrera, K, Udasin, I, Moline, J, Harrison, D, Friedman-Jimenez, G, Pietrzak, RH, Southwick, SM & Bromet, EJ 2012, 'Exposure, probable PTSD and lower respiratory illness among World Trade Center rescue, recovery and clean-up workers', Psychological Medicine, vol. 42, no. 5, pp. 1069-1079. https://doi.org/10.1017/S003329171100256X
Luft, B. J. ; Schechter, Clyde B. ; Kotov, R. ; Broihier, J. ; Reissman, D. ; Guerrera, K. ; Udasin, I. ; Moline, J. ; Harrison, D. ; Friedman-Jimenez, G. ; Pietrzak, R. H. ; Southwick, S. M. ; Bromet, E. J. / Exposure, probable PTSD and lower respiratory illness among World Trade Center rescue, recovery and clean-up workers. In: Psychological Medicine. 2012 ; Vol. 42, No. 5. pp. 1069-1079.
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