World trade center-related physical and mental health burden among New York City fire Department emergency medical service workers

Jennifer Yip, Rachel Zeig-Owens, Mayris P. Webber, Andrea Kablanian, Charles B. Hall, Madeline Vossbrinck, Xiaoxue Liu, Jessica Weakley, Theresa Schwartz, Kerry J. Kelly, David J. Prezant

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objectives To describe the health burden among Fire Department of the City of New York (FDNY) emergency medical service (EMS) workers and examine its association with work at the World Trade Center (WTC) disaster site. Methods In this observational cohort study, we used FDNY physician diagnoses to estimate the cumulative incidence of physical health conditions including rhinosinusitis, gastroesophageal reflux disease (GERD), obstructive airways disease (OAD) and cancer among EMS workers and demographically similar firefighters who were active on 11 September 2001 (9/11). Validated screening instruments were used to estimate the prevalence of probable post-traumatic stress disorder (PTSD), probable depression and probable harmful alcohol use. We also analysed the association between health conditions and WTC-exposure. Results Among 2281 EMS workers, the 12-year post-9/11 cumulative incidence (11 September 2001 to 31 December 2013) of rhinosinusitis was 10.6%; GERD 12.1%; OAD 11.8%; cancer 3.1%. The prevalence of probable PTSD up to 12 years after exposure was 7%; probable depression 16.7%; and probable harmful alcohol use 3%. Compared with unexposed, EMS workers who arrived earliest at the site had higher adjusted relative risks (aRR) for most conditions, including rhinosinusitis (aRR=3.7; 95% CI 2.2 to 6.0); GERD (aRR=3.8; 95% CI 2.4 to 6.1); OAD (aRR=2.4: 95% CI 1.7 to 3.6); probable PTSD (aRR=7.0; 95% CI 3.6 to 13.5); and, probable depression (aRR=2.3; 95% CI 1.6 to 3.1). Conclusions In this 12-year study, we documented a high burden of health conditions associated with WTC-exposure among FDNY EMS workers. These findings underscore the importance of continued monitoring and treatment of this workforce.

Original languageEnglish (US)
JournalOccupational and Environmental Medicine
DOIs
StateAccepted/In press - Apr 15 2015

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Emergency Medical Services
Mental Health
Post-Traumatic Stress Disorders
Gastroesophageal Reflux
Depression
Health
Alcohols
Firefighters
Incidence
Disasters
Observational Studies
Neoplasms
Cohort Studies
Physicians

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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World trade center-related physical and mental health burden among New York City fire Department emergency medical service workers. / Yip, Jennifer; Zeig-Owens, Rachel; Webber, Mayris P.; Kablanian, Andrea; Hall, Charles B.; Vossbrinck, Madeline; Liu, Xiaoxue; Weakley, Jessica; Schwartz, Theresa; Kelly, Kerry J.; Prezant, David J.

In: Occupational and Environmental Medicine, 15.04.2015.

Research output: Contribution to journalArticle

Yip, Jennifer ; Zeig-Owens, Rachel ; Webber, Mayris P. ; Kablanian, Andrea ; Hall, Charles B. ; Vossbrinck, Madeline ; Liu, Xiaoxue ; Weakley, Jessica ; Schwartz, Theresa ; Kelly, Kerry J. ; Prezant, David J. / World trade center-related physical and mental health burden among New York City fire Department emergency medical service workers. In: Occupational and Environmental Medicine. 2015.
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abstract = "Objectives To describe the health burden among Fire Department of the City of New York (FDNY) emergency medical service (EMS) workers and examine its association with work at the World Trade Center (WTC) disaster site. Methods In this observational cohort study, we used FDNY physician diagnoses to estimate the cumulative incidence of physical health conditions including rhinosinusitis, gastroesophageal reflux disease (GERD), obstructive airways disease (OAD) and cancer among EMS workers and demographically similar firefighters who were active on 11 September 2001 (9/11). Validated screening instruments were used to estimate the prevalence of probable post-traumatic stress disorder (PTSD), probable depression and probable harmful alcohol use. We also analysed the association between health conditions and WTC-exposure. Results Among 2281 EMS workers, the 12-year post-9/11 cumulative incidence (11 September 2001 to 31 December 2013) of rhinosinusitis was 10.6{\%}; GERD 12.1{\%}; OAD 11.8{\%}; cancer 3.1{\%}. The prevalence of probable PTSD up to 12 years after exposure was 7{\%}; probable depression 16.7{\%}; and probable harmful alcohol use 3{\%}. Compared with unexposed, EMS workers who arrived earliest at the site had higher adjusted relative risks (aRR) for most conditions, including rhinosinusitis (aRR=3.7; 95{\%} CI 2.2 to 6.0); GERD (aRR=3.8; 95{\%} CI 2.4 to 6.1); OAD (aRR=2.4: 95{\%} CI 1.7 to 3.6); probable PTSD (aRR=7.0; 95{\%} CI 3.6 to 13.5); and, probable depression (aRR=2.3; 95{\%} CI 1.6 to 3.1). Conclusions In this 12-year study, we documented a high burden of health conditions associated with WTC-exposure among FDNY EMS workers. These findings underscore the importance of continued monitoring and treatment of this workforce.",
author = "Jennifer Yip and Rachel Zeig-Owens and Webber, {Mayris P.} and Andrea Kablanian and Hall, {Charles B.} and Madeline Vossbrinck and Xiaoxue Liu and Jessica Weakley and Theresa Schwartz and Kelly, {Kerry J.} and Prezant, {David J.}",
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AU - Yip, Jennifer

AU - Zeig-Owens, Rachel

AU - Webber, Mayris P.

AU - Kablanian, Andrea

AU - Hall, Charles B.

AU - Vossbrinck, Madeline

AU - Liu, Xiaoxue

AU - Weakley, Jessica

AU - Schwartz, Theresa

AU - Kelly, Kerry J.

AU - Prezant, David J.

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N2 - Objectives To describe the health burden among Fire Department of the City of New York (FDNY) emergency medical service (EMS) workers and examine its association with work at the World Trade Center (WTC) disaster site. Methods In this observational cohort study, we used FDNY physician diagnoses to estimate the cumulative incidence of physical health conditions including rhinosinusitis, gastroesophageal reflux disease (GERD), obstructive airways disease (OAD) and cancer among EMS workers and demographically similar firefighters who were active on 11 September 2001 (9/11). Validated screening instruments were used to estimate the prevalence of probable post-traumatic stress disorder (PTSD), probable depression and probable harmful alcohol use. We also analysed the association between health conditions and WTC-exposure. Results Among 2281 EMS workers, the 12-year post-9/11 cumulative incidence (11 September 2001 to 31 December 2013) of rhinosinusitis was 10.6%; GERD 12.1%; OAD 11.8%; cancer 3.1%. The prevalence of probable PTSD up to 12 years after exposure was 7%; probable depression 16.7%; and probable harmful alcohol use 3%. Compared with unexposed, EMS workers who arrived earliest at the site had higher adjusted relative risks (aRR) for most conditions, including rhinosinusitis (aRR=3.7; 95% CI 2.2 to 6.0); GERD (aRR=3.8; 95% CI 2.4 to 6.1); OAD (aRR=2.4: 95% CI 1.7 to 3.6); probable PTSD (aRR=7.0; 95% CI 3.6 to 13.5); and, probable depression (aRR=2.3; 95% CI 1.6 to 3.1). Conclusions In this 12-year study, we documented a high burden of health conditions associated with WTC-exposure among FDNY EMS workers. These findings underscore the importance of continued monitoring and treatment of this workforce.

AB - Objectives To describe the health burden among Fire Department of the City of New York (FDNY) emergency medical service (EMS) workers and examine its association with work at the World Trade Center (WTC) disaster site. Methods In this observational cohort study, we used FDNY physician diagnoses to estimate the cumulative incidence of physical health conditions including rhinosinusitis, gastroesophageal reflux disease (GERD), obstructive airways disease (OAD) and cancer among EMS workers and demographically similar firefighters who were active on 11 September 2001 (9/11). Validated screening instruments were used to estimate the prevalence of probable post-traumatic stress disorder (PTSD), probable depression and probable harmful alcohol use. We also analysed the association between health conditions and WTC-exposure. Results Among 2281 EMS workers, the 12-year post-9/11 cumulative incidence (11 September 2001 to 31 December 2013) of rhinosinusitis was 10.6%; GERD 12.1%; OAD 11.8%; cancer 3.1%. The prevalence of probable PTSD up to 12 years after exposure was 7%; probable depression 16.7%; and probable harmful alcohol use 3%. Compared with unexposed, EMS workers who arrived earliest at the site had higher adjusted relative risks (aRR) for most conditions, including rhinosinusitis (aRR=3.7; 95% CI 2.2 to 6.0); GERD (aRR=3.8; 95% CI 2.4 to 6.1); OAD (aRR=2.4: 95% CI 1.7 to 3.6); probable PTSD (aRR=7.0; 95% CI 3.6 to 13.5); and, probable depression (aRR=2.3; 95% CI 1.6 to 3.1). Conclusions In this 12-year study, we documented a high burden of health conditions associated with WTC-exposure among FDNY EMS workers. These findings underscore the importance of continued monitoring and treatment of this workforce.

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