Associations between asthma trigger reports, mental health conditions, and asthma morbidity among world trade center rescue and recovery workers

Morales-Raveendran, Esperanza; Goodman, Elliot R.; West, Erin; Cone, James E.; Katz, Craig L.; Weiss, Jeffrey J.; Feldman, Jonathan; Harrison, Denise; Markowitz, Steven; Federman, Alex D.; Wisnivesky, Juan P.

doi:10.1080/02770903.2018.1502300

Cited by 7 publications

(7 citation statements)

References 43 publications

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“…More than half of WTC Health Registry enrollees who have asthma had poorly- or very poorly-controlled symptoms. Consistent with other studies in various populations [7,8], our study found that air pollution/irritants were the most prevalent asthma trigger, and poor asthma control worsened the HRQoL of asthmatic patients. Additionally, our study found that those who identified air pollution/irritants as their asthma trigger were more likely to have poorly- or very poorly-controlled asthma than those who did not report air pollution/irritants as their trigger.…”

Section: Discussionsupporting

confidence: 92%

“…Our study also supported previous findings that mental health is an important factor for asthma severity, exacerbation and HRQoL [7,15,30,36]. A previous study showed that the effect of air pollution/irritants on asthma control was heightened among WTC workers with panic disorder and PTSD [8]. The air pollution trigger was also found to be associated with anxiety in another study [36], suggesting those with comorbid anxiety might be more susceptible to exacerbation when exposed to air pollution/irritants.…”

Section: Discussionsupporting

confidence: 91%

“…A strength of this study was that it included a large sample size and data were available on a wide range of comorbid health conditions. There is a high level of agreement on risk factors of asthma control with previous studies of WTC-exposed populations [2,8], supporting the reliability of our findings.…”

Section: Discussionsupporting

confidence: 90%

“…Briefly, open-ended responses to the asthma triggers question “Please list up to six of the strongest triggers of your asthma” were grouped into 11 main categories: air pollution/irritants, exercise, infection, allergens (pollen), allergens (animal), allergens (general), air temperature, psychological, allergens (food), medications, and other. Similar to findings in previous studies [7,8], air pollution/irritants was the most prevalent type of trigger, reported by over 50% of the participants. We therefore derived a dichotomous variable of air pollution/irritants.…”

Section: Methodssupporting

confidence: 90%

“…The subsequent mucosal damage and impaired mucociliary clearance may facilitate access of inhaled allergens to the cells of the immune system [6]. Air pollutants/irritants were the most prevalent type of asthma triggers reported in previous studies [7,8]. The most abundant components of air pollution in urban areas are particulate matter (PM), nitrogen dioxide (NO 2 ), and ozone (O 3 ).…”

Section: Introductionmentioning

confidence: 99%

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Air Pollution/Irritants, Asthma Control, and Health-Related Quality of Life among 9/11-Exposed Individuals with Asthma

Yung

Osahan

Friedman

et al. 2019

IJERPH

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Asthma control is suboptimal among World Trade Center Health Registry (WTCHR) enrollees. Air pollution/irritants have been reported as the most prevalent trigger among World Trade Center responders. We examined the relationship between air pollution/irritants and asthma control. We also evaluated the association of asthma control with health-related quality of life (HRQoL). We included 6202 enrollees age ≥18 with a history of asthma who completed the WTCHR asthma survey between 2015 and 2016. Based on modified National Asthma Education and Prevention Program criteria, asthma was categorized as controlled, poorly-controlled, or very poorly-controlled. HRQoL indicators include ≥14 unhealthy days, ≥14 activity limitation days, and self-rated general health. We used multinomial logistic regression for asthma control, and unconditional logistic regression for HRQoL, adjusting for covariates. Overall, 27.1% had poorly-controlled and 32.2% had very poorly-controlled asthma. Air pollution/irritants were associated with poorly-controlled (adjusted odds ratio (AOR) = 1.70; 95% CI = 1.45–1.99) and very poorly-controlled asthma (AOR = 2.15; 95% CI = 1.83–2.53). Poor asthma control in turn worsened the HRQoL of asthmatic patients. Very poorly-controlled asthma was significantly associated with ≥14 unhealthy days (AOR = 3.60; 95% CI = 3.02–4.30), ≥14 activity limitation days (AOR = 4.37; 95% CI = 3.48–5.50), and poor/fair general health status (AOR = 4.92; 95% CI = 4.11–5.89). Minimizing World Trade Center (WTC) asthmatic patients’ exposure to air pollution/irritants may improve their disease management and overall well-being.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Methodssupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Air Pollution/Irritants, Asthma Control, and Health-Related Quality of Life among 9/11-Exposed Individuals with Asthma

Yung

Osahan

Friedman

et al. 2019

IJERPH

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Stroke hospitalizations, posttraumatic stress disorder, and 9/11‐related dust exposure: Results from the World Trade Center Health Registry

Alper

Nguyen

et al. 2021

American J Industrial Med

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Background Few studies have examined the association between disaster‐related factors and stroke by subtype or number. We investigated the association between 9/11‐related posttraumatic stress disorder (PTSD), dust exposure, and stroke subtype as well as recurrent strokes. Methods The study included 29,012 individuals enrolled in the World Trade Center Health Registry. Stroke cases were obtained by matching Registry enrollees to the New York State Department of Health's discharge records for inpatient visits between 2000 and 2016. Cox proportional hazards regression models were performed to examine the association between 9/11‐related risk factors and stroke by subtype. Multinomial logistic regression models were conducted to assess the associations between the same risk factors and the number of stroke hospitalizations. Results Having PTSD significantly increased the risk of developing ischemic and hemorrhagic stroke, with adjusted hazards ratios (AHRs) of 1.64 (95% confidence interval [CI]: 1.28–2.10) and 1.73 (95% CI: 1.10–2.71), respectively. The point estimate for dust cloud exposure, although not significant statistically, suggested an increased risk of ischemic stroke (AHR = 1.20, 95% CI: 0.96–1.50). PTSD was significantly associated with recurrent strokes with an adjusted odds ratio of 1.79 (95% CI: 1.09–2.95). Conclusions PTSD is a risk factor for both ischemic and hemorrhagic stroke and is associated with recurrent strokes. Dust exposure on 9/11 is a possible risk factor for ischemic stroke but not for hemorrhagic stroke, and was not associated with recurrent strokes. Our findings warrant additional research on stroke‐morbidity and mortality associated with 9/11‐related PTSD and dust exposure.

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Chemical public health disasters

Vallero,

Letcher

2024

Unraveling Environmental Disasters

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Associations between asthma trigger reports, mental health conditions, and asthma morbidity among world trade center rescue and recovery workers

Abstract: RRW with mental health conditions reported more asthma triggers and these triggers were associated with asthma morbidity. These data can help support interventions in RRW with asthma.

Cited by 7 publications

References 43 publications

Air Pollution/Irritants, Asthma Control, and Health-Related Quality of Life among 9/11-Exposed Individuals with Asthma

Air Pollution/Irritants, Asthma Control, and Health-Related Quality of Life among 9/11-Exposed Individuals with Asthma

Stroke hospitalizations, posttraumatic stress disorder, and 9/11‐related dust exposure: Results from the World Trade Center Health Registry

Chemical public health disasters

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