Effect of asthma and PTSD on persistence and onset of gastroesophageal reflux symptoms among adults exposed to the September 11, 2001, terrorist attacks

Li, Jiehui; Brackbill, Robert M.; Jordan, Hannah; Cone, James E.; Farfel, Mark R.; Stellman, Steven D.

doi:10.1002/ajim.22644

Cited by 20 publications

(22 citation statements)

References 51 publications

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“…The WTC Health Registry (Registry) is a prospective cohort study, comprising 71,430 persons who lived in, worked in, or were passing through lower Manhattan on September 11, 2001, or who conducted rescue, recovery, or clean-up work on 9/11 or during the months that followed. In 2003-2004, all enrollees completed a baseline survey regarding sociodemographic information, 9/11-related exposures, and physical and mental health history and symptoms primarily via a computer-assisted telephonic interview (Wave 1) [16].…”

Section: Study Populationmentioning

confidence: 99%

“…The current study was limited to Registry enrollees aged ࣙ18 who resided in New York State on September 11, 2001 and who reported having been diagnosed with asthma by a health professional before January 1, 2011 on Waves 1, 2, or 3 (N = 12,076). We excluded enrollees who had withdrawn from the Registry as of August 1, 2015 (n = 81) or had missing information on whether they had been diagnosed with asthma before or after 9/11 (N = 524), leaving an analytic sample of 11,471.…”

Section: Study Populationmentioning

confidence: 99%

“…SPARCS comprises approximately 95% of hospital discharges in New York since 1991 (excluding federal and psychiatric hospitals) [17]. The Registry and SPARCS were electronically linked to identify hospital discharges which occurred from September 11, 2001 to December 31, 2010. A record was matched based on an algorithm that used parts of the name, date of birth, social security number, and address.…”

Section: Study Proceduresmentioning

confidence: 99%

“…We defined dust cloud exposure as having been outdoors within the dust or debris cloud resulting from the collapse of the WTC Towers on September 11, 2001. We further restricted our definition to require having been caught in the dust cloud south of Chambers Street in lower Manhattan.…”

Section: /11 Exposuresmentioning

confidence: 99%

“…One population-based study found that lower Manhattan residents had higher rates of asthma hospitalization during the week of September 11, 2001 compared to residents of Queens, New York, who presumably had less exposure to the attack [15]; however, there are no published studies of asthma hospitalizations among 9/11-exposed cohorts.…”

Section: Introductionmentioning

confidence: 99%

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Hospitalizations for asthma among adults exposed to the September 11, 2001 World Trade Center terrorist attack

et al. 2017

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Objective: We described the patterns of asthma hospitalization among persons exposed to the 2001 World Trade Center (WTC) attacks, and assessed whether 9/11-related exposures or comorbidities, including posttraumatic stress disorder (PTSD) and gastroesophageal reflux symptoms (GERS), were associated with an increased rate of hospitalization. Methods: Data for adult enrollees in the WTC Health Registry, a prospective cohort study, with self-reported physician-diagnosed asthma who resided in New York State on 9/11 were linked to administrative hospitalization data to identify asthma hospitalizations during September 11, 2001-December 31, 2010. Multivariable zero-inflated Poisson regression was used to examine associations among 9/11 exposures, comorbid conditions, and asthma hospitalizations. Results: Of 11 471 enrollees with asthma, 406 (3.5%) had ࣙ1 asthma hospitalization during the study period (721 total hospitalizations). Among enrollees diagnosed before 9/11 (n = 6319), those with PTSD or GERS had over twice the rate of hospitalization (adjusted rate ratio (ARR) = 2.5, 95% CI = 1.4-4.1; ARR = 2.1, 95% CI = 1.3-3.2, respectively) compared to those without. This association was not statistically significant in enrollees diagnosed after 9/11. Compared to higher educational attainment, completing less than college was associated with an increased hospitalization rate among participants with both pre-9/11-and post-9/11-onset asthma (ARR = 1.9, 95% CI = 1.2-2.9; ARR = 2.6, 95% CI = 1.6-4.1, respectively). Sinus symptoms, exposure to the dust cloud, and having been a WTC responder were not associated with asthma hospitalization. Conclusions: Among enrollees with pre-9/11 asthma, comorbid PTSD and GERS were associated with an increase in asthma hospitalizations. Management of these comorbidities may be an important factor in preventing hospitalization.

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Section: Study Populationmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

Section: Study Proceduresmentioning

confidence: 99%

Section: /11 Exposuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hospitalizations for asthma among adults exposed to the September 11, 2001 World Trade Center terrorist attack

et al. 2017

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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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A comparison of physical comorbidities in patients with posttraumatic stress disorder developed after a terrorist attack or other traumatic event

Ferretti

Pozza

Bossini

et al. 2019

J of Neuroscience Research

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No study investigated whether the presence of specific medical comorbidities is associated with the type of traumatic event, in particular with terrorist attack (TA). In a group of subjects with posttraumatic stress disorder (PTSD), the current study investigated the association between the types of traumatic event (TA vs. other traumatic event [OTE]) and medical comorbidities, controlling for sex and PTSD duration. The Mini International Neuropsychiatric Interview, the Clinician‐Administered PTSD Scale, and the Davidson Trauma Scale were administered to 84 subjects diagnosed with PTSD. Thirty‐nine were victims of TA and 45 victims of OTE. TA was associated with higher prevalence of neoplasms (β = 2.60, p = 0.02). Females were more protected than males from circulatory system comorbidities (β = 1.47, p = 0.04), while PTSD duration was associated with higher prevalence of such comorbidities (β = 0.005, p = 0.01). Females showed a higher prevalence of neoplasms than males (β = 2.50, p = 0.02). Female sex was protective against metabolic syndrome (β = −1.79, p = 0.02). Patients with PTSD due to TA and female patients should be considered for their higher prevalence of neoplasms, while male patients and those with higher symptom duration should be monitored for circulatory disease and metabolic syndrome. Symptom duration might be associated with circulatory and metabolic disease. Implications for tailored and timely psychopharmacological and psychotherapeutic intervention for PTSD are discussed focusing on these specific medical comorbidities.

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Effect of asthma and PTSD on persistence and onset of gastroesophageal reflux symptoms among adults exposed to the September 11, 2001, terrorist attacks

Abstract: Clinicians should assess patients with post-9/11 GERS for comorbid asthma and PTSD, and plan medical care for these conditions in an integrated fashion. Am. J. Ind. Med. 59:805-814, 2016. © 2016 Wiley Periodicals, Inc.

Cited by 20 publications

References 51 publications

Hospitalizations for asthma among adults exposed to the September 11, 2001 World Trade Center terrorist attack

Hospitalizations for asthma among adults exposed to the September 11, 2001 World Trade Center terrorist attack

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

A comparison of physical comorbidities in patients with posttraumatic stress disorder developed after a terrorist attack or other traumatic event

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