Steven Stellman - Asthma and posttraumatic stress symptoms 5 to 6 years following exposure to the World Trade Center terrorist attack

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      Publication Details (including relevant citation   information):

      Brackbill, R. M., Hadler, J. L., DiGrande, L., Ekenga, C. C.,   Farfel, M. R., Friedman, S., Perlman, S. E., Stellman, S. D.,   Walker, D. J., Wu, D., Yu, S., Thorpe, L. E. 302 (5)   502-16-

      Abstract: CONTEXT: The World Trade Center Health   Registry provides a unique opportunity to examine long-term   health effects of a large-scale disaster. OBJECTIVE: To examine   risk factors for new asthma diagnoses and event-related   posttraumatic stress (PTS) symptoms among exposed adults 5 to 6   years following exposure to the September 11, 2001, World Trade   Center (WTC) terrorist attack. DESIGN, SETTING, AND PARTICIPANTS:   Longitudinal cohort study with wave 1 (W1) enrollment of 71,437   adults in 2003-2004, including rescue/recovery worker, lower   Manhattan resident, lower Manhattan office worker, and passersby   eligibility groups; 46,322 adults (68%) completed the wave 2 (W2)   survey in 2006-2007. MAIN OUTCOME MEASURES: Self-reported   diagnosed asthma following September 11; event-related current   PTS symptoms indicative of probable posttraumatic stress disorder   (PTSD), assessed using the PTSD Checklist (cutoff score > or =   44). RESULTS: Of W2 participants with no stated asthma history,   10.2% (95% confidence interval [CI], 9.9%-10.5%) reported new   asthma diagnoses postevent. Intense dust cloud exposure on   September 11 was a major contributor to new asthma diagnoses for   all eligibility groups: for example, 19.1% vs 9.6% in those   without exposure among rescue/recovery workers (adjusted odds   ratio, 1.5 [95% CI, 1.4-1.7]). Asthma risk was highest among   rescue/recovery workers on the WTC pile on September 11 (20.5%   [95% CI, 19.0%-22.0%]). Persistent risks included working longer   at the WTC site, not evacuating homes, and experiencing a heavy   layer of dust in home or office. Of participants with no PTSD   history, 23.8% (95% CI, 23.4%-24.2%) reported PTS symptoms at   either W1 (14.3%) or W2 (19.1%). Nearly 10% (9.6% [95% CI,   9.3%-9.8%]) had PTS symptoms at both surveys, 4.7% (95% CI,   4.5%-4.9%) had PTS symptoms at W1 only, and 9.5% (95% CI,   9.3%-9.8%) had PTS symptoms at W2 only. At W2, passersby had the   highest rate of PTS symptoms (23.2% [95% CI, 21.4%-25.0%]).   Event-related loss of spouse or job was associated with PTS   symptoms at W2. CONCLUSION: Acute and prolonged exposures were   both associated with a large burden of asthma and PTS symptoms 5   to 6 years after the September 11 WTC attack.

      Address (URL): http://www.ncbi.nlm.nih.gov/pubmed/19654385