Steven Stellman - Comparison of health outcomes among affiliated and lay disaster volunteers enrolled in the World Trade Center Health Registry

Document created by Steven Stellman on Dec 1, 2016
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  Publication Details (including relevant citation   information):

  Debchoudhury, I., Welch, A. E., Fairclough, M. A., Cone, J. E.,   Brackbill, R. M., Stellman, S. D., Farfel, M. R. 53 (6)   359-63-

  Abstract: BACKGROUND: Volunteers   (non-professional rescue/recovery workers) are universally   present at man-made and natural disasters and share experiences   and exposures with victims. Little is known of their   disaster-related health outcomes. METHODS: We studied 4974 adult   volunteers who completed the World Trade Center Health Registry   2006-07 survey to examine associations between volunteer type   (affiliated vs. lay) and probable posttraumatic stress disorder   (PTSD); new or worsening respiratory symptoms; post-9/11 first   diagnosis of anxiety disorder, depression, and/or PTSD; and   asthma or reactive airway dysfunction syndrome (RADS). Affiliated   volunteers reported membership in a recognized organization. Lay   volunteers reported no organizational affiliation and occupations   unrelated to rescue/recovery work. Adjusted odds ratios (OR(adj))   were calculated using multinomial regression. RESULTS: Lay   volunteers were more likely than affiliated volunteers to have   been present in lower Manhattan, experience the dust cloud,   horrific events and injury on 9/11 and subsequently to report   unmet healthcare needs. They had greater odds of early post-9/11   mental health diagnosis (OR(adj) 1.6; 95% CI: 1.4-2.0) and   asthma/RADS (1.8; 1.2-2.7), chronic PTSD (2.2; 1.7-2.8),   late-onset PTSD (1.9; 1.5-2.5), and new or worsening lower   respiratory symptoms (2.0; 1.8-2.4). CONCLUSIONS: Lay volunteers'   poorer health outcomes reflect earlier, more intense exposure to   and lack of protection from physical and psychological hazards.   There is a need to limit volunteers' exposures during and after   disasters, as well as to provide timely screening and health care   post-disaster.

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