Steven Stellman - Heart disease among adults exposed to the September 11, 2001 World Trade Center disaster: results from the World Trade Center Health Registry

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      Jordan, H. T., Miller-Archie, S. A., Cone, J. E., Morabia, A.,   Stellman, S. D. 53 (6) 370-6-

      Abstract: OBJECTIVE: To examine associations   between 9/11-related exposures, posttraumatic stress disorder   (PTSD), and subsequent development of heart disease (HD).   METHODS: We prospectively followed 39,324 WTC Health Registry   participants aged >/=18 on 9/11 for an average of 2.9 years.   HD was defined as self-reported physician-diagnosed angina, heart   attack, and/or other HD reported between study enrollment   (2003-2004) and a follow-up survey (2006-2008) in enrollees   without previous HD. A PTSD Checklist (PCL) score >/=44 was   considered PTSD. We calculated adjusted hazard ratios (AHR) and   95% confidence intervals (CI) to examine relationships between   9/11-related exposures and HD. RESULTS: We identified 1162 HD   cases (381 women, 781 men). In women, intense dust cloud exposure   was significantly associated with HD (AHR 1.28, 95% CI   1.02-1.61). Injury on 9/11 was significantly associated with HD   in women (AHR 1.46, 95% CI 1.19-1.79) and in men (AHR 1.33, 95%   CI 1.15-1.53). Participants with PTSD at enrollment had an   elevated HD risk (AHR 1.68, 95% CI 1.33-2.12 in women, AHR 1.62,   95% CI 1.34-1.96 in men). A dose-response relationship was   observed between PCL score and HD risk. CONCLUSION: This   exploratory study suggests that exposure to the WTC dust cloud,   injury on 9/11 and 9/11-related PTSD may be risk factors for HD.

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