Steven Stellman - Gastroesophageal reflux symptoms and comorbid asthma and posttraumatic stress disorder following the 9/11 terrorist attacks on World Trade Center in New York City

Version 1

      Publication Details (including relevant citation   information):

      Li, J., Brackbill, R. M., Stellman, S. D., Farfel, M. R.,   Miller-Archie, S. A., Friedman, S., Walker, D. J., Thorpe, L. E.,   Cone, J. 106 (11) 1933-41-

      Abstract: OBJECTIVES: Excess gastroesophageal   reflux disease (GERD) was reported in several populations exposed   to the September 11 2001 (9/11) terrorist attacks on the World   Trade Center (WTC). We examined new onset gastroesophageal reflux   symptoms (GERS) since 9/11 and persisting up to 5-6 years in   relation to 9/11-related exposures among the WTC Health Registry   enrollees, and potential associations with comorbid asthma and   posttraumatic stress disorder (PTSD). METHODS: This is a   retrospective analysis of 37,118 adult enrollees (i.e.,   rescue/recovery workers, local residents, area workers, and   passersby in lower Manhattan on 9/11) who reported no pre-9/11   GERS and who participated in two Registry surveys 2-3 and 5-6   years after 9/11. Post-9/11 GERS (new onset since 9/11) reported   at first survey, and persistent GERS (post-9/11 GERS reported at   both surveys) were analyzed using log-binomial regression.   RESULTS: Cumulative incidence was 20% for post-9/11 GERS and 13%   for persistent GERS. Persistent GERS occurred more often among   those with comorbid PTSD (24%), asthma (13%), or both (36%)   compared with neither of the comorbid conditions (8%). Among   enrollees with neither asthma nor PTSD, the adjusted risk ratio   (aRR) for persistent GERS was elevated among: workers arriving at   the WTC pile on 9/11 (aRR=1.6; 95% confidence interval (CI)   1.3-2.1) or working at the WTC site > 90 days (aRR=1.6;   1.4-2.0); residents exposed to the intense dust cloud on 9/11   (aRR=1.5; 1.0-2.3), or who did not evacuate their homes (aRR=1.7;   1.2-2.3); and area workers exposed to the intense dust cloud   (aRR=1.5; 1.2-1.8). CONCLUSIONS: Disaster-related environmental   exposures may contribute to the development of GERS. GERS may be   accentuated in the presence of asthma or PTSD.

      Address (URL):