Steven Stellman - Respiratory health of 985 children exposed to the World Trade Center disaster: report on world trade center health registry wave 2 follow-up, 2007-2008

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      Stellman, S. D., Thomas, P. A., S, S. Osahan, Brackbill, R. M.,   Farfel, M. R. 50 (4) 354-63-

      Abstract: BACKGROUND: The World Trade Center   (WTC) disaster of September 11, 2001, has been associated with   early respiratory problems including asthma in workers,   residents, and children. Studies on adults have documented   persistence of longer term, 9/11-related respiratory symptoms.   There are no comparable reports on children. METHODS: We surveyed   985 children aged 5-17 years who enrolled in the WTC Health   Registry in 2003-04, and who were re-surveyed in 2007-08. Health   data were provided by parents in both surveys and focused on   respiratory symptoms suggestive of reactive airway impairment   (wheezing or the combination of cough and shortness of breath) in   the preceding 12 months. At follow-up, adolescents aged 11-17   years completed separate surveys that screened for post-traumatic   stress symptoms and behavior problems (Strengths and Difficulties   Questionnaire, SDQ). Associations between respiratory symptoms in   the prior 12 months with 9/11 exposures and behavioral outcomes   were evaluated with univariate and multivariate methods. RESULTS:   Of the 985 children, 142 (14.4%) children reported respiratory   symptoms in the prior 12 months; 105 (73.9%) children with   respiratory symptoms had previously been diagnosed with asthma.   Among children aged 5-10 years, respiratory symptoms were   significantly elevated among African-Americans (adjusted odds   ratio, (aOR) 3.8; 95% confidence interval (CI) 1.2-11.5) and   those with household income below $75,000 (aOR 1.9; CI 1.0-3.7),   and was more than twice as great in children with dust cloud   exposure (aOR 2.2; CI 1.2-3.9). Among adolescents aged 11-17   years, respiratory symptoms were significantly associated with   household income below $75,000 (aOR 2.4; CI 1.2-4.6), and with a   borderline or abnormal SDQ score (aOR 2.7, 95% CI 1.4-5.2).   Symptoms were reported more than twice as often by adolescents   with vs. without dust cloud exposure (24.8% vs. 11.5%) but the   adjusted odds ratio was not statistically significant (aOR 1.7;   CI 0.9-3.2), CONCLUSIONS: Most Registry children exposed to the   9/11 disaster in New York City reported few respiratory problems.   Respiratory symptoms were associated with 9/11 exposures in   younger children and with behavioral difficulties in adolescents.   Our findings support the need for continued surveillance of 9/11   affected children as they reach adolescence and young adulthood,   and for awareness of both physical and behavioral difficulties by   treating clinicians.

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