Steven Stellman - Risk factors for and consequences of persistent lower respiratory symptoms among World Trade Center Health Registrants 10 years after the disaster

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      Friedman, S. M., Farfel, M. R., Maslow, C., Jordan, H. T., Li,   J., Alper, H., Cone, J. E., Stellman, S. D., Brackbill, R. M.   73 (10) 676-84-

      Abstract: OBJECTIVES: The prevalence of   persistent lower respiratory symptoms (LRS) among rescue/recovery   workers, local area workers, residents and passers-by in the   World Trade Center Health Registry (WTCHR) was analysed to   identify associated factors and to measure its effect on quality   of life (QoL) 10 years after 9/11/2001. METHODS: This   cross-sectional study included 18 913 adults who completed 3   WTCHR surveys (2003-2004 (Wave 1 (W1)), 2006-2007 (Wave 2 (W2))   and 2011-2012 (Wave 3 (W3)). LRS were defined as self-reported   cough, wheeze, dyspnoea or inhaler use in the 30 days before   survey. The prevalence of three LRS outcomes: LRS at W1; LRS at   W1 and W2; and LRS at W1, W2 and W3 (persistent LRS) was compared   with no LRS on WTC exposure and probable mental health conditions   determined by standard screening tests. Diminished physical and   mental health QoL measures were examined as potential LRS   outcomes, using multivariable logistic and Poisson regression.   RESULTS: Of the 4 outcomes, persistent LRS was reported by 14.7%.   Adjusted ORs for disaster exposure, probable post-traumatic   stress disorder (PTSD) at W2, lacking college education and   obesity were incrementally higher moving from LRS at W1, LRS at   W1 and W2 to persistent LRS. Half of those with persistent LRS   were comorbid for probable PTSD, depression or generalised   anxiety disorder. Enrollees with persistent LRS were 3 times more   likely to report poor physical health and approximately 50% more   likely to report poor mental health than the no LRS group.   CONCLUSIONS: LRS, accompanied by mental health conditions and   decreased QoL, have persisted for at least 10 years after   9/11/2001. Affected adults require continuing surveillance and   treatment.

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