Steven Stellman - Effect of asthma and PTSD on persistence and onset of gastroesophageal reflux symptoms among adults exposed to the September 11, 2001, terrorist attacks

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      Li, J., Brackbill, R. M., Jordan, H. T., Cone, J. E., Farfel, M.   R., Stellman, S. D. 59 (9) 805-14-

      Abstract: BACKGROUND: Little is known about the   direction of causality among asthma, posttraumatic stress   disorder (PTSD), and onset of gastroesophageal reflux symptoms   (GERS) after exposure to the 9/11/2001 World Trade Center (WTC)   disaster. METHODS: Using data from the WTC Health Registry, we   investigated the effects of early diagnosed post-9/11 asthma and   PTSD on the late onset and persistence of GERS using log-binomial   regression, and examined whether PTSD mediated the asthma-GERS   association using structural equation modeling. RESULTS: Of   29,406 enrollees, 23% reported GERS at follow-up in 2011-2012.   Early post-9/11 asthma and PTSD were each independently   associated with both the persistence of GERS that was present at   baseline and the development of GERS in persons without a prior   history. PTSD mediated the association between early post-9/11   asthma and late-onset GERS. CONCLUSIONS: Clinicians should assess   patients with post-9/11 GERS for comorbid asthma and PTSD, and   plan medical care for these conditions in an integrated fashion.   Am. J. Ind. Med. 59:805-814, 2016. (c) 2016 Wiley Periodicals,   Inc.

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