Persistent Respiratory Symptoms Are A Risk Factor For Mental Health Symptoms In Residents And Workers Exposed To World Trade Center Dust, Gas And Fumes Presenting For Medical Care

Numerous studies report elevated levels of chronic mental health conditions in those exposed to the World Trade Center attacks of 11 September 2001 (9/11), but few studies have examined the incidence of confusion or memory loss (CML) or its association with mental health in 9/11 attack survivors. We investigated the incidence of CML and its association with the number of post-9/11 mental health conditions (PTSD, depression, and anxiety) in 10,766 World Trade Center Health Registry (Registry) enrollees aged 35–64 at the time of the wave 4 survey (2015–2016) that completed all four-wave surveys and met the study inclusion criteria. We employed log-binomial regression to evaluate the associations between CML and the number of mental health conditions. A total of 20.2% of enrollees in the sample reported CML, and there was a dose-response relationship between CML and the number of mental health conditions (one condition: RR = 1.85, 95% CI (1.65, 2.09); two conditions: RR = 2.13, 95% CI (1.85, 2.45); three conditions: RR = 2.51, 95% CI (2.17, 2.91)). Survivors may be experiencing confusion or memory loss partly due to the mental health consequences of the 9/11 attacks. Clinicians treating patients with mental health conditions should be aware of potential cognitive impairment.

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An Overview of 9/11 Experiences and Respiratory and Mental Health Conditions among World Trade Center Health Registry Enrollees

Journal of Urban Health ◽

10.1007/s11524-008-9317-4 ◽

2008 ◽

Vol 85 (6) ◽

pp. 880-909 ◽

Cited By ~ 159

Author(s):

Mark Farfel ◽

Laura DiGrande ◽

Robert Brackbill ◽

Angela Prann ◽

James Cone ◽

...

Keyword(s):

Mental Health ◽

World Trade ◽

World Trade Center ◽

Health Conditions ◽

Mental Health Conditions ◽

Trade Center ◽

Health Registry

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Characterizing Mental Health Treatment Utilization among Individuals Exposed to the 2001 World Trade Center Terrorist Attacks 14–15 Years Post-Disaster

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16040626 ◽

2019 ◽

Vol 16 (4) ◽

pp. 626 ◽

Cited By ~ 3

Author(s):

Melanie H. Jacobson ◽

Christina Norman ◽

Pablo Sadler ◽

Lysa J. Petrsoric ◽

Robert M. Brackbill

Keyword(s):

Mental Health ◽

Mental Health Treatment ◽

World Trade ◽

World Trade Center ◽

Traumatic Experiences ◽

Treatment Utilization ◽

Health Treatment ◽

Trade Center ◽

Post Disaster ◽

Wtc Attacks

Following the World Trade Center (WTC) attacks in New York City (NYC) on 11 September 2001 (9/11), thousands in NYC experienced significant stress reactions and disorders, presenting an immediate need for counseling and treatment. While other studies documented post-9/11 mental health treatment utilization, none have data more than two years post-disaster. We used data from 35,629 enrollees of the WTC Health Registry, a longitudinal cohort study of those exposed to the WTC attacks, to examine predictors of counseling after 9/11, the types of practitioners seen, and the perceived helpfulness of therapy up to 15 years post-disaster. Among enrollees, 37.7% reported receiving counseling at some time after 9/11. Predictors of seeking counseling included race/ethnicity, age at 9/11, education level, exposure to the WTC attacks, other traumatic experiences, mental health symptomology, and pre-9/11 counseling. Whites and Hispanics, those who were children on 9/11, and those with high levels of exposure to the WTC attacks sought counseling soonest after 9/11. Among those who sought counseling, Blacks, Asians, and those with lower education and income were less likely to see mental health specialists and more likely to see general practitioners or religious advisors. Finally, among those who sought recent counseling, women, Blacks, those aged ≥65 years, and those with very high WTC exposures were more likely to rate their recent counseling as very helpful. This study used data up to 15 years post-disaster to document mental health treatment utilization patterns, trends, and disparities that have implications for future preparedness plans and needs assessments.

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4088 Longitudinal Assessment of Metabolic Syndrome as a Modifiable Risk factor of World Trade Center Particulate Matter Exposure Associated Lung Disease

Journal of Clinical and Translational Science ◽

10.1017/cts.2020.180 ◽

2020 ◽

Vol 4 (s1) ◽

pp. 49-50

Author(s):

Sophia Kwon ◽

Myeonggyun Lee ◽

Theresa Schwartz ◽

Rachel Zeig-Owens ◽

David Prezant ◽

...

Keyword(s):

Metabolic Syndrome ◽

Risk Factor ◽

Effect Size ◽

World Trade ◽

World Trade Center ◽

Time Dependent ◽

Mixed Effect ◽

High Exposure ◽

Single Index ◽

Trade Center

OBJECTIVES/GOALS: Metabolic syndrome (MetSyn) is a risk for World Trade Center-Lung Injury (WTC-LI; defined as developing FEV1<lower limit of normal [LLN]). Metabolic health is a modifiable disease risk factor. We propose to characterize how time-dependent covariates of MetSyn are longitudinally associated with WTC-LI. METHODS/STUDY POPULATION: WTC-particulate exposed firefighters, consented, with pre-9/11 FEV1 LLN (N = 5,746). Data assessed from last pre-9/11 till August 1, 2017. Longitudinal MetSyn characteristics were assessed using 3 models: i. A linear mixed effect model to assess the effect size of longitudinal MetSyn and its components on longitudinal FEV1% predicted as an outcome; ii. a time-dependent Cox regression to assess the associations of MetSyn to time of onset of WTC-LI; iii. a novel, partially linear single index regression model with repeatedly measured MetSyn to assess their joint effects and delineate their relative contribution on the longitudinal lung function in the WTC-FDNY cohort. RESULTS/ANTICIPATED RESULTS: In Model I, BMI 30 kg/m2 had the largest effect size compared to ever-smoking, with −2.524 (95%CI: −2.708,−2.340) compared to −1.681(−2.325,−1.038) respectively. Having MetSyn, defined as 3/5 risk factors, had an effect size of −2.319(−2.526,−2.112). In Model II, hazards of triglycerides 150mg/dL were highest at 1.497(1.336, 1.677), followed by BMI 30 kg/m2 at 1.406(1.256, 1.575), and HDL<40mg/dL 1.355(1.176-1.561), compared to ever-smoking (1.201, p = 0.002). Having high exposure to PM by being present in the morning of 9/11 was a significant covariate only in Model II investigating HDL<40mg/dL or triglycerides 150mg/dL. Model III The proposed methods will be applied to our cohort study. DISCUSSION/SIGNIFICANCE OF IMPACT: MetSyn is both a predictor and concurrent marker of WTC-LI. The single index model can not only reduce dimensionality of the covariates, but also provides efficient estimates of the joint MetSyn effects, allowing linear or nonlinear effects. Future studies will investigate dietary intervention as a potential disease-modifying factor. CONFLICT OF INTEREST DESCRIPTION: NA, nothing to disclose.

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