Attack on World Trade Center Causing New Mental and Physical Health Problems, Study Shows
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Reviewed By Brunilda Nazario, MD
The Sept. 11, 2001, attack that killed thousands and exposed hundreds of thousands to horrific images and potentially dangerous dust is still wreaking havoc on peoples' mental and physical health, researchers say in the Aug. 5 issue of the Journal of the American Medical Association.
The data come from the World Trade Center Health Registry, which follows enrollees who reported a range of disaster-associated exposures on 9/11.
Based on survey results, the researchers estimate that potentially 25,500 directly exposed adults have experienced asthma since the attack and 61,000 have suffered traumatic stress as a result of the attack.
In the registry, 71,000 adults were surveyed in 2003-2004. Adults were enrolled in the following groups: rescue-recovery workers, lower Manhattan residents, lower Manhattan office workers, and passersby.
Sixty-eight percent, or 46,000 adults, participated again in a 2006-2007 follow-up survey about symptoms of asthma and signs of posttraumatic stress. Less than half of the respondents completed the questionnaires.
Some of the study's findings:
- Of the participants with no history of asthma, 10% reported a new asthma diagnosis during the follow-up survey.
- Intense dust cloud exposure was associated with an increased risk of asthma for all of the groups. Of those with a new diagnosis of asthma, 19% reported intense dust exposure vs. about 10% without exposure.
- Risk for asthma was highest among rescue-recovery workers on the debris pile the day of the attack.
- Residents who did not evacuate reported higher asthma rates than those who did.
Posttraumatic Stress Disorder After Sept. 11
Asthma wasn't the only the lingering health effect of 9/11. The number of people with symptoms of posttraumatic stress disorder (PTSD) -- the mental health illness most often associated with wartime trauma -- also increased five to six years after the attack. Of participants with no PTSD history, 24% reported PTS symptoms at the initial evaluation (14%) or during the follow-up (19%).The greatest increase was in rescue-recovery workers.
- Passersby had the highest levels of symptoms when surveyed during the second phase of the study at 23%, and residents the lowest at 16%.
- Loss of a spouse related to the attack also was associated with symptoms of traumatic stress.
"Our findings confirm that, after a terrorist attack, mental health conditions can persist if not identified and adequately treated and that a substantial number of exposed persons may develop late-onset symptoms," the authors write.
"Our study highlights the need for surveillance, outreach, treatment, and evaluation of efforts for many years following a disaster to prevent and mitigate health consequences."
SOURCES: Brackbill, R. Journal of the American Medical Association, Aug. 5, 2009; manuscript received ahead of print. News release, Journal of the American Medical Association.
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