World Trade Center Emergency Workers At High Risk Of Health Conditions

Dr Mayris P Webber Dr.PH. MPH Bureau of Health Services Fire Department of the City of New York Brooklyn, NY Professor of Clinical Epidemiology & Population Health Montefiore Medical Center NYMedicalResearch.com Interview with:
Dr Mayris P Webber Dr.PH. MPH

Bureau of Health Services Fire Department of the City of New York Brooklyn, NY
Professor of Clinical Epidemiology & Population Health
Montefiore Medical Center NY

Medical Research: What is the background for this study? What are the main findings?

Dr. Webber:

  • To date, we and others have found adverse health outcomes associated with World Trade Center (WTC)  exposure among New York City’s first responders such as firefighters, police officers, and other rescue and recovery workers. We conducted the first study to concentrate on the health impact of the disaster on emergency medical service (EMS) workers.
  • In keeping with previous research on WTC’s first responders, we found that the WTC attacks adversely affected the physical and mental health of approximately 2,000 New York City Fire Department (FDNY) EMS who performed rescue and recovery work at the site.
  • We analyzed selected physical and mental health conditions that have been certified as being linked to the aftermath of the WTC attacks under the James Zadroga 9/11 Health and Compensation Act of 2010.
  • Over a 12 year period, between September 11 2001 and December 31 2013, the proportion of newly diagnosed cases of gastroesophageal reflux disease (GERD) was 12.1%; obstructive airways disease (OAD) 11.8%; rhinosinusitis 10.6%; and cancer 3.1%.
  • In their most recent mental health survey, nearly 17% of EMS workers reported symptoms consistent with depression; 7% with post-traumatic stress disorder (PTSD); and 3% with harmful alcohol use.
  • Compared with EMS workers who did not work at the WTC site, EMS workers who worked at the WTC site in the morning of 9/11 (i.e., most intensely exposed) were at greatest risk for nearly all of the health conditions analyzed.
  • For example, they were almost four times as likely to have GERD and rhinosinusitis, seven times as likely to have probable PTSD, and twice as likely to have probable depression. (We use the term probable because we used screening questionnaires instead of professional diagnoses for these mental health conditions).

Medical Research: What should clinicians and patients take away from your report?

Dr. Webber:

  • We hope to provide both clinicians and patients more information on the link between World Trade Center exposure and certain health outcomes.
  • FDNY EMS workers, and other individuals who were exposed to the WTC disaster, are currently at high risk for developing certain health conditions. We highlight the importance of continued medical monitoring and treatment of FDNY EMS workers, and indeed, of other responders and individuals who were affected by the WTC disaster.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Webber:

  • Cancer is an area of ongoing concern. Although we did not find an association between cancer and World Trade Center exposure in this study, we probably lacked statistical power to find an association because the number of cases was low.  Further, the time period since 9/11 was short for many cancer outcomes. We plan to examine this association in future studies.
  • Additionally, we found that compared with FDNY EMS workers who never worked at the site, those who arrived in the  morning of 9/11 (i.e., most intensely exposed) were seven times as likely to have symptoms consistent with PTSD and twice as likely to have depression. Given such a high risk found in our study’s EMS population, the longitudinal course of these conditions over time may be an important area of research.

Citation:

World Trade Center-related physical and mental health burden among New York City Fire Department emergency medical service workers

Jennifer Yip, Rachel Zeig-Owens, Mayris P Webber, Andrea Kablanian, Charles B Hall, Madeline Vossbrinck, Xiaoxue Liu, Jessica Weakley, Theresa Schwartz, Kerry J Kelly, David J Prezant

Occup Environ Med oemed-2014-102601Published Online First: 15 April 2015 doi:10.1136/oemed-2014-102601

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MedicalResearch.com Interview with: Dr Mayris P Webber Dr.PH. MPH (2015). World Trade Center Emergency Workers At High Risk Of Health Conditions

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