Change in Asthma Is Associated with Change in PTSD in World Trade Center Health Registrants, 2011 to 2016

Stephen M Friedman; Howard Alper; Rafael E de la Hoz; Sukhminder Osahan; Mark R Farfel; James Cone

doi:10.3390/ijerph19137795

Change in Asthma Is Associated with Change in PTSD in World Trade Center Health Registrants, 2011 to 2016

Int J Environ Res Public Health. 2022 Jun 25;19(13):7795. doi: 10.3390/ijerph19137795.

Authors

Stephen M Friedman¹, Howard Alper¹, Rafael E de la Hoz², Sukhminder Osahan¹, Mark R Farfel¹, James Cone¹

Affiliations

¹ World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York, NY 11101, USA.
² Division of Occupational Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.

Abstract

The WTC Health Registry (WTCHR) is a closed, longitudinal cohort of rescue/recovery workers and survivors exposed to the 11 September 2001 disaster. WTCHR enrollees diagnosed with asthma after 11 September 2001 continued to experience poor control despite treatment. Asthma is associated with mental problems, although their bidirectional movement has not been studied. This study tested whether a clinical change in mental problems was associated with a difference in asthma control, and whether a change in asthma control varied with a change in quality of life (QoL). Difference in the Asthma Control Test (ACT) on the WTCHR from 2011-12 to 2015-16 was compared with the change in the Post-traumatic Stress Disorder Checklist (PCL-17), the Patient Health Questionnaire depression scale, self-reported heartburn, and change of physical and mental QoL over this period. In adjusted multinomial multivariable logistic regression, improved PCL-17 was associated with a better ACT score, odds ratio (OR) = 1.42 (95% C.I. 1.01, 1.99), and a worsened PCL-17 score was associated with a worsened ACT score, OR = 1.77 (95% C.I. 1.26, 2.50). Decreased ACT was associated with poor physical QoL, OR = 1.97 (95% C.I. 1.48, 2.62). Change in mental health measures tracked with change in asthma control, which correlated with a change in QoL. Careful follow-up and treatment of all three are indicated to improve these inter-related issues.

Keywords: ACT; PTSD; World Trade Center Health Registry; asthma; disaster; quality of life.

Publication types

Research Support, U.S. Gov't, P.H.S.

MeSH terms

Asthma* / epidemiology
Humans
Mental Health
New York City / epidemiology
Quality of Life
Registries
September 11 Terrorist Attacks* / psychology
Stress Disorders, Post-Traumatic* / epidemiology

Grants and funding

This publication was supported by Cooperative Agreement Numbers 2U50/OH009739 and 5U50/OH009739 from the National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention (CDC); U50/ATU272750 from the Agency for Toxic Substances and Disease Registry (ATSDR), CDC, which included support from the National Center for Environmental Health, CDC; and by the New York City Department of Health and Mental Hygiene (NYC DOHMH). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIOSH-CDC.