ArticlePsychological medicine2012
Exposure, probable PTSD and lower respiratory illness among World Trade Center rescue, recovery and clean-up workers.
Article in Psychological medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 4 of them syntheses that pooled it.
What it found
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The trial behind it
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Who cites it
40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 106 citations in OpenAlex.
- Altered gene expression and PTSD symptom dimensions in World Trade Center responders.Molecular psychiatry · 2022Pooled it
- Occupational post-traumatic stress disorder: an updated systematic review.BMC public health · 2020Pooled it
- Social and occupational factors associated with psychological distress and disorder among disaster responders: a systematic review.BMC psychology · 2016Pooled it
- World Trade Center disaster exposure-related probable posttraumatic stress disorder among responders and civilians: a meta-analysis.PloS one · 2014Pooled it
- Toward multimodal MRI biomarkers of PTSD: functional and structural connectivity signatures in WTC responders.medRxiv : the preprint server for health sciences · 2026Article
- Work Disability, Early Retirement, and Loss of a Loved One in the World Trade Center Health Registry Cohort.American journal of industrial medicine · 2026Article
- The long shadow of 9/11: Mental health outcomes in adult children of World Trade Center Responders with PTSD.PLOS mental health · 2026Article
- MRI signature of brain age underlying post-traumatic stress disorder in World Trade Center responders.Translational psychiatry · 2025Article
- Lung Cancer Incidence After September 11, 2001, Among World Trade Center Responders.JAMA network open · 2025Article
- Exposure duration and cerebral amyloidosis in the olfactory cortex of World Trade Center responders: A positron emission tomography and magnetic resonance imaging study.Journal of Alzheimer's disease : JAD · 2025Article
- Cross-sectional association between posttraumatic stress and cognition is moderated by pulmonary functioning in world trade center responders.American journal of industrial medicine · 2024Article
- (Fire)fighting the pandemic: PTSD and depression symptom profiles and longitudinal correlates.European journal of psychotraumatology · 2024Article
- Functional changes in neural mechanisms underlying post-traumatic stress disorder in World Trade Center responders.Translational psychiatry · 2023Article
- Glial suppression and post-traumatic stress disorder: A cross-sectional study of 1,520 world trade center responders.Brain, behavior, & immunity - health · 2023Article
- Impact of the 7/14/2016 Nice terrorist attack on pediatric emergency department visits thanks to syndromic surveillance: a descriptive study.Frontiers in public health · 2023Article
- Posttraumatic Stress Disorder Mediates the Association between Traumatic World Trade Center Dust Cloud Exposure and Ongoing Systemic Inflammation in Community Members.International journal of environmental research and public health · 2022Article
- The Impact of World Trade Center Related Medical Conditions on the Severity of COVID-19 Disease and Its Long-Term Sequelae.International journal of environmental research and public health · 2022Article
- Investigating the impact of terrorist attacks on the mental health of emergency responders: systematic review.BJPsych open · 2022Review
- The Association Between Body Mass Index and Anxious Arousal, Depressive, and Insomnia Symptoms Among World Trade Center Responders.Health behavior research · 2022Article
- Cortical complexity in world trade center responders with chronic posttraumatic stress disorder.Translational psychiatry · 2021Article
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundThousands of rescue and recovery workers descended on the World Trade Center (WTC) in the wake of the terrorist attack of September 11, 2001 (9/11). Recent studies show that respiratory illness and post-traumatic stress disorder (PTSD) are the hallmark health problems, but relationships between them are poorly understood. The current study examined this link and evaluated contributions of WTC exposures.
methodParticipants were 8508 police and 12 333 non-traditional responders examined at the WTC Medical Monitoring and Treatment Program (WTC-MMTP), a clinic network in the New York area established by the National Institute for Occupational Safety and Health (NIOSH). We used structural equation modeling (SEM) to explore patterns of association among exposures, other risk factors, probable WTC-related PTSD [based on the PTSD Checklist (PCL)], physician-assessed respiratory symptoms arising after 9/11 and present at examination, and abnormal pulmonary functioning defined by low forced vital capacity (FVC).
resultsFewer police than non-traditional responders had probable PTSD (5.9% v. 23.0%) and respiratory symptoms (22.5% v. 28.4%), whereas pulmonary function was similar. PTSD and respiratory symptoms were moderately correlated (r=0.28 for police and 0.27 for non-traditional responders). Exposure was more strongly associated with respiratory symptoms than with PTSD or lung function. The SEM model that best fit the data in both groups suggested that PTSD statistically mediated the association of exposure with respiratory symptoms.
conclusionsAlthough longitudinal data are needed to confirm the mediation hypothesis, the link between PTSD and respiratory symptoms is noteworthy and calls for further investigation. The findings also support the value of integrated medical and psychiatric treatment for disaster responders.
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Registered trials
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