ArticlemedRxiv : the preprint server for health sciences2026
Urban Exposures, Frailty, and Mental Illness in World Trade Center Health Program Responders.
Article in medRxiv : the preprint server for health sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Importance: General responders of the World Trade Center (WTC) Health Program (WTCHP), who were uniquely exposed to chemical toxicants and extreme psychological stress during the 2001 terrorist attack, now experience a wide range of unusually prevalent health outcomes for a mid-aged population, including frailty, Post Traumatic Stress Disorder (PTSD), and depression. Objective: We investigated whether these outcomes are associated with urban environmental exposures experienced in the two decades post 9/11. Design: Prospective cohort study. Setting: WTCHP general responders' cohort. Participants: We included 18,861 WTCHP general responders between the years 2003 to 2023 who took part in rescue, recovery, and clean-up tasks following the 9/11/2001 attack on the WTC. Exposures: We evaluated the distinct and combined associations with annual fine particulate matter (PM Outcomes: We assessed frailty using a validated index developed specifically for the WTCHP. We determined PTSD and depression status based on repeated test scores from validated tools administered during the monitoring visits. Results: We included 18,861 responders, 81.89% were males, and the mean age at entry was 47. Interquartile range increases in PM Conclusion and relevance: Exposures to heat and PM
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