Persistent mental and physical health impact of exposure to the September 11, 2001 World Trade Center terrorist attacks

Jordan, Hannah T.; Osahan, Sukhminder; Li, Jiehui; Stein, Cheryl R.; Friedman, Stephen M.; Brackbill, Robert M.; Cone, James E.; Gwynn, Charon; Mok, Ho Ki; Farfel, Mark R.

doi:10.1186/s12940-019-0449-7

Environmental Health

Table 1 Prevalence of asthma and gastroesophageal reflux disease (GERD) among adult World Trade Center Health Registry enrollees in 2015–16

From: Persistent mental and physical health impact of exposure to the September 11, 2001 World Trade Center terrorist attacks

		Asthma						GERD
	Adult W4 participants	Lifetime prevalence ^a	Participants without pre-9/11 asthma	Newly diagnosed asthma since 9/11^c		Persistent LRS among those with post-9/11 asthma ^d		Age adjusted lifetime prevalence ^e	Participants without pre-9/11 GERD diagnosis	Newly diagnosed GERD since 9/11^f		Frequent GERS among those with post-9/11 GERD ^g
Characteristic	N	% (age adjusted) ^b	N	N	% (age adjusted) ^b	N	%	% (age adjusted) ^b	N	N	% (age adjusted) ^b	N	%
Overall	35,897	25.4 (24.7)	31,951	4556	15.4 (14.3)	3318	76.5	25.5 (24.2)	34,552	7119	22.3 (20.7)	5068	72.7
Sex
Male	21,861	22.9	19,885	2674	14.6	2088	81.2	26.5	21,095	4595	23.6	3353	74.4
Female	14,036	29.3	12,066	1882	16.8	1230	69.6	23.9	13,457	2524	20.4	1715	69.7
Age on 9/11
18–24	1775	26.6	1485	168	11.7	95	58.6	12.1	1750	181	10.8	131	72.4
25–44	18,830	26.1	16,748	2576	16.3	1831	74.8	24.9	18,285	3870	22.5	2822	74.1
45–64	14,412	24.5	12,920	1739	14.9	1338	80.7	28.1	13,687	2945	23.9	2043	71.3
65+	880	20.7	798	73	11.0	54	79.4	23.9	830	123	18.2	72	62.1
Race/ethnicity
White	25,160	23.4	22,560	2955	14.0	2096	74.6	26.1	24,123	5128	22.7	3639	72.3
Black/African American	3483	27.8	3035	445	16.1	349	81.4	21.1	3387	566	18.6	382	70.0
Hispanic/Latino	4064	34.8	3471	709	22.5	561	82.1	27.8	3947	900	25.4	684	77.8
Asian	1951	25.1	1791	266	17.3	184	72.4	19.5	1903	278	17.1	181	66.8
Other	1239	28.6	1094	181	18.2	128	78.1	26.6	1192	247	23.4	182	75.5
Education (at Wave 1)
Less than high school	7450	27.8	6704	1132	18.8	933	86.1	30.0	7206	1763	27.3	1313	77.3
At least some college	8821	27.1	7891	1301	17.8	1034	83.1	29.7	8505	2110	26.9	1560	75.3
College or higher	19,347	23.7	17,105	2084	13.0	1319	66.8	22.0	18,572	3199	18.5	2162	68.6
Income (at W1)
Less than $25,000	2681	32.4	2343	441	21.3	337	82.4	24.2	2609	494	21.8	370	78.7
$25,000 - $74,999	13,408	26.6	11,901	1820	16.6	1346	77.5	25.7	12,908	2673	22.5	1921	73.4
$75,000 - $150,000	12,303	24.5	11,057	1594	15.4	1157	75.6	27.4	11,842	2711	24.4	1937	72.8
$150,000 or more	4048	21.0	3556	314	9.4	196	66.4	20.4	3882	614	16.8	417	68.7
Smoking status (wave 1)
Never	20,375	25.4	18,107	2565	15.3	1782	73.6	24.1	19,711	3881	21.3	2746	72.1
Former	10,270	25.4	9148	1296	15.4	973	78.2	28.3	9768	2177	24.3	1532	72.2
Current	5022	25.2	4497	659	15.8	537	83.9	25.6	4854	1020	22.8	761	76.2
Self identified
Yes	26,806	27.2	23,749	3772	17.1	2744	76.4	27.4	25,770	5782	24.3	4163	73.4
No	9091	19.9	8202	784	10.4	574	76.8	19.8	8782	1337	16.7	905	69.6
Registry eligibility group
Rescue/recovery worker	16,898	26.2	15,327	2579	18.1	2016	81.6	30.9	16,324	4290	28.3	3153	75.1
Lower Manhattan area resident	4847	24.7	4255	511	13.2	327	68.3	19.7	4680	701	16.5	462	67.3
Lower Manhattan area worker/student	12,517	24.1	10,964	1264	12.5	843	70.4	20.7	11,987	1862	16.9	1265	69.5
Passerby	1400	28.5	1202	175	15.8	116	70.3	21.3	1338	214	17.3	152	71.7
Dust cloud exposure
Yes	18,677	27.8	16,526	2683	17.6	2008	78.1	27.4	17,974	4006	24.3	2917	74.4
No	17,070	22.7	15,298	1860	13.1	1298	74.0	23.5	16,433	3090	20.3	2134	70.6
Rescue/recovery workers and volunteers
Duration of R/R work
1–7 days	5800	25.0	5120	680	14.3	482	74.6	25.5	5576	1152	22.3	806	71.7
8–30 days	5155	24.6	4740	781	17.6	614	82.1	31.9	4969	1356	29.1	1007	75.6
31–90 days	2799	28.9	2586	542	22.6	446	85.1	37.2	2730	906	35.5	679	76.4
>90 days	2523	30.1	2336	517	24.0	430	86.2	35.5	2456	756	33.6	582	78.7
Date of arrival for R/R work
9/11 on pile	2536	33.7	2400	666	29.7	567	88.3	48.8	2467	1100	47.3	865	79.7
9/11, other site	2371	28.9	2120	391	19.8	313	82.6	31.8	2297	626	29.4	457	74.3
9/12–9/17	6671	26.1	6049	1006	17.9	773	80.0	30.7	6468	1696	28.3	1248	75.7
9/18 or later	4702	21.3	4215	454	11.6	317	74.1	21.8	4501	752	18.0	508	68.7

GERD gastroesophageal reflux disease
GERS gastroesophageal reflux symptoms
LRS lower respiratory symptoms
^aProportion of adult W4 participants who reported clinician-diagnosed asthma at Wave 1 or 4
^bAge adjusted to the 2010 United States Census
^cAsthma diagnosed after 9/11/2001 reported at Wave 1 or 4. Denominator is number of participants without pre-9/11 asthma
^dPersistent LRS defined as cough, wheeze, or shortness of breath for at least 8 of the 30 days preceding Wave 4 completion, or use of a prescription inhaler
^eProportion of adult W4 participants who reported clinician-diagnosed GERD at Wave 4
^fGERD diagnosed in 2002 or later as reported on Wave 4. Denominator is number of participants without pre-9/11 GERD
^gFrequent GERS at Wave 4 defined as heartburn or acid reflux reported at least weekly during the year before survey completion

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ISSN: 1476-069X

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