Content area
Full Text
(ProQuest: ... denotes formulae and/or non-US-ASCII text omitted; see image)
Original Articles
Introduction
Responders to the World Trade Center (WTC) disaster of 11 September 2001 (9/11), particularly the men and women who were at the site on 11 September, were exposed to emotionally horrifying events and environmental toxins from multiple gases and fine airborne particulate matter from the collapse of the towers. The responders who participated in the rescue, recovery and clean-up operations included experienced workers with extensive training, such as police and firefighters, and non-traditional responders with no disaster training, such as construction workers, electricians, and transportation and utility workers (Dasaro et al. 2015). In the aftermath of the attacks, two programs were established to monitor responders' health and treat WTC-related conditions, one for police and non-traditional responders (World Trade Center Health Program; WTCHP) and one for New York City firefighters. In addition, the New York City Department of Health established the WTC Health Registry to track the health and well-being of individuals directly exposed to the collapse of the towers or its immediate aftermath.
All three programs obtained serial data on post-traumatic stress symptoms from the PTSD Checklist (PCL) (Blanchard et al. 1996). During the first decade after 9/11, 5-23% of responders had PCL scores suggestive of possible post-traumatic stress disorder (PTSD) (Liu et al. 2014), with higher rates among non-traditional compared with professional responders (Perrin et al. 2007; Ozbay et al. 2013). Trajectory analyses for responders who made three monitoring visits to the WTCHP found that 5.3% of police and 9.5% of non-traditional responders had chronically elevated symptoms, and 8.4% and 12.4%, respectively, experienced a reduction in symptom severity (Pietrzak et al. 2014). A recent analysis of responders in the WTC Health Registry found that half of police responders with probable PTSD in the first few years after 9/11 continued to have probable PTSD at 10-11 year follow-up (Cone et al. 2015).
WTC exposures, particularly being in the dust cloud and death of colleagues, were significantly associated with self-report PTSD symptoms (e.g. Perrin et al. 2007; Yip et al. 2015) independent of demographic and other risk factors (Friedman et al. 2013). In addition, consistent with the broader literature (O'Toole & Catts, 2008; McFarlane, 2010; Pacella et al. 2013), PTSD symptom severity...