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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 and James Cone
Additional contact information
Stephen M. Friedman: World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York, NY 11101, USA
Howard Alper: World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York, NY 11101, USA
Rafael E. de la Hoz: Division of Occupational Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
Sukhminder Osahan: World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York, NY 11101, USA
Mark R. Farfel: World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York, NY 11101, USA
James Cone: World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, Long Island City, New York, NY 11101, USA

IJERPH, 2022, vol. 19, issue 13, 1-14

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: World Trade Center Health Registry; disaster; asthma; ACT; PTSD; quality of life (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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