September 11 leaves legacy of chronic ill health among US emergency medical workersBMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h2032 (Published 17 April 2015) Cite this as: BMJ 2015;350:h2032
The September 11 attacks on the World Trade Center in 2001 have left a legacy of chronic ill health among emergency medical workers who attended the scene, a study reported in Occupational and Environmental Medicine has shown.1
The researchers, all from health services around New York City, found that those who arrived in the immediate aftermath of the attacks were most at risk of physical and mental ailments. Previous research has looked at the health effects of the disaster on firefighters and police officers, but none has looked specifically at emergency medical workers, such as paramedics and emergency medical technicians.
To fill this gap the researchers examined the medical records of 2281 of the New York City Fire Department’s emergency medical workers deployed to the scene of the attacks, from the date of the incident to the end of December 2013.
During that time the cumulative incidence of acid reflux disease (GERD) was just over 12%, while that of obstructive airways disease (OAD), including bronchitis and emphysema, was just under 12%. The cumulative incidences of rhinosinusitis and cancer were 10.6% and 3.1%, respectively.
Validated screening tests were used to gauge the prevalence of mental health conditions: the prevalence was 16.7% for probable depression, 7.0% for probable post-traumatic stress disorder (PTSD), and 3.0% for probable harmful alcohol use.
Women were more likely than men to have rhinosinusitis (17% v 8.9%; P<0.0001), GERD (17.9% v 10.5%), OAD (20.3% v 9.5%), probable PTSD (10.4% v 6.1%), and probable depression (23.5% v 14.8%).
Compared with the workers who did not attend the aftermath of the World Trade Center attacks, those who arrived earliest on the scene were at greatest risk for nearly all of the health conditions studied. For example, they were almost four times more likely to have acid reflux and rhinosinusitis (adjusted relative risk 3.7 (95% confidence interval 2.2 to 6.0)), seven times more likely to have probable PTSD (7.0 (3.6 to 13.5)), and twice as likely to have probable depression (2.3 (1.6 to 3.1)).
The degree of ill health among emergency medical workers attending the scene was generally lower than that of a demographically similar group of New York City firefighters, probably because of the differences in tasks they performed at the World Trade Center site, the researchers said.
They concluded that the findings of a substantial amount of ill health underscore the need for continued monitoring and treatment of emergency medical workers who helped the victims of the attacks.
Cite this as: BMJ 2015;350:h2032
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