Abstract
Fifteen years after the disaster, the World Trade Center Health Registry (Registry) conducted The Health and Quality of Life Survey (HQoL) assessing physical and mental health status among those who reported sustaining an injury on 11 September 2001 compared with non-injured persons. Summary scores derived from the Short Form-12 served as study outcomes. United States (US) population estimates on the Physical Component Score (PCS-12) and Mental Component Score (MCS-12) were compared with scores from the HQoL and were stratified by Post-traumatic Stress Disorder (PTSD) and injury status. Linear regression models were used to estimate the association between both injury severity and PTSD and PCS-12 and MCS-12 scores. Level of injury severity and PTSD history significantly predicted poorer physical health (mean PCS-12). There was no significant difference between injury severity level and mental health (mean MCS-12). Controlling for other factors, having PTSD symptoms after 9/11 predicted a nearly 10-point difference in mean MCS-12 compared with never having PTSD. Injury severity and PTSD showed additive effects on physical and mental health status. Injury on 9/11 and a PTSD history were each associated with long-term decrements in physical health status. Injury did not predict long-term decrements in one’s mental health status. Although it is unknown whether physical wounds of the injury healed, our results suggest that traumatic injuries appear to have a lasting negative effect on perceived physical functioning.
Highlights
The World Trade Center (WTC) disaster on 11 September 2001 exposed thousands of persons to both environmental pollutants and psychological trauma, which have had long-term physical and psychological ramifications
When the means were restricted to the ‘no injury and never posttraumatic stress disorder (PTSD)’ group, they provided an approximate comparison to population-level measures of PCS-12 and MCS-12, which were based on a United States (US)
2001 were experiencing diminished physical health 15 years after the event. To put it into context, the mean PCS-12 score for persons injured without PTSD is comparable to reported mean PCS-12 scores for those with cerebral aneurysms (39.5) or congestive heart failure (42.8) [44,45]
Summary
The World Trade Center (WTC) disaster on 11 September 2001 exposed thousands of persons to both environmental pollutants and psychological trauma, which have had long-term physical and psychological ramifications. Having been injured on 9/11 has emerged as a common risk factor for both physical and mental health conditions [1,2,3]. One study found that, among those injured on the day of the 9/11 disaster, the likelihood of having been diagnosed with a physical health condition, including respiratory disease problems (i.e., asthma, chronic bronchitis, emphysema) and/or circulatory disease (i.e., heart attack, angina, stroke) increased with the number of types of injuries they sustained (e.g., burn, head injury, and musculoskeletal) [4]. Injury on 9/11 increased the likelihood of posttraumatic stress disorder (PTSD) 2-fold to 3-fold, which was measured by a post-traumatic stress checklist (PCL) screening instrument after adjusting for demographic factors and other WTC-related exposures [2,3]. Public Health 2019, 16, 1054; doi:10.3390/ijerph16061054 www.mdpi.com/journal/ijerph
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