Abstract
The World Trade Center attacks of 11 September 2001 (9/11) have been associated with the subsequent development of chronic diseases. Few studies have investigated the burden of somatic symptoms on attack victims, or the association of such symptoms with exposure to the 9/11 attacks. World Trade Center Health Registry (Registry) enrollees who were present south of Chambers Street during or immediately after the 9/11 attacks and who provided consistent answers regarding injury sustained on 9/11 were followed prospectively for up to 16 years post-9/11/01. We employed linear regression to evaluate the associations between injury severity, psychological distress and somatic symptoms in 2322 persons who completed all four Registry surveys and a subsequent Health and Quality of Life survey. Twenty-one percent of subjects had a “very high” burden of somatic symptoms, greater than in populations not exposed to a disaster. Somatic symptoms exhibited a dose-response association separately with injury severity and psychological distress trajectories. Victims of the 9/11 attacks suffer from a substantial burden of somatic symptoms which are associated with physical and psychological consequences of exposure to the attacks. Physical and mental health professionals need to work together when treating those exposed to complex disasters such as 9/11.
Highlights
The terrorist attacks on the World Trade Center (WTC) on 11 September 2001 resulted in over2800 deaths, and many thousands more injured
The goals of this study were to: (1) evaluate the prevalence of somatic symptoms among those exposed to the 11 September 2001 attacks, with comparison to other groups not exposed to a disaster, (2) estimate the association between the severity of injuries sustained on 9/11, and (3) history of non-specific psychological distress, with somatic symptoms after controlling for pre-9/11 history of physical and mental health diseases, demographics, and other risk factors
While previous Registry studies showed an association between injury, post-traumatic stress disorder (PTSD), and heart disease [6,14] out to 10–11 years post-disaster, the present study demonstrated that injury severity and psychological distress trajectories are associated with somatic symptoms measured 16 years after the 9/11 attacks
Summary
The terrorist attacks on the World Trade Center (WTC) on 11 September 2001 resulted in over2800 deaths, and many thousands more injured. The dust/debris cloud generated by the collapse of the WTC towers enveloped many survivors and responders, who may have been injured or witnessed horrific events such as seeing airplanes strike the towers. These exposures led to the development of a variety of physical and mental conditions, such as asthma [1,2,3,4,5], post-traumatic stress disorder (PTSD) [6,7,8,9], heart disease [6,10], stroke [8], and cancer [11,12]
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