World Trade Center Research Articles

Neuroimaging Resilience to Trauma in World Trade Center Rescue and Recovery Workers

Neuroimaging Resilience to Trauma in World Trade Center Rescue and Recovery Workers

Genetic Regulation of PTSD and Resilience Among World Trade Center Responders

Genetic Regulation of PTSD and Resilience Among World Trade Center Responders

PTSD Symptoms and Attachment Styles in World Trade Center Responders and Survivors: A Symptomics Approach

PTSD Symptoms and Attachment Styles in World Trade Center Responders and Survivors: A Symptomics Approach

Pathway Analysis for Plasma β-Amyloid, Tau and Neurofilament Light (ATN) in World Trade Center Responders at Midlife.

IntroductionWorld Trade Center (WTC) responders who aided in the search and rescue efforts are now at midlife, and evidence has demonstrated that many are experiencing early-onset cognitive impairment and are at risk of developing dementia, such as Alzheimer’s disease (AD). According to the recent NIA-AA framework, AD is characterized by a neuropathological cascade commencing with β-amyloid deposition (A), followed by tauopathy (T) and neurodegeneration (N). However, the ATN model has not been replicated utilizing recently validated plasma-based biomarkers, and the role of the Aβ40 subtype in A is not well understood. This study examined plasma-based neuropathological markers of Aβ42 and Aβ40 for A, total tau for T, and NfL for N in a cohort of World Trade Center responders at midlife in order to determine the role for the two β-amyloid subtypes in the ATN model.MethodsUltrasensitive Simoa technology was utilized to measure neuropathology in plasma collected from a consecutive clinical sample (n =398). Generalized structural equation modeling was utilized for modeling linkages between pathological markers. Model fit was utilized to determine proposed directions of association.ResultsOur findings support the ATN neuropathological cascade model of AD and further identify an associative role for Aβ40 in A as playing a central role linking T to N. A strong correlation was found between CI and age, and it was found that women may be at increased risk of elevated T levels, with plasma NfL levels higher in responders with CI. Notably, our model reported associations between: Aβ42, CI and N; Aβ40, T and N; T and CI; Aβ42 and Aβ40.ConclusionsThe current ATN model of AD does not specify the subtype of β-amyloid to be considered, which may be overlooking the differential roles that these two subtypes serve in the pathogenesis of AD.

‘World Trade Center, Accra’: production of urban space for the continued peripheral linkage of Ghana under globalization

ABSTRACT West Ridge in Accra, Ghana, a residential enclave for colonial administrators is being produced again to serve as the financial center of the country. The area is identified after one building: World Trade Center, Accra (WTCA). We map the transformation of WTCA and situate its emergence within three frameworks. We argue that the continued peripheral linkage of Ghana and the unwillingness of global capital to bear the overhead cost of extracting wealth from the country have created a vacuum for semi-peripheral, peripheral, and state capital to serve the financial needs of global capital. Ghana’s financial structural adjustment facilitated these processes.

Evaluation of Medical Surveillance and Incidence of Post-September 11, 2001, Thyroid Cancer in World Trade Center–Exposed Firefighters and Emergency Medical Service Workers

Elevated incidence rates of thyroid cancer among World Trade Center (WTC)-exposed individuals may be associated with the identification of asymptomatic cancers during medical surveillance. To examine the association between WTC exposure and thyroid cancer among Fire Department of the City of New York (hereafter, Fire Department) rescue/recovery workers as well as the association with medical surveillance. This closed-cohort study classified the method of detection (asymptomatic and symptomatic) of thyroid cancers in 14 987 men monitored through the Fire Department-WTC Health Program diagnosed from September 12, 2001, to December 31, 2018. Age-, sex-, and histologic-specific Fire Department incidence rates were calculated and compared with demographically similar men in Olmsted County, Minnesota, from the Rochester Epidemiology Project using age-standardized rates, relative rates (RRs), and 95% CIs. The secondary analysis was restricted to papillary carcinomas. World Trade Center exposure was defined as rescue/recovery work at the WTC site from September 11, 2001, to July 25, 2002. The outcomes evaluated comprised (1) number of incident thyroid cancers and their detection method categorizations in the Fire Department and Rochester Epidemiology Project cohorts; (2) Fire Department, Rochester Epidemiology Project, and Surveillance, Epidemiology, and End Results-21 age-standardized incidence rates of thyroid cancer; and (3) RRs comparing Fire Department and Rochester Epidemiology Project overall and by detection method categorization. Seventy-two post-9/11 Fire Department cases of thyroid cancer were identified. Among the 65 cases (90.3%) with a categorized detection method, 53 cases (81.5%) were asymptomatic and 12 cases (18.5%) were symptomatic. Median (interquartile range) age at diagnosis was 50.2 (44.0-58.6) vs 46.6 (43.9-52.9) years for asymptomatic vs symptomatic cases. Associated primarily with asymptomatic cancers, the overall age-standardized incidence of Fire Department thyroid cancers (24.7; 95% CI, 17.4-52.3) was significantly higher than the Rochester Epidemiology Project (10.4; 95% CI, 8.5-12.7) and Surveillance, Epidemiology, and End Results-21 (9.1; 95% CI, 9.0-9.1) per 100 000 person-years. Furthermore, the RR of thyroid cancer among symptomatic men in Fire Department cases was not significantly different from that of men in the Rochester Epidemiology Project (0.8; 95% CI, 0.4-1.5); however, the rate of asymptomatic cancers was more than 3-fold that of the Rochester Epidemiology Project rate (RR, 3.1; 95% CI, 2.1-4.7). Excess asymptomatic thyroid cancer in Fire Department WTC-exposed rescue/recovery workers is apparently attributable to the identification of occult lesions during medical surveillance. Among WTC-exposed cohorts and the general population, these findings appear to have important implications for how thyroid cancer incidence rates are interpreted and how diagnoses should be managed.

Impact on rats from acute intratracheal inhalation exposures to WTC dusts

Background: Studies have revealed the increased incidence of health disorders in First Responders (FR) who were at Ground Zero over the initial 72 hr after the World Trade Center (WTC) collapses. Previous studies in rats exposed to WTC dusts using exposure scenarios that mimicked FR mouthbreathing showed exposure led to altered expression of genes whose products could be involved in lung ailments. Nevertheless, it was uncertain if repeated exposures (as occurred in earliest days post-disaster) might have given rise to long-term changes in the lungs/other organs, in white blood cell (WBC) profiles, and/or systemic expression of select (mostly immune-related) proteins.Methods: To examine this, rats were exposed on 2 consecutive days (2 hr/d, intratracheal inhalation) to WTC dusts and then examined over a 1-yr period thereafter. At select times post-exposure, organ (lung, heart, liver, kidney, spleen) weights, WBC profiles, and blood levels of a variety of proteins were evaluated.Results: The study showed that over the 1-yr period, there were nominal effects on organ weights (absolute, index) as a result of the dust exposures. There were significant changes (relative to in naïve rats) in WBC profiles, with exposed rats having increased monocyte-macrophage and decreased lymphocyte percentages. The study also found that dust exposure led to significant systemic increases in many proteins, including MCP-1, RANTES, MMP-9, RAGE, and Galectin-3.Conclusions: These results provide further support for our longstanding hypothesis that the WTC dusts could potentially have acted as direct inducers of many of the health effects that have been seen in the exposed FR.

Systemic Autoimmune Disease Among Adults Exposed to the September 11, 2001 Terrorist Attack.

ObjectiveAutoimmune disease is an emerging condition among persons exposed to the September 11, 2001 attack on the World Trade Center (WTC). Components of the dust cloud resulting from the collapse of the WTC have been associated with development of a systemic autoimmune disease, as has posttraumatic stress disorder (PTSD). We undertook this study to determine whether dust exposure and PTSD were associated with an increased risk of systemic autoimmune disease in a 9/11‐exposed cohort.MethodsAmong 43,133 WTC Health Registry enrollees, 2,786 self‐reported having a post‐9/11 systemic autoimmune disease. We obtained informed consent to review medical records to validate systemic autoimmune disease diagnoses for 1,041 enrollees. Diagnoses of systemic autoimmune diseases were confirmed by classification criteria, rheumatologist diagnosis, or having been prescribed systemic autoimmune disease medication. Controls were enrollees who denied having an autoimmune disease diagnosis (n = 37,017). We used multivariable log‐binomial regression to examine the association between multiple 9/11 exposures and risk of post‐9/11 systemic autoimmune disease, stratifying by responders (rescue, recovery, and clean‐up workers) and community members (e.g., residents, area workers).ResultsWe identified 118 persons with systemic autoimmune disease. Rheumatoid arthritis was most frequent (n = 71), followed by Sjӧgren's syndrome (n = 22), systemic lupus erythematosus (n = 20), myositis (n = 9), mixed connective tissue disease (n = 7), and scleroderma (n = 4). Among 9/11 responders, those with intense dust cloud exposure had almost twice the risk of systemic autoimmune disease (adjusted risk ratio 1.86 [95% confidence interval 1.02–3.40]). Community members with PTSD had a nearly 3‐fold increased risk of systemic autoimmune disease.ConclusionIntense dust cloud exposure among responders and PTSD among community members were associated with a statistically significant increased risk of new‐onset systemic autoimmune disease. Clinicians treating 9/11 survivors should be aware of the potential increased risk of systemic autoimmune disease in this population.

Impact assessment of the implementation of food defense plan in a Brazilian army military organization

The concepts of food defense have been incorporated into the food production chain after the attacks on the World Trade Center in the U.S. in 2001, when the susceptibility to mass terrorist actions was evident. An attack on a water or food supply network could cause an incalculable physical, psychological, or financial impact. In the Brazilian armed forces, although the concept is already present in food manuals, there is still no doctrinal regulation on the subject. In military operations, especially in foreign territories, the concept assumes greater importance, since the opponent is looking for any vulnerabilities that could cause a decrease in the human force headcount and loss of operability. In this scope, the present study evaluated in an unprecedented way the impacts of the implementation of the concepts of the food defense in a military organization of the Brazilian Army, using the application of the tool Food Defense Plan Builder. Most of the demands (60.7%) of the Action Plan was fully or partially met. The greatest difficulties were observed in the field of personnel control, still being an obstacle in the management of the vulnerabilities.

Case-Control Study of Paresthesia Among World Trade Center-Exposed Community Members.

To investigate whether paresthesia of the lower extremities following exposure to the World Trade Center (WTC) disaster was associated with signs of neuropathy, metabolic abnormalities, or neurotoxin exposures. Case-control study comparing WTC-exposed paresthesia cases with "clinic controls" (WTC-exposed subjects without paresthesias), and "community controls" (WTC-unexposed persons). Neurological histories and examination findings were significantly worse in cases than controls. Intraepidermal nerve fiber densities were below normal in 47% of cases and sural to radial sensory nerve amplitude ratios were less than 0.4 in 29.4%. Neurologic abnormalities were uncommon among WTC-unexposed community controls. Metabolic conditions and neurotoxin exposures did not differ among groups. Paresthesias among WTC-exposed individuals were associated with signs of neuropathy, small and large fiber disease. The data support WTC-related exposures as risk factors for neuropathy, and do not support non-WTC etiologies.

Occupational aspects of irritable larynx syndrome.

The aim of this article is to provide an update on occupational aspects of irritable larynx syndrome (ILS). It is being increasingly recognized that ILS is common amongst certain occupations. This is particularly true of occupations that require frequent voice use such as teachers; where there is exposure to workplace irritants such as World Trade Center responders; or mechanical factors that cause laryngeal dysfunction such as elite athletes. Work associated ILS impacts on quality of life but responds to speech and language therapy focusing on education, vocal hygiene, and laryngeal exercises that reduce cough and treat acute laryngeal obstruction episodes. ILS may be caused or exacerbated by many occupational exposures, causes significant symptoms, and impacts on quality of life. It is potentially treatable and may well be preventable. More research in this important area is required.

Rebuilding and re-embodying: music after 9/11

Sandra Boer, [Untitled], 2001, from Here Is New York: A Democracy of Photographs in Remembering 9/11 at the International Center of Photography Even before it was standing, the World Trade Center had acquired a lifelike quality, and this quality could not be separated from music. In the Sonic Memorial Project–initiated by independent producers The Kitchen Sisters–, a sound collage of interviews and phone calls made to NPR after 9/11, we can hear Les Robertson, the lead structural enginee...

RUSSIAN-TURKISH WAR 1877-1878 IN IRANIAN HISTORIOGRAPHY OF THE XIX CENTURY AND MODERN IRANIAN HISTORIOGRAPHY

The conflict between the Russian and Turkish in 1877-1878, though formed on the pretext of Russia's support for Christian nations under the rule of the Ottoman Empire, was actually part of the great scheme that European governments had begun to break up the Ottoman Empire and resolve the Eastern Question. The goals of these powers for world domination, that would sometimes results in wars among themselves, were mainly focused on expanding the territorial realm and winning economic gains. These goals were followed under the disguise of gaining freedom for Christians and securing independence for non-Turkish nations. The scientific and technological impairment of the Ottoman Empire compared to the European countries, accompanied by internal rivalries and frequent overthrow of the rulers, were some of the main weaknesses of the Ottoman state causing their demise. In the meantime, Russia was in pursue of its policy of territorial expansion and seeking access to warm waters. Russia's main objective was to obtain access to the Black Sea and the Mediterranean Sea. Having control over the Straits of Bosporus and Dardanelles that were under the rule of the Ottoman Empire would have connected Russia to the center of world trade in the Mediterranean and would have freed Russia from its land blockages and frozen ports. The causality, the start, and the ramifications of these wars have been reflected in the Iranian historiography of that era. Mohammad Hassan Khan Etemad al-Saltanah, a great historian of the Nasereddin Shah Qajar Age (1848-1898), using the reports of Iranian officials in Russia and the Ottoman Empire, and two books of Montazame Nasseri and Merat al-Boldan that were translations of selected articles from the French and Ottoman newspapers have recorded this important historical event. The reasons for Iranian attention to this historical event forms part of the modern and global historiography of Iran, in which attention to the developments in the Ottoman Empire plays an important role in Iran's acquaintance with modern civilization.

The association between prenatal exposure to perfluoroalkyl substances and childhood neurodevelopment

Perfluoroalkyl substances (PFAS) were among various persistent organic pollutants suspected to have been released during the collapse of the World Trade Center (WTC) on 9/11. Evidence on the association between prenatal PFAS exposure and child neurodevelopment is limited and inconsistent. This study evaluated the association between prenatal PFAS exposure and child cognitive outcomes measured at 5 different time points in a population prenatally exposed to the WTC disaster. The study population included 302 pregnant women in the Columbia University WTC birth cohort enrolled between December 13, 2001 and June 26, 2002 at three hospitals located near the WTC site: Beth Israel, St. Vincent’s, and New York University Downtown. We evaluated the association between prenatal exposure to four PFAS (perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorohexanesulfonic acid (PFHxS), perfluorononanoic acid (PFNA)) and child neurodevelopment measured using the Bayley Scales of Infant Development (BSID-II) at approximately 1, 2 and 3 years of age and using The Wechsler Preschool and Primary Scale of Intelligence (WPPSI) at approximately 4 and 6 years of age. Geometric mean (range) concentrations of PFAS were 6.03 (1.05, 33.7), 2.31 (0.18, 8.14), 0.43 (<LOQ, 10.3) and 0.67 (<LOQ, 15.8) ng/mL for PFOS, PFOA, PFNA and PFHxS, respectively. Several PFAS were associated with increases in cognitive outcomes in females and overall (males and females combined). Child sex modified the association between PFOS and the mental development index measured using BSID-II, with the observed relationship being positive for females and negative for males. Through principal component analyses, we observed a negative relationship between PFNA and the psychomotor development index measured using BSID-II and the verbal IQ measured using WPPSI. Our results suggest a sex- and compound-specific relationship between prenatal PFAS exposures and childhood neurodevelopment.

Scoping review of fire safety behaviors among high-rise occupants: Implications for public health nursing.

The purpose of this review was to identify gaps in the research literature regarding high-rise (HR) building occupant fire safety behaviors. Findings from this review will inform further development of the role of public health nurses (PHNs) in promoting population-based strategies to enhance HR occupant fire safety. The search included peer-reviewed English language articles published after 2001 describing fire safety behaviors among HR building occupants in the United States. Fourteen articles were included in the final review. Twelve articles reported exclusively on commercial HR building fire safety; two reported on both the residential and commercial HR building fire safety; 10 reported on events related to the September 11, 2001 attack on the World Trade Center (WTC) towers. Various factors influenced HR occupants' fire safety behaviors, including knowledge about building fire safety features and emergency plans, participation in drills, and organizational emergency preparedness. People with mobility impairments required special considerations. Two theoretical models explaining HR occupants' fire safety behaviors were identified. Gaps in the research literature exist regarding residential HR occupant fire safety behaviors. Further research regarding ways that PHNs are currently engaged in this important public health issue should be further explored.

Association Between Socioeconomic Status and Asthma-Related Emergency Department Visits Among World Trade Center Rescue and Recovery Workers and Survivors

Although the association between poor economic or social standing and health is well established, few studies have attempted to examine the mediational pathways that produce adverse outcomes in disadvantaged populations. To determine whether barriers to care mediate the association between socioeconomic status (SES) and asthma-related emergency department (ED) visits. This cohort study used data from the World Trade Center Health Registry, which comprises rescue and recovery workers and community members who worked, lived, studied or were otherwise present in downtown Manhattan, New York, during or immediately after the September 11, 2001, disaster. Data were matched to an administrative database of ED visits. Those who experienced an asthma-related ED visit and those who did not were compared in bivariate analysis. A mediation analysis was conducted to determine the role of barriers to care in the association between number of ED visits and SES. Education, income, and race/ethnicity, which were collected at first survey in 2003 to 2004. Asthma-related ED visits that occurred after survey responses regarding barriers to care were collected (2006-2007) but before 2016, the latest date that data were available. The analytic sample included 30 452 enrollees (18 585 [61%] male; median [interquartile range] age, 42.0 [35.0-50.0] years; 20 180 [66%] white, 3834 [13%] African American, and 3961 [13%] Hispanic or Latino [any race]). Approximately half (49%) had less than a bachelor's degree, and 15% had an annual income less than $35 000. Those of lower SES were more likely to experience an asthma-related ED visit. Although number of barriers to care mediated this association, they explained only a small percentage of the overall health disparity (ranging from 3.0% [95% CI, 2.3%-3.9%]) of the differences between African American and white individuals to 9.8% [95% CI, 7.7%-11.9%]) comparing those with less than a high school diploma to those with at least a bachelor's degree. However, the association varied by specific barrier to care. Lack of money, insurance, and transportation mediated up to 11.8% (95% CI, 8.1%-15.9%), 12.5% (95% CI, 8.5%-17.4%), and 4.3% (95% CI, 1.7%-8.4%), respectively, of the association between SES and number of ED visits. Lack of childcare, not knowing where to go for care, and inability to find a health care professional mediated a smaller or no percentage of the association. The identification of vulnerable subpopulations is an important goal to reduce the burden of asthma-related hospital care. More research is needed to fully understand all of the pathways that lead disaster survivors of lower SES to disproportionately experience ED visits due to asthma.

E-ДЖИХАД. ІНФОРМАЦІЙНА БОРОТЬБА АЛЬ-КАЇДИ Й ІСЛАМСЬКОЇ ДЕРЖАВИ НА «СТЕЖЦІ БОГА» – ВИБРАНІ ПРИКЛАДИ

У статті розглянуто питання е-джихад (кіберджихад) як ведення джихаду з використанням інформаційних засобів. Зазначено, що мовна обсерваторія Варшавського університету зареєструвала слово «кіберджихад» у 2016 р. у «Словнику польської мови» зазначено, що це «дії проти невіруючих і послідовників інших релігій, котрі проводяться ісламськими фундаменталістами в Інтернеті». Однак таке визначення дуже неточне й навіть частково хибне. Джихад є поняттям дуже розмитим і складним. Історію використання джихадистами Інтернету розділено на три основні періоди. Перший мав місце до атаки на World Trade Center (11 вересня 2001 р.). По-перше, Інтернет не був тоді ще поширеним інструментом, по-друге, ісламісти лише ставали сильніші. Початок конфлікту Аль-Каїди і талібів зі США започаткував другий етап. Третім етапом є нинішня ситуація, яка змінилася в результаті виникнення Ісламської держави (ISIS). Доведено, що е-джихад – це концепція, що прийнята й використовується в науці протягом деякого часу. Мета статті – перевірити, чи відповідає діяльність Ісламської держави та Аль-Каїди в Інтернеті концепції джихаду. Завдяки цьому поняття джихаду прояснено та зіткнулося з обраними прикладами діяльності. Науковці стверджують, що «Ісламська держава» й «Каїда» використовують нові технології для широкого розуміння джихаду, уключаючи бойові дії (kital).

Post-traumatic stress disorder and risk of prescription opioid use, over-use, and misuse among World Trade Center Health Registry enrollees, 2015–2016

BackgroundAmong veterans, post-traumatic stress disorder (PTSD) has been shown to be associated with the use and misuse of prescription opioids. Less is known about PTSD among the general population and PTSD resulting from non-combat related trauma. We sought to determine if PTSD following exposure to the World Trade Center (WTC) disaster is associated with the recent use, over use, or misuse of prescription opioids. MethodsThis study, conducted in 2018, examined 26,840 individuals from the WTC Health Registry. PTSD symptoms were assessed on multiple surveys (2003–2016) using the PCL Checklist-17. Three categories of post-9/11 PTSD were derived: never, past, and current. Self-reported opioid use outcomes (past year, 2015–2016) were defined as (yes/no): recent use (use of a prescription opioid), over-use (use of a prescribed opioid in a manner other than prescribed) and misuse (use of a prescription opioid prescribed to someone else). ResultsOpioid use, over-use, and misuse prevalence was highest among those with current PTSD (prevalence: 12.2 %–46.1 %) compared to past PTSD (prevalence: 6.7 %–35.8 %) and never PTSD (prevalence: 3.6 %–22.9 %). In adjusted models, individuals with past and current PTSD had a greater risk of all opioid outcomes compared to never PTSD. ConclusionsPast and current 9/11-related PTSD is a risk factor for opioid use and misuse among the general population, findings which may assist in improving screening and surveillance measures.

Shoe: Towards a promiscuous politics of emergency evacuation mobility

The paper works against the articulation of emergency politics within an Agambenian framework of a ‘state of exception’ which has heretofore dominated writing about emergencies. Instead it develops a more hopeful albeit agonistic politics of emergency evacuation mobilities. By way of Elaine Scarry, Bonnie Honig, Ben Anderson and the writings of gay rights and AIDS activist Douglas Crimp, the paper explores the promise of a ‘politics of promiscuity’, alighting on the role of shoes in emergency evacuation mobilities in two cases. Through detailed analysis of the evacuation of the World Trade Centre during 9/11, and the debacle of the evacuation of Australian PM Julia Gillard during ‘Australia Day’ protests in 2012, the paper teases out the concept of promiscuity through feminist and queer reworkings of emergency politics.

Adapting meaning-centered psychotherapy for World Trade Center responders.

To date, nearly 10,000 World Trade Center (WTC) responders have been diagnosed with at least one type of WTC-related cancer, and over 70 types of cancer have been related to WTC occupational exposure. Due to the observed latency period for malignancies, the WTC Health Program anticipates increases in rates of new cancer diagnoses. Given the growing number of cancer diagnoses in this population, there is an urgent need to develop a novel intervention to address the psychosocial needs of WTC responders with cancer. Meaning-centered psychotherapy (MCP) is a structured psychotherapeutic intervention originally developed to help patients with advanced cancer find and sustain meaning in life despite illness-related limitations. Existential distress and loss of meaning are critical and understudied elements of psychological health that have been widely overlooked among WTC responders with cancer. We have adapted MCP for WTC responders (MCP-WTC) for the treatment of WTC responders who have been diagnosed with WTC-certified cancers. MCP-WTC aims to target the complex crisis in meaning faced by those responders who responded to the 9/11 attacks and subsequently were diagnosed with cancer as a result of their service. We describe the adaptation of MCP-WTC and the application of this intervention to meet the unique needs of those exposed to the terrorist attacks of September 11, 2001 (9/11), participated in the rescue, recovery, and clean-up effort at Ground Zero, and were diagnosed with WTC-related cancer. We highlight the novel aspects of this intervention which have been designed to facilitate meaning-making in the context of the patient's response to 9/11 and subsequent diagnosis of cancer. This work provides a rationale for MCP-WTC and the potential for this intervention to improve the quality of life of WTC responders and help these patients navigate life after 9/11 and cancer.