Background: Disasters have major traumatizing effects on large and unselected populations. Prior studies have examined the impact of natural or human-induced disasters in the community. The impact of a large-scale traumatic event that occurred in the work environment on office workers who may have witnessed the events but were not directly involved in rescue or clean-up activities has not been addressed. The organizational factors determining the types of crisis intervention programs available to employees, utilization of such programs, and the impact of organizational factors on perceived job stress, psychological distress and worker productivity in the aftermath of a large-scale traumatic event in the work environment is unknown. Study Objective: To examine the relationship between organizational factors, workplace disaster-related crisis intervention programs and psychological distress as well as work productivity among employees exposed to a large-scale disaster in the work environment. The specific aims were to: 1) Identify the resources that were available to workers in the aftermath of the disaster, 2) assess how helpful these resources were to the workers 3) determine the prevalence of physical symptoms and psychological distress and their impact on work productivity two years after "9/11' and, 4) to explore the relationship between work organizational factors such as job-stress, workplace culture, disaster-related corporate programs, workers' physical health and psychological well-being. Methods: We conducted a survey of federal, state, municipal and union employees in 17 different work sites within a ten-mile radius of the World Trade Center (WTC) on physical symptoms and psychological well-being two years after the WTC disaster ("9/11 "). We obtained data on employer-sponsored "9/11" psychological, educational and social assistance/programs, utilization and perceived helpfulness of such programs, job stress and the culture of the organization. Surveys were mailed to 750 subjects and the response rate for those with valid addresses was 52%. Results: Majority (86%) of the subjects were in good/excellent physical and mental health. Persons who worked south of canal street (SaC) reported severe headache/migraine more frequently than those who worked north of Canal Street (NOC) (p=0.0202). Relative to other victims and non victims, primary victims reported severe headache/migraine and cough more frequently (p=0.0086 & 0.0043 respectively). Persons who worked in organizations with negative (aggressive defensive or passive defensive) cultures were 34% more likely to report cough compared to those who worked in organizations with a positive (constructive) culture (p =0.02). Only 7% of the subjects endorsed symptoms suggestive of nonspecific psychological distress. Logistic regression analysis showed that this was likely related to personal life event stressors and not due to "9/11" events. None of the subjects met the criteria for clinically significant PTSD (impact of event scale -revised IES- R), however, primary victims tended to have higher IES-R scores relative to other victims and non victims (p = 0.04). Persons who worked in iso-strain jobs (high demand, low control, low social support) had higher IES-R scores relative to those with other types of jobs (p = 0.03). Workers who were ~ 60 years tended to have higher IES-R scores relative to those that were ~ 39 years old (p = 0.02). Overall, subjects reported a 10% decrease in job performance in the 4 weeks prior to the survey relative to the months prior to "9/11". Persons who had iso- strain jobs (high demand, low control, low social support) were more likely to have higher on-the-job productivity losses (presenteeism) relative to those with other types of jobs (p =0.04). The majority (83.74%) reported that their employers provided at least one of the WTC disaster-related psychological, educational or social assistance/programs. Those who reported positive organizational cultures were 97% more likely to report that their employers provided educational materials compared to those who reported negative work cultures (p = 0.008). Relative to their counterparts who reported positive work cultures, those who reported negative work cultures were 74% less likely to utilize the employer-sponsored resources even though they felt that they needed help coping with "9/11" events (p = 0.049). Respondents who reported negative organizational cultures were 80% more likely to be concerned about their personal safety at work, relative to their counterparts who reported positive work cultures (p=0.02). Implications: This study provides data on the prevalence of physical and mental health symptoms in office workers two years after "9/11". It details the employer-sponsored programs that were offered in the aftermath of "9/11", as well as the organizational factors (culture, job stress) which predict long-term symptoms, health and safety concerns and utilization of employer-sponsored programs. Organizations need to consider interventions that address negative work cultures and mitigate job strain in order to optimize workers' health. This data provides useful information and insight for disaster preparedness program planners and is applicable to other types of employer-sponsored health promotion and wellness programs.
Omowunmi Y. O. Osinubi, Assistant Professor of Environmental and Occupational Health, University of Medicine and Dentistry of New Jersey, School of Public Health, 170 Frelinghuysen Road, Piscataway, NJ, 08854