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A computerized, self-administered questionnaire to evaluate posttraumatic stress among firefighters after the World Trade Center collapse.

Corrigan M; McWilliams R; Kelly KJ; Niles J; Cammarata C; Jones K; Wartenberg D; Hallman WK; Kipen HM; Glass L; Schorr JK; Feirstein I; Prezant DJ
Am J Public Health 2009 Nov; 99(Suppl 3):S702-S709
We sought to determine the frequency of psychological symptoms and elevated posttraumatic stress disorder (PTSD) risk among New York City firefighters after the World Trade Center (WTC) attack and whether these measures were associated with Counseling Services Unit (CSU) use or mental health-related medical leave over the first 2.5 years after the attack. METHODS: Shortly after the WTC attack, a computerized, binary-response screening questionnaire was administered. Exposure assessment included WTC arrival time and "loss of a co-worker while working at the collapse." We determined elevated PTSD risk using thresholds derived from Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, and a sensitivity-specificity analysis. RESULTS: Of 8487 participants, 76% reported at least 1 symptom, 1016 (12%) met criteria for elevated PTSD risk, and 2389 (28%) self-referred to the CSU, a 5-fold increase from before the attack. Higher scores were associated with CSU use, functional job impairment, and mental health-related medical leave. Exposure-response gradients were significant for all outcomes. CONCLUSIONS: This screening tool effectively identified elevated PTSD risk, higher CSU use, and functional impairment among firefighters and therefore may be useful in allocating scarce postdisaster mental health resources.
Clinical-diagnosis; Epidemiology; Exposure-assessment; Exposure-methods; Fire-fighters; Health-hazards; Health-services; Health-surveys; Medical-services; Mental-health; Mental-stress; Occupational-exposure; Occupational-hazards; Occupational-health; Occupational-psychology; Psychological-effects; Psychological-factors; Psychological-reactions; Psychological-stress; Questionnaires; Risk-analysis; Statistical-analysis; Stress; Work-analysis; Work-environment; Worker-health; Work-operations; Work-performance
David J. Prezant, MD, Fire Department of the City of New York, Office of Medical Affairs, Room 4w-1, 9 Metrotech Center, Brooklyn, NY 11201
Publication Date
Document Type
Journal Article
Email Address
Funding Type
Cooperative Agreement
Fiscal Year
Identifying No.
Cooperative-Agreement-Number-U10-OH-008242; Cooperative-Agreement-Number-U10-OH-008243; Cooperative-Agreement-Number-U10-CCU-221158
Priority Area
Source Name
American Journal of Public Health
Performing Organization
New York City Fire Department
Page last reviewed: June 15, 2021
Content source: National Institute for Occupational Safety and Health Education and Information Division