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Trends of elevated PTSD risk in firefighters exposed to the World Trade Center disaster: 2001-2005.

Berninger A; Webber MP; Cohen HW; Gustave J; Lee R; Niles JK; Chiu S; Zeig-Owens R; Soo J; Kelly K; Prezant DJ
Public Health Rep 2010 Jul-Aug; 125(4):556-566
OBJECTIVES: We identified trends in the prevalence of elevated posttraumatic stress disorder (PTSD) risk as determined by the Fire Department of the City of New York (FDNY)-modified PTSD Checklist in World Trade Center (WTC)-exposed firefighters. We also examined trends in relation to WTC exposure, social support, change in recreational activities, and functional health. METHODS: We analyzed 16,826 questionnaires from 10,074 firefighters in yearly intervals, from September 12, 2001, to September 11, 2005. RESULTS: The prevalence of elevated PTSD risk increased over time, from 9.8% in year 1 to 10.6% in year 4 (p < 0.0001). Earliest arrival at the WTC site (odds ratio [OR] = 6.0; 95% confidence interval [CI] 4.4, 8.3), prolonged work at the site (OR = 2.0; 95% CI 1.8, 2.3), providing supervision without previous supervisory experience (OR = 4.1; 95% CI 2.8, 6.1), and retirement due to a WTC-related disability (OR=1.3; 95% CI 1.1, 1.5) were associated with ever having elevated PTSD risk. Difficulty functioning at home was strongly associated with elevated PTSD risk (ORs ranged from 17.0 [95% CI 14.5, 20.0] in year 1 to 26.7 [95% CI 20.3, 35.2] in year 3), as was difficulty functioning at work (ORs ranged from 12.1 [95% CI 10.2, 14.2] in year 1 to 23.0 [95% CI 14.6, 36.3] in year 2). CONCLUSIONS: Elevated PTSD risk was associated with exposure to the WTC site as well as functional impairment, and remained largely unabated during the first four years of the study. Screening for elevated PTSD risk may be useful in identifying those who could benefit from interventions during long-term follow-up, as well as in the immediate aftermath of disasters.
Fire-fighters; Emergency-responders; Psychological-effects; Psychological-reactions; Psychological-responses; Psychological-stress; Post-traumatic stress disorder; PTSD; World Trade Center; WTC
Mayris P. Webber, DrPH, Fire Department of the City of New York, Bureau of Health Services, 4N-1 9 Metrotech Center, Brooklyn, NY 11201
Publication Date
Document Type
Journal Article
Email Address
Funding Type
Grant; Cooperative Agreement
Fiscal Year
Identifying No.
Grant-Number-R01-OH-007350; Cooperative-Agreement-Number-U10-OH-008243; Cooperative-Agreement-Number-U10-OH-008242
Issue of Publication
Source Name
Public Health Reports
Page last reviewed: June 10, 2022
Content source: National Institute for Occupational Safety and Health Education and Information Division