Air Pollution/Irritants Trigger and Factors Associated with Asthma Control and Quality of Life Among World Trade Center Health Registry Enrollees with Asthma

2019 ◽  
Author(s):  
J. Yung ◽  
S. Osahan ◽  
S. Friedman ◽  
J. Cone
Keyword(s):  
Quality Of Life ◽  
Air Pollution ◽  
Asthma Control ◽  
World Trade ◽  
World Trade Center ◽  
Factors Associated ◽  
Trade Center ◽  
Health Registry

scholarly journals Allergen Sensitization and Asthma Outcomes among World Trade Center Rescue and Recovery Workers

2019 ◽  
Vol 16 (5) ◽  
pp. 737 ◽  
Author(s):  
Belen Rojano ◽  
Erin West ◽  
Emily Ferdermann ◽  
Steven Markowitz ◽  
Denise Harrison ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Asthma Control ◽  
World Trade ◽  
World Trade Center ◽  
Life Questionnaire ◽  
Indoor Allergens ◽  
Allergen Sensitization ◽  
Asthma Morbidity ◽  
Trade Center

A large number of World Trade Center (WTC) rescue and recovery workers are affected by asthma. While physical and mental health comorbidities have been associated with poor asthma control in this population, the potential role of allergen sensitization is unknown. This study examined the association of indoor sensitization and exposure as a risk factor for increased asthma morbidity in WTC workers. We used data from a prospective cohort of 331 WTC workers with asthma. Sensitization to indoor allergens was assessed by measurement of antigen-specific serum immunoglobulin E (IgE) levels. We used validated tools to evaluate the exposure to indoor allergens. Asthma morbidity outcomes included level of control (Asthma Control Questionnaire, ACQ), quality of life (Asthma Quality of Life Questionnaire, AQLQ) and acute resource utilization. The prevalence of sensitization to cat, dog, mouse, dust mite, cockroach, and mold allergens were 33%, 21%, 17%, 40%, 17%, and 17%, respectively. Unadjusted and regression analyses showed no significant relationship between sensitization and increased asthma morbidity (p > 0.05 for all comparisons), except for sensitization to Aspergillus Fumigatus, cat and mouse epithelium, which were associated with decreased morbidity.

scholarly journals Air Pollution/Irritants, Asthma Control, and Health-Related Quality of Life among 9/11-Exposed Individuals with Asthma

2019 ◽  
Vol 16 (11) ◽  
pp. 1924 ◽  
Author(s):  
Janette Yung ◽  
Sukhminder Osahan ◽  
Stephen M. Friedman ◽  
Jiehui Li ◽  
James E. Cone
Keyword(s):  
Air Pollution ◽  
Asthma Control ◽  
World Trade ◽  
World Trade Center ◽  
Health Related Quality ◽  
Asthmatic Patients ◽  
Related Quality ◽  
Health Related ◽  
Trade Center

Asthma control is suboptimal among World Trade Center Health Registry (WTCHR) enrollees. Air pollution/irritants have been reported as the most prevalent trigger among World Trade Center responders. We examined the relationship between air pollution/irritants and asthma control. We also evaluated the association of asthma control with health-related quality of life (HRQoL). We included 6202 enrollees age ≥18 with a history of asthma who completed the WTCHR asthma survey between 2015 and 2016. Based on modified National Asthma Education and Prevention Program criteria, asthma was categorized as controlled, poorly-controlled, or very poorly-controlled. HRQoL indicators include ≥14 unhealthy days, ≥14 activity limitation days, and self-rated general health. We used multinomial logistic regression for asthma control, and unconditional logistic regression for HRQoL, adjusting for covariates. Overall, 27.1% had poorly-controlled and 32.2% had very poorly-controlled asthma. Air pollution/irritants were associated with poorly-controlled (adjusted odds ratio (AOR) = 1.70; 95% CI = 1.45–1.99) and very poorly-controlled asthma (AOR = 2.15; 95% CI = 1.83–2.53). Poor asthma control in turn worsened the HRQoL of asthmatic patients. Very poorly-controlled asthma was significantly associated with ≥14 unhealthy days (AOR = 3.60; 95% CI = 3.02–4.30), ≥14 activity limitation days (AOR = 4.37; 95% CI = 3.48–5.50), and poor/fair general health status (AOR = 4.92; 95% CI = 4.11–5.89). Minimizing World Trade Center (WTC) asthmatic patients’ exposure to air pollution/irritants may improve their disease management and overall well-being.

Considerations for future disaster registries

2018 ◽  
Vol 27 (3) ◽  
pp. 321-333 ◽  
Author(s):  
Lysa Petrsoric ◽  
Sara A. Miller-Archie ◽  
Alice Welch ◽  
James Cone ◽  
Mark Farfel
Keyword(s):  
World Trade ◽  
Effective Means ◽  
World Trade Center ◽  
Phone Call ◽  
Outreach Program ◽  
Content Type ◽  
Trade Center ◽  
Health Registry ◽  
Post Disaster

Purpose The purpose of this paper is to evaluate the effectiveness of a targeted outreach program that referred World Trade Center Health Registry (Registry) enrollees, to specific post-disaster health care available through the World Trade Center Health Program (WTCHP) and evaluate differences in outreach effectiveness based on demographic and health characteristics. Design/methodology/approach The Registry’s Treatment Referral Program (TRP) targeted 22,981 enrollees based on symptoms and conditions known to be related to 9/11, reported on a 2011-2012 follow-up survey. A call vendor was utilized for the initial outreach phone call. Enrollees who requested a WTCHP application had follow-up from TRP staff, which typically included 4-6 interactions per enrollee until outreach was completed. Findings As of 12/31/2015, the vendor had reached 8,778 (38 percent) of the targeted sample. TRP staff spoke to 6,016 (68 percent) enrollees reached by the vendor, 5,554 (92 percent) of whom requested a WTCHP application, and 2,425 (43 percent) reported having submitted the WTCHP application. Application requests and submissions differed by survivor or responder status, race, income and health symptoms. Originality/value Registries created for surveillance and research among disaster-exposed populations provide a unique and effective outreach approach. A dedicated treatment referral unit within a disaster registry is an effective means for conducting post-disaster outreach to a large, diverse sample of exposed individuals.

scholarly journals Post-9/11 Mental Health Comorbidity Predicts Self-Reported Confusion or Memory Loss in World Trade Center Health Registry Enrollees

2020 ◽  
Vol 17 (19) ◽  
pp. 7330
Author(s):  
Howard E. Alper ◽  
Rifat A. Tuly ◽  
Kacie Seil ◽  
Jennifer Brite
Keyword(s):  
Mental Health ◽  
World Trade ◽  
World Trade Center ◽  
Memory Loss ◽  
Health Conditions ◽  
Mental Health Conditions ◽  
Binomial Regression ◽  
Trade Center ◽  
Health Registry ◽  
World Trade Center Attacks

Numerous studies report elevated levels of chronic mental health conditions in those exposed to the World Trade Center attacks of 11 September 2001 (9/11), but few studies have examined the incidence of confusion or memory loss (CML) or its association with mental health in 9/11 attack survivors. We investigated the incidence of CML and its association with the number of post-9/11 mental health conditions (PTSD, depression, and anxiety) in 10,766 World Trade Center Health Registry (Registry) enrollees aged 35–64 at the time of the wave 4 survey (2015–2016) that completed all four-wave surveys and met the study inclusion criteria. We employed log-binomial regression to evaluate the associations between CML and the number of mental health conditions. A total of 20.2% of enrollees in the sample reported CML, and there was a dose-response relationship between CML and the number of mental health conditions (one condition: RR = 1.85, 95% CI (1.65, 2.09); two conditions: RR = 2.13, 95% CI (1.85, 2.45); three conditions: RR = 2.51, 95% CI (2.17, 2.91)). Survivors may be experiencing confusion or memory loss partly due to the mental health consequences of the 9/11 attacks. Clinicians treating patients with mental health conditions should be aware of potential cognitive impairment.

scholarly journals An Overview of 9/11 Experiences and Respiratory and Mental Health Conditions among World Trade Center Health Registry Enrollees

2008 ◽  
Vol 85 (6) ◽  
pp. 880-909 ◽  
Author(s):  
Mark Farfel ◽  
Laura DiGrande ◽  
Robert Brackbill ◽  
Angela Prann ◽  
James Cone ◽  
...  
Keyword(s):  
Mental Health ◽  
World Trade ◽  
World Trade Center ◽  
Health Conditions ◽  
Mental Health Conditions ◽  
Trade Center ◽  
Health Registry

scholarly journals Hurricane Sandy Evacuation Among World Trade Center Health Registry Enrollees in New York City

2016 ◽  
Vol 10 (3) ◽  
pp. 411-419 ◽  
Author(s):  
Shakara Brown ◽  
Lisa M. Gargano ◽  
Hilary Parton ◽  
Kimberly Caramanica ◽  
Mark R. Farfel ◽  
...  
Keyword(s):  
New York ◽  
Physical Health ◽  
World Trade ◽  
World Trade Center ◽  
Hurricane Sandy ◽  
Adverse Outcomes ◽  
Community Cohesion ◽  
Poor Physical Health ◽  
Trade Center ◽  
Health Registry

AbstractObjectiveTimely evacuation is vital for reducing adverse outcomes during disasters. This study examined factors associated with evacuation and evacuation timing during Hurricane Sandy among World Trade Center Health Registry (Registry) enrollees.MethodsThe study sample included 1162 adults who resided in New York City’s evacuation zone A during Hurricane Sandy who completed the Registry’s Hurricane Sandy substudy in 2013. Factors assessed included zone awareness, prior evacuation experience, community cohesion, emergency preparedness, and poor physical health. Prevalence estimates and multiple logistic regression models of evacuation at any time and evacuation before Hurricane Sandy were created.ResultsAmong respondents who evacuated for Hurricane Sandy (51%), 24% had evacuated before the storm. In adjusted analyses, those more likely to evacuate knew they resided in an evacuation zone, had evacuated during Hurricane Irene, or reported pre-Sandy community cohesion. Evacuation was less likely among those who reported being prepared for an emergency. For evacuation timing, evacuation before Hurricane Sandy was less likely among those with pets and those who reported 14 or more poor physical health days.ConclusionsHigher evacuation rates were observed for respondents seemingly more informed and who lived in neighborhoods with greater social capital. Improved disaster messaging that amplifies these factors may increase adherence with evacuation warnings. (Disaster Med Public Health Preparedness. 2016;10:411–419)

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