The world trade center clean up and recovery worker cohort study: respiratory health amongst cleanup workers approximately 20 months after initial exposure at the disaster site.

OBJECTIVE: Respiratory health among cleanup workers at the World Trade Center (WTC) disaster site was evaluated approximately 20 months after the initial exposure to assess the risk of lower respiratory symptoms. METHODS: In 2003 a self-administered questionnaire requesting information about site experience, current respiratory and historical health, and smoking was sent to 4,546 workers employed at the site (response 25%), and 2103 workers who were never at the WTC (response 12%). RESULTS: As compared with those never at the site, WTC workers were more than three times as likely to report any lower respiratory symptoms (rate ratio = 3.40, 95% confidence interval: 2.33-4.94). CONCLUSIONS: These results suggest an impact on respiratory health related to work experience at the WTC and indicate further monitoring to address potential long-term effects.

Posttraumatic stress disorder and other psychological sequelae among world trade center clean up and recovery workers.

We assessed the health of workers exposed to the World Trade Center (WTC) site and of a comparison group of unexposed workers, by means of a mail survey. Exposed workers reported higher frequency of symptoms consistent with posttraumatic stress disorder (PTSD), depression, anxiety, and other psychological problems, approximately 20 months after the disaster. PTSD was positively associated with traumatic on-site experiences and with respiratory problems. These findings may have important clinical and public health implications.

Rethinking first response: effects of the clean up and recovery effort on workers at the world trade center disaster site.

OBJECTIVE: We sought to describe the physical and mental health effects of the cleanup and recovery effort on workers at the World Trade Center disaster site. METHODS: A mailed survey was sent to truck drivers, heavy equipment operators, laborers, and carpenters. It assessed work-related exposures and somatic and mental health symptoms. In one open-ended question, respondents shared any aspect of their experiences they wished; these 332 narrative responses were analyzed using qualitative techniques. RESULTS: Respondents reported suffering debilitating consequences of their work, including depression, drug use, and posttraumatic stress disorder. They felt poorly prepared to work in a disaster, lacked protective equipment and training, and felt overwhelmed by the devastation they faced. CONCLUSIONS: These workers' experiences were qualitatively similar to the experiences of the first responders. To protect workers in the future, the focus on preparing "first" responders should be reconsidered more broadly.