Change in binge drinking behavior after Hurricane Sandy among persons exposed to the 9/11 World Trade Center disaster.

The objective of this study was to examine changes in drinking behavior after Hurricane Sandy among 3199 World Trade Center Health Registry (Registry) enrollees before (2011-12) and after Hurricane Sandy (2015-16). A composite Sandy exposure scale (none, low, medium and high) included Sandy traumatic experiences, financial and other factors. Probable Sandy-related posttraumatic stress disorder (PTSD) was defined as scoring ≥44 on PTSD Checklist, and binge drinking as consuming ≥5 alcoholic drinks for men or ≥4 for women on one occasion in the past 30 days. Some of the enrollees reported binge drinking post Sandy as new binge drinkers (4.7%) or consistent binge drinkers pre- and post-Sandy (19%). Compared with non-binge drinkers pre- and post-Sandy (66.9%), the adjusted odds ratios (aOR) for being new binge drinkers and consistent binge drinkers among high Sandy exposure enrollees were 2.1 (95%CI 1.1-4.1) and 2.5 (95%CI: 1.7-3.6), respectively. High Sandy traumatic experience alone was associated with consistent binge drinking (aOR: 1.9, 95%CI: 1.4-2.6). Among enrollees without 9/11 PTSD, those with Sandy PTSD were more likely to become new binge drinkers (aOR: 4.4, 95%CI: 1.4-13.9), while Sandy PTSD was not associated with any binge drinking behavior changes among those with 9/11 PTSD. Sandy exposure, Sandy traumatic experience, and Sandy PTSD were all associated with higher binge drinking intensity. Future natural disaster response should plan for treatment to address alcohol use and PTSD simultaneously.

Post-Traumatic Stress Disorder among Survivors of the September 11, 2001 World Trade Center Attacks: A Review of the Literature.

Prior reviews of 9/11-related post-traumatic stress disorder (PTSD) have not focused on the civilian survivors most directly exposed to the attacks. Survivors include those individuals who were occupants of buildings in or near the World Trade Center (WTC) towers, those whose primary residence or workplace was in the vicinity, and persons who were on the street passing through the area. This review reports published information on the prevalence of and risk factors for PTSD, as well as comorbidities associated with PTSD among 9/11 survivors. Articles selected for inclusion met the following criteria: (1) full-length, original peer-reviewed empirical articles; (2) published in English from 2002-2019; (3) collected data from persons directly exposed; (4) adult populations; and (5) focused on non-rescue or recovery workers (i.e., survivors). Data were extracted with focus on study design, sample size, time frame of data collection post-9/11, PTSD assessment instrument, and PTSD prevalence, risk factors, and comorbidities. Our review identified the use of cross-sectional and longitudinal designs, finding multiple direct comorbidities with PTSD, as well as the prevalence and persistence of PTSD. Future research would benefit from incorporating more mixed methods designs, and exploring the mediating mechanisms and protective factors of the known associations of PTSD among the 9/11 survivor population.

Hearing Loss Among World Trade Center Firefighters and Emergency Medical Service Workers.

OBJECTIVE: To determine if World Trade Center (WTC) exposure is associated with hearing loss. METHODS: Logistic regression to evaluate the immediate impact of WTC exposure and parametric survival analysis to assess longitudinal outcomes. RESULTS: Those arriving on the morning of September 11, 2001 had elevated odds of low-frequency (odds ratio [OR]: 1.24; 95% confidence interval [CI]: 1.04 to 1.47) and high-frequency (OR: 1.16; 95% CI: 1.02 to 1.31) hearing loss at their first post-September 11, 2001 examination. Longitudinally, participants arriving before September 13, 2001 and spending more than or equal to 6 months at the WTC-site had greater risk of hearing loss in the low frequencies (risk ratio [RR]: 1.31; 95% CI: 1.05 to 1.60) and high frequencies (RR: 1.37; 95% CI: 1.22 to 1.54). By 2016, 3194 (37%) had abnormal hearing sensitivity in either ear and 1751 (20%) in both ears. CONCLUSIONS: More heavily WTC-exposed workers were at increased risk of hearing loss, and group differences persisted for at least 15 years. Those with abnormal hearing sensitivity may benefit from interventions such as hearing aids and other rehabilitation.