Factors Associated with Poor Control of 9/11-related Asthma

Categories: Respiratory Health, World Trade Center Health Program

November 9th, 2015 8:51 am ET - Hannah Jordan, MD, MPH

Many people who were exposed to dust and fumes during the September 11, 2001 World Trade Center terrorist attacks developed asthma. Although asthma is a chronic illness, symptoms can be prevented with medications and avoidance of triggers. However, many factors, including co-existing medical conditions, can make it difficult to keep asthma symptoms under control.

The New York City Department of Health and Mental Hygiene’s World Trade Center Health Registry (the Registry) follows the health of over 71,000 people who were exposed following the September 11, 2001 (9/11) World Trade Center terrorist attacks and are enrolled in the Registry. The Registry conducted a study to see if enrollees who were diagnosed with asthma in the first few years following the 9/11 terrorist attacks continued to have symptoms a decade later. This is important because persistent asthma symptoms can cause substantial stress and make it difficult to do routine tasks. The study sought to identify groups of Registry enrollees who might benefit from special efforts to improve control of their asthma symptoms.

The study[i], published in the Journal of Asthma

, included approximately 2,500 enrollees who were diagnosed with asthma between September 12, 2001 and December 31, 2003. The Registry found that, in 2011-2012, about two-thirds of the 2,500 study participants reported continued asthma symptoms that interfered with their usual activities. The factors that were most closely tied to severe, persistent asthma symptoms were co-existing mental health conditions, such as post-traumatic stress disorder (PTSD). Co-existing gastroesophageal reflux and obstructive sleep apnea were also associated with worse asthma symptoms.

These study results show that, approximately ten years after 9/11, many people who developed asthma after exposure to the 9/11 attacks continued to experience symptoms that could be treated or even prevented. People with both asthma and PTSD may benefit from targeted efforts to prevent or minimize asthma symptoms. Study findings also emphasize the importance of integrating care for both mental and physical health conditions.

This research was funded by NIOSH. For more 9/11 research findings, visithttp://www.nyc.gov/html/doh/wtc/html/studies/bibliography.shtml

Hannah Jordan, MD, MPH

Dr. Jordan is the Deputy Medical Director of the World Trade Center Health Registry in the New York City Department of Health and Mental Hygiene

[i] Jordan H, Stellman S, Reibman J, Farfel M, Brackbill R, Friedman S, Li J, Cone J. Factors associated with poor control of 9/11-related asthma 10–11 years after the 2001 World Trade Center terrorist attacks. J Asthma 2015; 52:630-637.