title: World Trade Center disaster exposure-related probable posttraumatic stress disorder among responders and civilians: a meta-analysis.
abstract: The World Trade Center (WTC) disaster on September 11, 2001 was an unprecedented traumatic event with long-lasting health consequences among the affected populations in the New York metropolitan area. This meta-analysis aimed to estimate the risk of probable posttraumatic stress disorder (PTSD) associated with specific types of WTC exposures. Meta-analytical findings from 10 studies of 3,271 to 20,294 participants yielded 37 relevant associations. The pooled summary odds ratio (OR) was 2.05 (95% confidence interval (CI): 1.82, 2.32), with substantial heterogeneity linked to exposure classification, cohort type, data source, PTSD assessment instrument/criteria, and lapse time since 9/11. In general, responders (e.g. police, firefighters, rescue/recovery workers and volunteers) had a lower probable PTSD risk (OR = 1.61; 95% CI: 1.39, 1.87) compared to civilians (e.g. residents, office workers, and passersby; OR = 2.71, 95% CI: 2.35, 3.12). The differences in ORs between responders and civilians were larger for physical compared to psychosocial exposure types. We also found that injury, lost someone, and witnessed horror were the three (out of six) most pernicious exposures. These findings suggest that these three exposures should be a particular focus in psychological evaluation and treatment programs in WTC intervention and future emergency preparedness efforts.
authors.affiliation: Department of Population Health, Hofstra North Shore-LIJ School of Medicine, Great Neck, New York, United States of America.
authors.forename: Bian
authors.initials: B
authors.lastname: Liu
authors.affiliation: Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, United States of America.
authors.forename: Lukman H
authors.initials: LH
authors.lastname: Tarigan
authors.affiliation: Department of Psychiatry and Behavioral Science, State University of New York-Stony Brook, Stony Brook, New York, United States of America.
authors.forename: Evelyn J
authors.initials: EJ
authors.lastname: Bromet
authors.affiliation: Department of Population Health, Hofstra North Shore-LIJ School of Medicine, Great Neck, New York, United States of America.
authors.forename: Hyun
authors.initials: H
authors.lastname: Kim
mesh_terms: D061388:Firefighters / Q000523:psychology; D006801:Humans; D009518:New York / Q000453:epidemiology; D016017:Odds Ratio; D016495:Police; D018635:Rescue Work; D012307:Risk Factors; D047851:September 11 Terrorist Attacks / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D014838:Volunteers / Q000523:psychology