title: Health Conditions as Mediators of the Association Between World Trade Center Exposure and Health-Related Quality of Life in Firefighters and EMS Workers.
abstract: OBJECTIVE
  Studies have reported reduced health-related quality of life (HrQoL) in rescue/recovery workers for years postdisaster. Few have examined specific postdisaster physical and mental health conditions as mediators of the association between exposure to disaster and HrQoL.
  
  
  METHODS
  We used the Short Form-12 to measure HrQoL in 7190 male World Trade Center (WTC)-exposed first responders. Potential mediators included physician diagnoses obtained from medical records and mental health conditions obtained from questionnaires.
  
  
  RESULTS
  Among moderately and highly WTC-exposed workers, health conditions fully mediated the observed relationship between WTC-exposure and physical health functioning of HrQoL, and substantially mediated the association between WTC-exposure and mental health functioning.
  
  
  CONCLUSIONS
  Because WTC-related health conditions explain the relationship between WTC-exposure and HrQoL, medical monitoring with treatment of affected populations is necessary to mitigate the adverse effects of WTC-exposure on HrQoL.
authors: Fire Department of the City of New York (Ms Yip, Dr Zeig-Owens, Dr Webber, Ms Olivieri, Ms Schwartz, Dr Kelly, Dr Prezant), Bureau of Health Services, Brooklyn; Montefiore Medical Center (Ms Yip, Dr Zeig-Owens, Ms Olivieri, Ms Schwartz), Department of Medicine; Department of Pulmonary Medicine (Dr Prezant); Department of Epidemiology and Population Health (Dr Webber); Albert Einstein College of Medicine (Dr Webber and Dr Hall), Department of Epidemiology and Population Health; and Department of Medicine (Dr Prezant), Pulmonary Division, Bronx, New York.
authors: Jennifer
authors: J
authors: Yip
authors: Rachel
authors: R
authors: Zeig-Owens
authors: Charles B
authors: CB
authors: Hall
authors: Mayris P
authors: MP
authors: Webber
authors: Brianne
authors: B
authors: Olivieri
authors: Theresa
authors: T
authors: Schwartz
authors: Kerry J
authors: KJ
authors: Kelly
authors: David J
authors: DJ
authors: Prezant
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004634:Emergency Medical Technicians / Q000523:psychology; D061388:Firefighters / Q000523:psychology; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology* / Q000523:psychology; D016273:Occupational Exposure / Q000009:adverse effects*; D011788:Quality of Life; D012307:Risk Factors; D047851:September 11 Terrorist Attacks