title: Hurricane Sandy Exposure and the Mental Health of World Trade Center Responders.
abstract: The psychological consequences of a second disaster on populations exposed to an earlier disaster have rarely been studied prospectively. Using a pre- and postdesign, we examined the effects of Hurricane Sandy on possible World Trade Center (WTC) related posttraumatic stress disorder (PTSD Checklist score of ≥ 50) and overall depression (major depressive disorder [MDD]; Patient Health Questionnaire depression score of ≥ 10) among 870 WTC responders with a follow-up monitoring visit at the Long Island WTC Health Program during the 6 months post-Hurricane Sandy. The Hurricane Sandy exposures evaluated were damage to home (8.3%) and to possessions (7.8%), gasoline shortage (24.1%), prolonged power outage (42.7%), and filing a Federal Emergency Management Agency claim (11.3%). A composite exposure score also was constructed. In unadjusted analyses, Hurricane Sandy exposures were associated with 1.77 to 5.38 increased likelihood of PTSD and 1.58 to 4.13 likelihood of MDD; odds ratios for ≥ 3 exposures were 6.47 for PTSD and 6.45 for MDD. After adjusting for demographic characteristics, WTC exposure, pre-Hurricane Sandy mental health status, and time between assessments, reporting ≥ 3 Hurricane Sandy exposures was associated with a 3.29 and 3.71 increased likelihood of PTSD and MDD, respectively. These findings underscore the importance of assessing the impact of a subsequent disaster in ongoing responder health surveillance programs.
authors.affiliation: Department of Psychiatry, Stony Brook University, Stony Brook, New York, USA.
authors.forename: Evelyn J
authors.initials: EJ
authors.lastname: Bromet
authors.affiliation: Program in Public Health, Department of Preventive Medicine, Stony Brook University, Stony Brook, New York, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Clouston
authors.affiliation: Department of Psychiatry, Stony Brook University, Stony Brook, New York, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Gonzalez
authors.affiliation: Department of Psychiatry, Stony Brook University, Stony Brook, New York, USA.
authors.forename: Roman
authors.initials: R
authors.lastname: Kotov
authors.affiliation: Department of Medicine, Stony Brook University, Stony Brook, New York, USA.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Guerrera
authors.affiliation: Department of Medicine, Stony Brook University, Stony Brook, New York, USA.
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Luft
mesh_terms: D000328:Adult; D055867:Cyclonic Storms; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D004190:Disasters; D060731:Emergency Responders / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D047851:September 11 Terrorist Attacks / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires