Prevalence and incidence of high risk for obstructive sleep apnea in World Trade Center-exposed rescue/recovery workers
ABSTRACT World Trade Center (WTC)-exposed rescue/recovery workers continue to have high rates of gastroesophageal reflux disease (GERD), chronic rhinosinusitis, and posttraumatic stress disorder (PTSD) symptoms. This study examines the relationship between these WTC-related conditions and being at high risk for obstructive sleep apnea (OSA).
The Fire Department of the City of New York (FDNY) performs periodic health evaluations on FDNY members every 12 to 18 months. Evaluations consist of physician examinations and self-administered health questionnaires, which, since 2005, have incorporated questions about sleep problems that were adapted from the Berlin Questionnaire. The study population consisted of 11,701 male firefighters and emergency medical service personnel. Incidence analyses were limited to a cohort (n = 4,576) who did not meet the criterion for being at high risk for OSA at baseline (between September 12, 2005 and September 8, 2006) and had at least one follow-up assessment, on average, 1.4 (±0.5) years later.
The baseline prevalence of high risk for OSA was 36.5%. By follow-up, 16.9% of those not at high risk initially became at high risk for OSA. In multivariable logistic regression models predicting incident high risk for OSA, independent predictors included: earlier time of arrival at the WTC site, GERD, chronic rhinosinusitis, PTSD symptoms, self-assessed fair/poor health, low body mass index (BMI < 18.5 kg/m(2)), and, as expected, BMI > 30 kg/m(2) and weight gain of ≥10 lb (4.5 kg).
We found significant associations between being at high risk for OSA and common WTC-related conditions, although the responsible causative mechanisms remain unknown. Since the etiology of OSA is likely multifactorial, improvement may require successful treatment of both OSA and its comorbid conditions.
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- "specific type, duration, and severity of trauma exposure) and in the status of the affected individuals (e.g. age when exposure occurred, sex, education, occupation, psychiatric and physical comorbidity, coping mechanisms and capability, etc.) may influence the PTSD outcome . In terms of characterizing the WTC exposure, given the magnitude of the impact of 9/11 and the diverse population affected by the event, it is not surprising that we found diverse exposure types across the relevant studies. "
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.PLoS ONE 07/2014; 9(7):e101491. DOI:10.1371/journal.pone.0101491 · 3.23 Impact Factor
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ABSTRACT: More than ten years after the September 11, 2001 World Trade Center (WTC) disaster, 9/11 responders and lower Manhattan community residents still suffer from the adverse health consequences of this horrific event. Upper and lower respiratory conditions such as rhinosinusitis and asthma have been found in a significant number of people in WTC-exposed populations. A lack of appropriate respiratory protection may have contributed to these effects. Other commonly observed physical health conditions include gastro-esophageal reflux disease, obstructive sleep apnea and musculoskeletal injuries. Many WTC-exposed individuals also suffer from mental health conditions, primarily post-traumatic stress disorder, depression, panic disorder, and substantial stress reaction. Recent studies suggest that WTC exposure may increase the risk of cancer and of mortality from cardiac disease. Further research should be conducted to fully understand the impact of the WTC disaster on the health of these populations.Fire Technology 07/2012; 49(3). DOI:10.1007/s10694-012-0284-7 · 1.30 Impact Factor
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ABSTRACT: We study the geodesics on an invariant surface of a three dimensional Riemannian manifold. The main results are the characterization of geodesic orbits, Clairaut’s relation and its geometric interpretation in some remarkable three dimensional spaces, the local description of the geodesics, and the explicit description of geodesic curves on an invariant surface with constant Gauss curvature.Journal of Geometry and Physics 12/2009; 61(8-61):1385-1395. DOI:10.1016/j.geomphys.2011.03.002 · 0.87 Impact Factor