NEW YORK CITY – August 31, 2006 – Today, the Health Department released updated clinical guidelines for New York City health care providers on how to treat adults exposed to the World Trade Center (WTC) disaster. The guidelines also recommend screening approaches to improve detection of illness possibly associated with WTC exposures. The guidelines are available online at http://www.nyc.gov/html/doh/downloads/pdf/chi/chi25-7.pdf, and are being mailed out to all doctors and to other providers citywide. They will also be posted on state and federal websites for use by providers outside the New York City area. The guidelines will be updated periodically based on published scientific data.
The guidelines released today incorporate the latest available published information on physical health effects as well as new national guidelines on general treatment of respiratory disorders released earlier this year. They provide information to help assess exposures, assist in diagnosis and treatment, provide preventive services, and refer for consultation or specialty care. Previously, the Health Department provided guidelines on treatment of depression, post-traumatic stress disorder, and chemical dependency to clinicians in New York City. The guidelines released today update these previous guidelines, as well as previously released medical guidelines prepared by Mt. Sinai hospital and FDNY physicians, and provide physical and mental health information in one document.
"Five years after the World Trade Center attacks, many New Yorkers have disaster-associated physical and mental health conditions," said Health Commissioner Dr. Thomas R. Frieden. "Today, we are releasing an important document to help doctors better recognize and treat these illnesses. Doctors should ask their patients about WTC exposure, especially patients who are experiencing respiratory symptoms, reflux disease, mental health problems, or substance use disorders."
"We anticipate that the updated guidelines will help health professionals diagnose and treat prevalent World Trade Center associated conditions," said Dr. John Howard, coordinator of WTC health response programs for the U.S. Department of Health and Human Services. "We will help distribute the guidelines to physicians and others who are assisting individuals exposed to the WTC disaster."
These guidelines have been written and rigorously reviewed in collaboration with medical experts across WTC Medical Monitoring and Treatment Programs, the New York City Fire Department's WTC medical monitoring program, and NYU/Bellevue. Drafts were shared with community physicians as well as with the WTC Health Registry's Labor and Community Advisory Committees for input.
Tracking the Long-Term Health of People in the WTC Health Registry
The World Trade Center Health Registry is a collaborative effort between the Health Department and the federal Agency for Toxic Substances and Disease Registries (ATSDR). The Registry tracks the long-term physical and mental effects of more than 71,000 Registry participants, which include first responders (fire fighters, police officers), other City agency and private recovery workers, individuals who were working in office buildings on the morning of the attacks, school children in lower Manhattan, and others who were highly exposed to the WTC disaster. This Registry is the largest registry of its kind in the history of the U.S. and enrollees will be tracked for up to 20 years. The Registry serves as a platform to maintain communication with a wide range of affected people and has developed and maintained a frequently-updated resource guide to assist enrollees and the public in locating specialized care and learn about additional services in New York City and the surrounding counties. It is also a unique resource for health researchers around the country. Results from the first survey of Registry enrollees indicate that:
- Nearly half of adult enrollees reported new or worsened sinus or nasal problems after 9/11.
- There are high levels of psychological distress among registrants compared to the citywide average two to three years after the event.
- More than half of 8,000 registrants who survived the collapse and/or escaped from damaged buildings on 9/11 reported new or worsening respiratory symptoms, and almost all witnessed events with a strong potential for causing psychological trauma. More than one in ten (11%) screened positive for serious psychological distress.