What We Know From The Research

Physical Health

A month after 9/11, nearly 50% of people living near the WTC site who participated in a survey about their health needs and concerns said they had nose, throat or eye irritation.¹

A small study of non-smoking women who delivered a baby within a month after 9/11 at a facility within 2 miles of the WTC  showed significant decreases in birth weight and length.²

A study compared the estimated smoke plume path 5 days after 9/11 with health survey findings of about 3,000 New Yorkers 6 months after 9/11. Of respondents outside lower Manhattan, the study showed no connection between the estimated smoke plume intensity and new or worsening respiratory symptoms among those with asthma. However, the smoke plume was different from the WTC dust cloud.³ 

Eight percent (8%) of residents enrolled in the WTC Health Registry reported newly diagnosed asthma 5 to 6 years after 9/11.  Intense dust cloud exposure on 9/11, experiencing a heavy coating of dust in the home and not evacuating homes were major contributors to new asthma diagnoses.⁴

A  study of nearly 2,000 people exposed to WTC dust who sought care at the WTC Environmental Health Center 5 to 7 years after 9/11 showed high rates of respiratory symptoms, including persistent shortness of breath, cough and sinus or nasal problems.  While pulmonary function was normal for the total group, about one-third (31%) had below-normal pulmonary function similar to the level found in WTC rescue, recovery and clean up workers.⁵

Mental Health

Those directly affected by 9/11 were more likely to report post-traumatic stress disorder (PTSD) symptoms 6 months after 9/11.  However, a substantial number not directly affected also met the criteria for probable PTSD.⁶

In a study that examined the prevalence of resilience among New Yorkers during the 6 months after 9/11, 65% of participants showed resilience (ability to recover). This suggests that more New Yorkers demonstrated resilience during the 6 months after 9/11 than previously believed. Even  among those with the highest levels of exposure and highest probable PTSD, the proportion that were resilient never dropped below 33%.⁷

A small study of New Yorkers 18 to 21 years of age with and without generalized anxiety disorder compared their mental health before and after 9/11.  Among those with generalized anxiety disorder, findings showed high rates of functional impairment but no increase in  post-traumatic stress symptoms.⁸

A study of 2,300  New Yorkers interviewed 1, 2 and 3 years after 9/11 showed that:

• People who received early, brief interventions at their worksites reported better mental health than those who received more extensive interventions, such as  psychotherapy of 30 minutes or longer.  Although the study adjusted for  9/11 exposure, it  did not adjust for illness severity.  Support from friends, neighbors and spiritual communities was also beneficial.⁹
• Problem drinking and alcohol use were connected with psychological trauma up to 4 years after 9/11, as well as other mental health problems.¹⁰

More than 21% of residents enrolled in the WTC Health Registry reported new PTSD symptoms 5 to 6 years after 9/11.  Probable PTSD among residents increased from more than 13% 2-3 years after the attacks to more than 16% 5-6 years later. Risk factors included:

• Intense dust cloud exposure
• Witnessing horror
• Returning to a home with a heavy layer of dust
• Job loss
• Lack of social support¹¹

To search for 2003/2004 baseline survey data, visit the Health Department's interactive data tool.

References

1. Kramer R, Hayes MA, Nolan V, et al. Community needs assessment of lower Manhattan residents following the World Trade Center Attacks — Manhattan, New York City, 2001. Morbidity and Mortality Weekly Report. 2002. 51;10-13.
2. Lederman SA, Rauh V, Weiss L, et al. The effects of the WTC event on birth outcomes among term deliveries at three lower Manhattan hospitals. Environmental Health Perspectives. 2004. 112;1772-1778.
3. Laumbach RJ, Harris G, Kipen HM, et al. Lack of Association Between Estimated WTC Plume Intensity and Respiratory Symptoms among New York City Residents Outside of Lower Manhattan. American Journal of Epidemiology 2009; [Epub ahead of print].
4. Brackbill RM, Hadler JL, Ekenga CC, et al. Asthma and Posttraumatic Stress Symptoms 5 to 6 Years Following Exposure to the WTC Terrorist Attack. Journal of the American Medical Association 2009; 302(5):502-516.
5. Reibman J, Liu M, Cheng Q, et al. Characteristics of a Residential and Working Community with Diverse Exposure to WTC Dust, Gas and Fumes. Journal of Occupational and Environmental Medicine 2009; 51(5):534-541.
6. Galea S, Vlahov D, Resnick H, et al. Trends of probable post-traumatic stress disorder in New York City after the September 11 terrorist attacks. American Journal of Epidemiology. 2003. 58;514-524.
7. Bonanno GA, Galea S, Bucciarelli A,  et al. Psychological resilience after disaster:  New York City in the aftermath of the September 11th terrorist attacks. Psychological Science 2006. 17;181-186.
8. Farach FJ, Mennin DS, Smith RL, & Mandelbaum M. The Impact of Pretrauma Analogue GAD and Posttraumatic Emotional Reactivity Following Exposure to the September 11 Terrorist Attacks: A Longitudinal Study. Behavior Therapy 2008; 39: 262-276.
9. Boscarino JA & Adams RE. Overview of Findings from the WTC Disaster Outcome Study: Recommendations for Future Research after Exposure to Psychological Trauma. International Journal of Emergency Mental Health 2008; 10(4): 275-290.
10. Cerda M, Vlahov D, Tracy M & Galea S. Alcohol Use Trajectories among Adults in an Urban Area after a Disaster: Evidence from a Population-based Cohort Study. Addiction 2008; 103: 1296-1307.11. 
11. Brackbill RM, Hadler JL, Ekenga CC, et al. Asthma and Posttraumatic Stress Symptoms 5 to 6 Years Following Exposure to the WTC Terrorist Attack. Journal of the American Medical Association 2009; 302(5): 502-516.