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Neurological and Cognitive Health Publications

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2020

  • Post-9/11 Mental health comorbidity predicts self-reported confusion or memory loss in world trade center health registry enrollees
    • Numerous studies have reported elevated levels of chronic mental health conditions in those exposed to the 9/11 World Trade Center attacks. Few studies have examined the confusion or memory loss (CML) or its association with mental health among 9/11 survivors. We investigated CML and its association with having one or more mental health conditions (PTSD, depression, and anxiety) in 10,766 World Trade Center Health Registry enrollees. These enrollees were aged 35–64 at the time of the Wave 4 survey (2015–2016) and had also completed Waves 1-3. Twenty percent of enrollees reported having CML. We also found the likelihood of having CML in-creased with the number of mental health conditions a person reported. Confusion or memory loss experienced by 9/11 survivors may be due in part to the mental health consequences of the 9/11 attacks. Doctors treating 9/11 survivors with mental health conditions should be aware of potential cognitive impairment such as confusion or memory loss. 
    • Alper, H. E., Tuly, R. A., Seil, K., & Brite, J. (2020). Post-9/11 Mental Health Comorbidity Predicts Self-Reported Confusion or Memory Loss in World Trade Center Health Registry Enrollees. International Journal of Environmental Research and Public Health, 17(19), 7330. https://doi.org/10.3390/ijerph17197330 

2019

  • Population-based age adjustment tables for use in occupational hearing conservation programs
    • Hearing tests are used to assess changes in hearing and report worker health problems. This study developed tables that adjusted for age. It validated the tables using data on firefighter and emergency medical service workers from a large U.S. survey. Different trends were observed among people identifying with non-Hispanic Black race/ethnicity. The population-based tables matched well with changes over time in hearing sensitivity. The tables provide a good replacement for those used by current U.S. regulations. They address a broader range of worker ages, account for differences in hearing sensitivity by race/ethnicity and have been validated for men. 
    • Flamme, G. A., Deiters, K. K., Stephenson, M. R., Themann, C. L., Murphy, W. J., Byrne, D. C., Goldfarb, D. G., Zeig-Owens, R., Hall, C., Prezant, D. J., & Cone, J. E. (2020). Population-based age adjustment tables for use in occupational hearing conservation programs. International Journal of Audiology, 59(sup1), S20–S30. https://doi.org/10.1080/14992027.2019.1698068 
  • Hearing Loss Among World Trade Center Firefighters and Emergency Medical Service Workers
    • A study examined how being near the World Trade Center (WTC) during the 9/11 attacks affected people's long-term health, specifically their hearing. The study found that people who were at the WTC on the morning of September 11, 2001, had a higher chance of having trouble hearing sounds at both low and high frequencies when they were checked after the attacks. People who spent more than six months working at the WTC site were also more likely to have hearing problems. People who were exposed to the WTC dust and debris for a longer time were at a greater risk of hearing loss. These differences in hearing problems between groups lasted for at least 15 years.
    • Flamme, G. A., Goldfarb, D. G., Zeig-Owens, R., Hall, C. B., Vaeth, B. M., Schwartz, T., Yip, J., Vossbrinck, M., Stein, C. R., Friedman, L., Cone, J. E., & Prezant, D. J. (2019). Hearing Loss Among World Trade Center Firefighters and Emergency Medical Service Workers. Journal of Occupational & Environmental Medicine, 61(12), 996–1003. https://doi.org/10.1097/JOM.0000000000001717 
  • Persistent Hearing Loss Among World Trade Center Health Registry Residents, Passersby, and Area Workers, 2006-2007
    • A previous publication from the World Trade Center (WTC) Health Registry (Registry) on a cohort of individuals exposed to the events of the WTC disaster of September 11th , 2001 (9/11), found that exposure to the dust cloud, an environmental hazard resulting from the collapse of the WTC towers, among those who evacuated damaged and destroyed buildings was associated with self-reported hearing problems. A more recent publication from the Registry reported that among rescue and recovery workers, higher levels of WTC exposure – defined using a composite score based on one’s location on the morning of 9/11, date of arrival at the WTC site, total days worked a the WTC site, and specific time periods worked on the debris pile at the WTC site- and being unable to hear in the dust cloud were both independently associated with more than double the odds of hearing problems. For our latest study, we used responses to the first two Registry surveys to examine the association between exposure to the dust cloud and persistent hearing loss among survivors (n = 22,741). The prevalence of post-9/11 persistent hearing loss among WTC survivors was 2.2%. Those who were in the dust cloud and unable to hear had three times the odds of reporting persistent hearing loss. Survivors with persistent sinus problems, headaches, Post Traumatic Stress Disorder, and chronic disease histories had an increased prevalence of reported hearing problems compared to those without symptoms or chronic-health problems. Public health officials should consider including questions about hearing trouble in surveys following future disasters involving chemical, dust, or blast exposures. Audiometric screening is also recommended as part of ongoing medical surveillance for subsequent health effects.
    • Cone, J. E., Stein, C. R., Lee, D. J., Flamme, G. A., & Brite, J. (2019). Persistent Hearing Loss among World Trade Center Health Registry Residents, Passersby and Area Workers, 2006–2007. International Journal of Environmental Research and Public Health, 16(20), 3864. https://doi.org/10.3390/ijerph16203864 
  • A Cognitive Reserve and Social Support-Focused Latent Class Analysis to Predict Self-Reported Confusion or Memory Loss among Middle-Aged World Trade Center Health Registry Enrollees
    • A study conducted by the World Trade Center Health Registry surveyed 9/11 survivors about their health conditions over time. The prevalence of posttraumatic stress disorder (PTSD) remains high among the cohort. It is a risk factor for memory loss. The study examined the degree of confusion or memory loss occurring among enrollees aged 35–64 years.
    • Seil K, Yu S, Alper H. A Cognitive Reserve and Social Support-Focused Latent Class Analysis to Predict Self-Reported Confusion or Memory Loss among Middle-Aged World Trade Center Health Registry Enrollees. Int. J. Environ. Res. Public Health. 2019 April;16(8):1401. https://doi.org/10.3390/ijerph16081401. PMID: 31003460; PMCID: PMC6517899

2017

  • Persistent Post-9/11 Hearing Problems Among World Trade Center Health Registry Rescue and Recovery Workers, 2001-2007
    • Hearing loss is a concern among World Trade Center Health Registry (WTCHR) enrollees. A previous study of enrollees who were WTC Tower survivors found that exposure to the cloud of dust and debris generated by the collapse and fires in the WTC Towers and surrounding buildings was associated with reported hearing problems. More recently enrollees have contacted the Registry to discuss concerns about hearing loss. Possible WTC-related causes for hearing loss include ruptured ear drums, head trauma from injuries, toxic exposures in smoke, dust and debris, or noise exposure. Our recently published study found that among those rescue and recovery workers without pre-9/11 hearing problems, 4.4% reported persistent hearing problems in 2006-2007. Men reported more hearing problems than women, and on average, those with hearing problems were older. The prevalence of hearing problems increased with increased numbers of WTC-related environmental hazards. Workers who reported being unable to hear in the dust cloud had over 2 times the odds of reporting hearing problems, compared to workers not in the dust cloud. This study has led the Registry to partner with the Fire Department of the City of New York in a study of hearing function before and after 9/11/01 among firefighters and Emergency Medical Service workers. Future disaster follow-up should include surveillance evaluation of hearing loss among responders.
    • Stein, C. R., Lee, D. J., Flamme, G. A., & Cone, J. E. (2017). Persistent Post-9/11 Hearing Problems Among World Trade Center Health Registry Rescue and Recovery Workers, 2001 to 2007. Journal of Occupational & Environmental Medicine, 59(12), 1229–1234. https://doi.org/10.1097/JOM.0000000000001171