Effects of Hurricane Sandy on the Respiratory and Mental Health of WTC Responders

描述(申请人提供)：飓风桑迪造成了纽约许多社区的破坏。特别是，长岛经历了大洪水和强风，导致许多人几周没有电，房屋被毁，霉菌和其他环境毒素留下。生活在这些高度受影响地区的最脆弱群体之一是2001年9月11日世界贸易中心(WTC)遇袭(9/11)的响应人员，他们中的许多人仍然是积极的响应人员，由于对9/11的反应，他们有持续的呼吸和心理问题，或者两者兼而有之。石溪WTC健康计划为7000名WTC响应人员提供每年与WTC相关的健康监测和治疗。每年，我们都会系统地评估身体和精神健康状况，过去八年来，我们一直在跟踪这一情况。飓风桑迪过后，我们立即开始筛查与飓风桑迪相关的风险。暴露在这场灾难中的WTC响应人员可能特别有可能出现新的或恶化的健康问题。拟议研究的总体目标是评估飓风桑迪造成的环境毒素和心理创伤的暴露水平及其对呼吸和心理健康的影响，样本为550名来自受严重影响地区的WTC响应人员。其具体目标是：(1)通过检查飓风桑迪前后呼吸系统症状、肺功能、创伤后应激障碍和抑郁症状的变化，评估灾害对WTC响应人员的影响；(2)记录暴露于环境毒素(即霉菌和粉尘)和心理创伤，并评估这些暴露对呼吸症状、肺功能和心理健康的影响；(3)确定飓风桑迪后创伤后应激障碍症状是否为灾后呼吸系统症状和肺功能的风险因素，以及创伤后应激障碍是否调节有毒暴露对呼吸健康的影响。我们将使用多模式评估，包括自我报告、结构化临床访谈以及皮肤和血清过敏测试。通过利用飓风桑迪之前的健康数据，我们将能够识别 灾后身心健康问题。这项研究还将提供翻译价值，通过进一步了解呼吸系统疾病和创伤后应激障碍是如何相互作用的。因此，目前的调查提供了一个独特的科学机会，以了解飓风桑迪在高危人群中的后遗症以及干预和预防的可能途径。

DESCRIPTION (provided by applicant): Hurricane Sandy resulted in the devastation of many communities in New York. In particular, Long Island experienced major flooding and powerful winds that left many without electricity for weeks, destroyed homes, and left behind mold and other environmental toxins. One of the most vulnerable groups living in these highly affected areas is responders to the attacks on the World Trade Center (WTC) on September 11, 2001 (9/11), many of whom continue to be active responders and, have persistent respiratory and psychological problems, or both, as a result of their response to 9/11. The Stony Brook WTC Health Program provides yearly health monitoring and treatment for WTC-related conditions for 7,000 WTC responders. Each year we systematically assess physical and mental health conditions, which we have been tracking in our cohort for the past eight years. Immediately after Hurricane Sandy, we began screening for Hurricane Sandy-related exposures. WTC responders exposed to this disaster may be particularly at-risk for new or exacerbation of health problems. The overall objective of the proposed study is to evaluate levels of exposure to environmental toxins and psychological trauma as a result of Hurricane Sandy and their effects on respiratory and mental health in a sample of 550 WTC responders from highly affected areas. The specific aims are to: (1) evaluate the impact of the disaster on WTC responders by examining changes from pre to post hurricane Sandy, in respiratory symptoms, lung functioning, and PTSD and depression symptoms; (2) document exposure to environmental toxins (i.e., mold and dust) and psychological trauma, and evaluate the impact of these exposures on respiratory symptoms, lung functioning, and mental health; (3) determine whether post-Hurricane Sandy PTSD symptoms are a risk factor for post disaster respiratory symptoms and lung functioning, and if PTSD mediates the impact of toxic exposures on respiratory health. We will use multimodal assessments including self-report, structured clinical interviews, and skin and serum allergy testing. By utilizing pre-Hurricane Sandy health data, we will be able to identify risk factors for post- disaster physical and mental health problems. This study will also provide translational value by furthering our understanding how respiratory disease and PTSD interact with one another. Thus, the current investigation offers a unique scientific opportunity to learn about the sequelae of Hurricane Sandy in an at-risk population and possible avenues for intervention and prevention.