Longitudinal study of probable post-traumatic stress disorder in firefighters exposed to the World Trade Center disaster

Am J Ind Med. 2010 Dec;53(12):1177-85. doi: 10.1002/ajim.20894.


Background: Symptoms of post-traumatic stress disorder (PTSD) have been reported even years after the terrorist attacks of September 11, 2001 (9/11).

Methods: We used screening tools to assess the prevalence of probable PTSD in 9/11-exposed firefighters at two time points, within 6 months of 9/11 (baseline) and 3-4 years post-disaster (follow-up).

Results: Five thousand six hundred fifty-six individuals completed assessments at both times. 15.5% reported probable PTSD post-9/11, 8.6% at baseline and 11.1% at follow-up, on average 2.9 (SD 0.5) years later. Analyses revealed that nearly half of all probable PTSD occurred as delayed onset (absent baseline, present follow-up). Compared with the resilient group (no probable PTSD at either time), probable PTSD at baseline, and delayed onset at follow-up were each associated with concomitant functional impairment (OR 19.5 and 18.9), respectively.

Conclusion: Similar percentages of firefighters met criteria for baseline and delayed onset probable PTSD at follow-up, years later. Both were associated with substantial functional impairment. Early risk identification could provide opportunities for mental health interventions before symptoms compromise work and social relationships.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Alcoholism
  • Confidence Intervals
  • Disease Progression
  • Female
  • Fires / statistics & numerical data*
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Mental Health
  • Middle Aged
  • Multivariate Analysis
  • New York City / epidemiology
  • Occupational Diseases / diagnosis
  • Occupational Diseases / epidemiology
  • Occupational Diseases / etiology
  • Occupational Diseases / psychology*
  • Occupational Exposure / adverse effects*
  • Odds Ratio
  • Prevalence
  • Psychometrics
  • Risk Assessment
  • Risk Factors
  • September 11 Terrorist Attacks / statistics & numerical data*
  • Stress Disorders, Post-Traumatic / diagnosis
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / etiology
  • Stress Disorders, Post-Traumatic / psychology*
  • Surveys and Questionnaires
  • Time Factors
  • Young Adult