Impact of the September 11 attack on flight attendants: a study of an essential first responder group

This paper discusses a study (funded by the Center for Substance Abuse Prevention) of the health/mental health and work-related well-being of flight attendants in the aftermath of September 11. Flight attendants, as an occupational group, had a distinctive exposure to September 11. In addition to work-related exposure in the immediate aftermath of the attacks, flight attendants have experienced major and ongoing changes in their work environment and job description and many have been exposed to potentially traumatic incidents on the job. Analysis of survey and focus group data from flight attendants in the Association of Flight Attendants showed high reported stress and related mental health and behavioral impacts among flight attendants since September 11. A significant new finding is that the effect of continued trauma in the flight attendants' work environment impacted their ability to recover from the original trauma associated with the events of that day. This study highlights the role of the after-effects of a traumatic event on trauma response and suggests that direct exposure, as traditionally defined, is not necessarily a primary mediating factor in trauma response for this occupational group.