Exposure to the World Trade Center Disaster, Health, and Health-Related Quality of Life Nearly 20 Years After 9/11

Exposure to the terrorist attacks on the World Trade Center (WTC) on September 11, 2001, has been associated with several chronic physical and mental health conditions. We assessed the burden, nearly 20 years after the attacks, of several 9/11-related health conditions and indicators of poor health-related quality of life (HRQOL) among individuals exposed to the WTC disaster.

Among individuals enrolled in the longitudinal WTC Health Registry in 2020-2021 (N = 26,964), we estimated post-9/11 prevalence of: self-reported diagnosed physical health conditions known to be associated with WTC exposure; probable posttraumatic stress disorder (PTSD) and depression; and poor HRQOL indicators. We also compared lifetime prevalence of selected conditions and poor-HRQOL indicators among WTC-exposed rescue and recovery workers and community members, separately, to New York State general population estimates, using multivariable-adjusted logistic regression.

Prevalence of post-9/11 physical health conditions ranged from 10.5% (chronic obstructive pulmonary disease, COPD) to 26.3% (gastroesophageal reflux disease). Prevalence of probable post-9/11 PTSD and depression were 9.6% and 12.7%, respectively. Lifetime prevalence of physician-diagnosed asthma, COPD, and depression were higher among WTC-exposed individuals compared to the general population. Indicators of poor HRQOL were higher among WTC Registry enrollees relative to the general population, and among enrollees with any physical or probable mental health conditions compared to enrollees without any conditions.

Nearly 20 years after 9/11, WTC-exposed populations experience a high burden of health conditions that affect their wellbeing, highlighting the need for continued monitoring of this population.