A study involving nearly 13,000 World Trade Center (WTC) responders has examined post-traumatic stress disorder (PTSD) symptoms over a 20-year period from July 2002 to December 2022. The research shows that while PTSD symptoms can change, they persist for many responders and increase in a smaller portion of them. These changes help predict physical impairment and mental health outcomes years after the trauma.
Conducted by researchers at Stony Brook Medicine in affiliation with the World Trade Center Health and Wellness Program at Stony Brook University, the findings have been published online in Nature Mental Health.
The study is based on more than 81,000 clinical observations from 12,822 responders. It found that symptoms were stable in the short term but changed significantly over two decades, peaking over a decade after exposure and declining modestly thereafter. For confirmed PTSD cases, symptoms improved within eight to ten years on average. However, about 10 percent of participants reported elevated symptoms two decades post-trauma. Changes in symptoms also predicted higher functional impairments and increased mental health care utilization.
“Our findings highlight the enduring and long-term impact of PTSD among WTC responders, even with the substantial individual variability in PTSD symptom trajectories within the large sample,” said Frank Mann, lead author and senior research scientist in the Program in Public Health and Department of Medicine at the Renaissance School of Medicine (RSOM).
All participants are part of the Long Island WTC Health and Wellness Program funded by the National Institute for Occupational Safety and Health (NIOSH). This program provides annual monitoring visits for WTC-related disorders including PTSD.
“We believe that these findings...are an important roadmap to the ongoing nature of PTSD in our WTC responders,” said co-author Benjamin Luft, MD, director of the Stony Brook WTC Health and Wellness Program.
Luft noted an additional finding: Non-professional responders like construction workers were at greater risk for chronic PTSD compared to professional first responders. This highlights significant financial consequences associated with chronic PTSD development.
Mann, Luft, and their colleagues emphasize several takeaways: Consider long-term effects as symptom changes occur slowly; continual patient monitoring is essential as single-time screenings may miss late-emerging or relapsing cases; ongoing care is necessary due to high rates of accompanying physical and mental impairment among severe cases.