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WTC Rescue and Recovery Workers Suffering High Rates of Post-Traumatic Stress

Rescue and recovery workers at the World Trade Center (WTC) site are suffering from rates of post-traumatic stress syndrome (PTSD) as high as four times greater than those found among the general population.

And, say researchers, they are showing higher rates of panic and anxiety than the general population. Surprisingly, rates for depression are nearly half that found in the general population and the prevalence of alcohol abuse and dependence is just slightly higher than that found among the general population.

After the 9/11 attacks on the World Trade Center (WTC), a comprehensive screening program was established to evaluate the physical and mental health of rescue and recovery workers and volunteers. Anyone who participated in the WTC rescue or recovery efforts and met specific time criteria for exposure to the site were eligible for the study.

From July 16, 2002 to Aug. 6, 2004, the program evaluated 11,768 workers and volunteers. A report in the Sept. 10 edition of the Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention summarizes data analyzed from a subset of 1,138 of the 11,768 participants evaluated at the Mount Sinai School of Medicine

The questionnaires evaluated general psychiatric symptoms; possible cases of post-traumatic stress syndrome; symptoms of panic, generalized anxiety, and depression; alcohol dependence and abuse; and functioning levels at home and work. Participants who met threshold criteria or acknowledged suicidal ideation or substantial disability on any questionnaire were referred for clinical evaluations by mental health professionals on the same day.

Participants, who were predominantly male and non-Hispanic white, worked, on average, approximately 4 months of 8-hour workdays at the WTC site. The study found that the majority of participants (51 percent) met criteria for a clinical mental health evaluation on at least one screening questionnaire. Symptoms of depression, panic, and generalized anxiety were each reported by approximately 6 percent of participants. The top three emotionally related disabilities were problems with social life (15 percent), work (14 percent) and home life (13 percent).

Approximately 20 percent of participants reported symptoms meeting the thresholds for PTSD, a number four times higher than the rate of PTSD found in the general population.

"The direct and protracted nature of the rescue and recovery workers and volunteers' exposure to the aftermath of the 9/11 attacks differentiates these persons from the general population," noted researchers. "These responders are unlike previous populations of rescue workers because of the heterogeneity of their occupations (e.g., construction trades, utilities and sanitation workers and first responders) and the documented health effects of their WTC work."

They noted the preliminary findings regarding the possible cases of PTSD among the WTC workers underscore the need for better tools to assess the mental health of responders to a disaster.

"Approximately half of the participants met pre-established screening criteria for mental health problems," noted researchers. "Despite substantial resources directed at the mental health effects of 9/11, only 3 percent of this population reported having accessed mental health treatment. The mental health effects observed in this population suggest the need for further mental health screening, follow-up and access to mental health services for WTC rescue and recovery workers and volunteers."

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