Resources

The Health Department released clinical guidelines  for health care providers on how to treat children and adolescents exposed to the WTC disaster. The guidelines were written and reviewed in collaboration with external medical experts and other clinical advisors.

In October 2007, a pediatrician joined the program staff at Bellevue World Trade Center Environmental Health Center. Parents who wish to make an appointment for a child who was exposed to the World Trade Center disaster and whom they believe is suffering from a health problem related to this exposure should call 877-WTC-0107.

Other Resources

What We Know from the Research

Among 3,184 children and adolescents enrolled in the WTC Health Registry: ¹

• 22% experienced an eye irritation or eye injury on September 11, 2001 as a result of the WTC attack.
• Nearly half (45%) were caught in the dust cloud.
• 50% witnessed a disturbing event.

Among child and adolescent enrollees 2 to 3 years after 9/11: ¹

• More than half (53%) had at least 1 new or worsened respiratory symptom, such as shortness of breath, sinus problems or wheezing.
• Young children caught in the dust cloud were twice as likely to have newly diagnosed asthma as children not caught in the dust cloud. About 6% of children under 5 years of age were diagnosed with asthma after 9/11, a rate twice as high as the regional (northeastern) rate for the same age group.

A high proportion of NYC public school children exposed to 9/11-related trauma developed a probable mental disorder.  The level of exposure and previous trauma increased the likelihood of  a mental health problem. A family member’s exposure to 9/11 was more strongly associated with a probable mental disorder than direct exposure, indicating that a parent or caregiver's 9/11-related trauma may have affected the child’s mental health.²

• In a study of 116 preschool children, those with prior traumatic experiences exposed to WTC-related trauma were at increased risk for developing sleep problems and behavioral issues. When evaluating the impact of terrorism and disaster on very young children, clinicians should consider disaster-related exposure and prior traumatic experience.³
• A study of 200 middle school children in lower Manhattan suggests that children exposed to additional trauma, before or after 9/11, had more severe PTSD symptoms than those exposed to 9/11-related trauma alone, regardless of how directly they were exposed.⁴

Among 1,040 adolescents attending schools closest to the WTC site, 10% reported an increase in alcohol or substance use 18 months after 9/11. While the study didn’t include a general population comparison group to adjust for time or age trends, substance use rose with reported 9/11 exposure, even after controlling for depression and PTSD.  For example, substance use among adolescents with 3 or more exposure risk factors was nearly 20 times higher as those with no exposure risk factors. Increased substance use was associated with impaired schoolwork, school behavior and grades.⁵

A small study of 102 pairs of mothers and their pre-school children exposed to 9/11 found that 3 years after 9/11:

• Children, especially boys, whose mothers had depression and PTSD were at greater risk for aggressive behavior, emotionally reactive behavior and physical complaints with no medical basis.⁶

References

1. Thomas, P, Brackbill R, Thalji L, et al. Respiratory and Other Health Effects Reported in Children Exposed to the World Trade Center Disaster of September 11, 2001 . Environmental Health Perspectives. 2008 October;116(10):1383-1390.
2. Hoven CW, Duarte CS, Lucas CP, et al. Psychopathology Among New York City Public School Children 6 Months After September 11. Archives of General Psychiatry. 2005;62:545-551.
3. Chemtob CM, Nomura Y, Abramovitz RA. Impact of Conjoined Exposure to the World Trade Center Attacks and to Other Traumatic Events on the Behavioral Problems of Preschool Children. Archives of Pediatric & Adolescent Medicine. 2008;162(2):126-133.
4. Mullett-Hume E, Anshel D, Guevara V et al.  Cumulative Trauma and Posttraumatic Stress Disorder among Children Exposed to the 9/11 World Trade Center Attack.  American Journal of Orthopsychiatry 2008; 78(1):103-108.
5. Chemtob CM, Nomura Y, Josephson L, et al.  Substance Use and Functional Impairment among Adolescents Directly Exposed to the 2001 WTC Attacks. Disasters 2009; 33(3):  337-352.
6. Nomura Y & Chemtob CM.  Effect of Maternal Psychopathology on Behavioral Problems in Preschool Children Exposed to Terrorism. Archives of Pediatric & Adolescent Medicine 2009; 163(6): 531-539.