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PTSD Among 9/11 Recovery Workers

Rescue CrewA report shows that thousands of World Trade Center rescue and recovery workers were still suffering serious mental health effects three years after the disaster.

The data comes from the World Trade Center Health Registry’s initial survey of nearly 30,000 rescue and recovery workers. New findings released from the World Trade Center Health Registry show that one in eight rescue and recovery workers (12.4 percent) likely had post-traumatic stress disorder when they were interviewed in 2003 and 2004.

The respondents ranged from police officers and firefighters to clergy and construction workers. The prevalence of post-traumatic stress disorder (PTSD) varied significantly by occupation, with rates ranging from 6.2 percent among police officers to 21.2 percent among unaffiliated volunteers (those who were not working with an organization such as the Red Cross).

The prevalence of PTSD in the U.S. population is roughly 4 percent at any given time.

The findings are published in the American Journal of Psychiatry.

Like the unaffiliated volunteers, workers from non-emergency occupations such as construction, engineering and sanitation also suffered particularly high rates of PTSD.
It is unlikely that these workers had gone through disaster preparedness training or had experience with previous emergencies, both of which can help buffer psychological trauma.

People who started work on or soon after 9/11, or who worked for longer periods, were also more vulnerable to PTSD. For all occupations except police, the risk of PTSD was greatest among those who worked at the site for more than three months. The finding suggests that shortening work periods, and limiting exposure of those who have less prior exposure to trauma, might help reduce PTSD rates in future emergencies.

“Post-traumatic stress disorder can be devastating, affecting people’s families and work lives,” said Dr. Thomas R. Frieden, New York City Health Commissioner.

“People with PTSD are also more likely to suffer from depression and substance abuse. The Registry helps us gauge the persistence of these problems over time. It also helps us inform the public and the medical community about the health effects of 9/11, so that people can get the best possible care.”

The survey found that firefighters developed PTSD at nearly twice the rate of police officers (12.2 percent versus 6.2 percent), a finding consistent with past research. The discrepancy is not well understood, but the authors offer several possible explanations.

It may reflect the rigorous screening that police recruits undergo, but it could also reflect under-reporting by police officers who fear being judged unfit for duty. In addition, firefighters lost six times as many comrades as police officers, suggesting that grief may have compounded the trauma and the risk of PTSD.

Sustaining an injury, or having to evacuate a building, raised the risk of PTSD in nearly all of the groups surveyed. But other risk factors affected only certain types of workers. Performing search and rescue work raised the risk of PTSD for engineering and sanitation workers, but civilian volunteers were more likely to suffer if they engaged in firefighting or light construction work.

This suggests again that working outside of one’s area of expertise can place people at risk for developing PTSD.

The new findings highlight the value of disaster preparedness and training for all types of emergency responders, and point to concrete steps that could help minimize PTSD in future disasters:

    • Use shift rotations to reduce workers’ and volunteers’ duration of service at emergency sites.
    • Establish mental-health services to address the needs of rescue and recovery workers who have received less disaster training than police and fire staff.

The Health Department has linked all survey participants with mental-health issues to LifeNet, a 24-hour hotline operated by the Mental Health Association of New York City.

LifeNet provides an assessment, information and referrals and assists the caller in determining an appropriate place for care. When a person is in crisis, LifeNet will refer to a Mobile Crisis Team and will follow up to ensure contact is made. If you or someone you know is suffering with PTSD, or any other emotional or substance abuse problem, call 311 and ask for LifeNet. Services are available in multiple languages.

Update on Efforts to Learn More about WTC-Related Illness
The World Trade Center Health Registry, the largest public health registry in U.S. history, was launched in 2003 to track the health of people exposed to the collapse of the World Trade Center and those who worked at the WTC site. The registry is a collaborative effort involving the Health Department, the CDC’s Agency for Toxic Substances and Disease Registry (ATSDR), with funding from the Federal Emergency Management Agency (FEMA).

The Health Department is now re-surveying all 71,000 registrants to learn more about their current health status. So far, nearly 60 percent of registrants have responded. The re-survey will help determine whether respiratory and mental health conditions have persisted five to six years after the disaster. Because of its size, the registry can illuminate patterns that would elude individual physicians and provide valuable guidance to affected groups. Previous findings from the WTC Health Registry can be found at

The Health Department is also conducting a separate study of respiratory health among registrant and analyzing records to see whether the disaster has had affected cancer incidence. The Health Department – along with the Fire Department, Mount Sinai Medical Center and Bellevue Hospital – is also updating guidelines for treating adults with WTC-related illness. The same group is developing guidelines for treating affected children.

Source: New York City Health Department

PTSD Among 9/11 Recovery Workers

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). PTSD Among 9/11 Recovery Workers. Psych Central. Retrieved on January 21, 2019, from
Scientifically Reviewed
Last updated: 8 Aug 2018
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
Published on Psych All rights reserved.