Long Island WTC Health Program
Stony Brook University Medical School
Nassau and Suffolk counties
1,200 square miles, suburban
- Goal: Accessible and Convenient Options
- 2 Clinical Centers on in each county
I 9 Islandia, Suffolk County: Central hub for the Lonj
Island Clinical Center of Excellence. Affiliated with
Stony Brook Medical Center.
• Garden City, Nassau County: Affiliated with
Winthrop University Hospital.
Brooklyn- New clinic to open at SUNY- Downstate
Long Island Clinical Center of Excellence
(Nassau and Suffolk)
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• Cohort size is 6,205 responders.
By the end of Year 7, our retention rate was in the
enrolled in Treatment Program - 2,900 active patients
(seen past 12 months) and - 4,200 ever enrolled.
50% traditional 1 st responder.
50% non-traditional responder (construction and
Growth of LI Clinic over 7 Years
Collaborative Care Treatment Model
(internists, clinical social workers and specialists) and care across
illness and health domains, for example, management of pulmonary
disease that is comorbid with PTSD.
- Better management of complex cases
- Increase adherence
- Overcame barriers to treatment:
• Provider Lack of Availability
• Financial Barriers
• Geographic Barriers
Exposure, Probable PTSD, and Lower Respiratory
Illness among World Trade Center Rescue,
Recovery, and Clean-up Workers
Luft et al. (in press). Psychological Medicine.
• Physical illness and PTSD have been linked in various
8,508 police and 12,333 non-traditional responders
examined at the WTC Health Program
PTSD and respiratory symptoms were correlated (r = 0.28).
PTSD statistically mediated the association of WTC
exposures with respiratory symptoms.
The link between PTSD and respiratory symptoms is
notable, supports integrated medical and psychiatric
treatment for disaster responders.
'Burden of mental-physical comorbidity'
E. Bromet, R. Kotov, B. Luft
Identify mechanisms responsible for the comorbidity
- Psychiatric: PTSD, anxiety, depression
- Medical: lower respiratory symptoms, asthma, abnormal lung
function, GERD, hypertension
Telephone interviews with 5,000 patients from all of the clinics
- Quality of life, health risk perceptions, and PTSD diagnosis
Compare outcomes at Islandia, which provides integrated medical
and psychiatric care, with other patients receiving "usual" care
- Control for Visit 1 demographic and illness characteristics
"Enhanced smoking cessation intervention"
R. Kotov, E. Bromet, B. Luft
Key risk factors to pulmonary problems: smoking & PTSD
PTSD makes quitting more difficult, enhanced treatment
(smoking cessation + psychotherapy) is needed
Study will compare, in a randomized clinical trial, the effect
of enhanced treatment vs. standard treatment on
1 . Abstinence from tobacco
2. PTSD symptoms
3. Respiratory symptoms
100 smokers with PTSD symptoms will be randomized
Develop a powerful new intervention for a difficult to treat
group of WTC responders
WTC Oral History Project
about their personal experiences and its impact 10 years later.
- Document the human perspective of the WTC disaster.
- Focus on personal stories from the Responder perspective.
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- Expand our knowledge about the disaster beyond the medical effects.
- Develop a resource for future generations to learn about 9/11.
Library of Congress will provide a permanent
home in the American Folklife Center.