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Long Island WTC Health Program 

Stony Brook University Medical School 














Geography 







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 
Medical Center. 










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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 
various trades). 













Growth of LI Clinic over 7 Years 





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Collaborative Care Treatment Model 




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(internists, clinical social workers and specialists) and care across 
illness and health domains, for example, management of pulmonary 
disease that is comorbid with PTSD. 



Result: 






- Cost-effective 

- Comprehensive 



- 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 
populations. 



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 



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about their personal experiences and its impact 10 years later. 

Purpose: 

- 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.