Health Conditions as Mediators of the Association Between World Trade Center Exposure and Health-Related Quality of Life in Firefighters and EMS Workers

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Objective:Studies have reported reduced health-related quality of life (HrQoL) in rescue/recovery workers for years postdisaster. Few have examined specific postdisaster physical and mental health conditions as mediators of the association between exposure to disaster and HrQoL.Methods:We used the Short Form-12 to measure HrQoL in 7190 male World Trade Center (WTC)-exposed first responders. Potential mediators included physician diagnoses obtained from medical records and mental health conditions obtained from questionnaires.Results:Among moderately and highly WTC-exposed workers, health conditions fully mediated the observed relationship between WTC-exposure and physical health functioning of HrQoL, and substantially mediated the association between WTC-exposure and mental health functioning.Conclusions:Because WTC-related health conditions explain the relationship between WTC-exposure and HrQoL, medical monitoring with treatment of affected populations is necessary to mitigate the adverse effects of WTC-exposure on HrQoL.

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