{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T02:51:26Z","timestamp":1785466286010,"version":"3.56.0"},"reference-count":100,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2022,7,15]],"date-time":"2022-07-15T00:00:00Z","timestamp":1657843200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute of Occupational Safety and Health (NIH\/NIOSH), Centers of Disease Control and Prevention (CDC)","award":["200-2017-93327"],"award-info":[{"award-number":["200-2017-93327"]}]},{"name":"National Institute of Occupational Safety and Health (NIH\/NIOSH), Centers of Disease Control and Prevention (CDC)","award":["200-2017-93427"],"award-info":[{"award-number":["200-2017-93427"]}]},{"name":"National Institute of Occupational Safety and Health (NIH\/NIOSH), Centers of Disease Control and Prevention (CDC)","award":["U01 OH012486"],"award-info":[{"award-number":["U01 OH012486"]}]},{"name":"National Institute of Occupational Safety and Health (NIH\/NIOSH), Centers of Disease Control and Prevention (CDC)","award":["5P30ES000260"],"award-info":[{"award-number":["5P30ES000260"]}]},{"name":"National Institute of Environmental Health Sciences (NIEHS)","award":["200-2017-93327"],"award-info":[{"award-number":["200-2017-93327"]}]},{"name":"National Institute of Environmental Health Sciences (NIEHS)","award":["200-2017-93427"],"award-info":[{"award-number":["200-2017-93427"]}]},{"name":"National Institute of Environmental Health Sciences (NIEHS)","award":["U01 OH012486"],"award-info":[{"award-number":["U01 OH012486"]}]},{"name":"National Institute of Environmental Health Sciences (NIEHS)","award":["5P30ES000260"],"award-info":[{"award-number":["5P30ES000260"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Exposure to World Trade Center (WTC) dust\/fumes and traumas on 11 September 2001 has been reported as a risk factor for post-traumatic stress disorder (PTSD) and other mental\/physical health symptoms in WTC-affected populations. Increased systemic inflammation and oxidative stress from the exposure and subsequent illnesses have been proposed as contributors to the underlying biological processes. Many blood-based biomarkers of systemic inflammation, including C-reactive protein (CRP), are useful for non-invasive diagnostic and monitoring of disease process, and also potential targets for therapeutic interventions. Twenty years after 9\/11, however, the relationships between WTC exposure, chronic PTSD, and systemic inflammation are only beginning to be systematically investigated in the WTC-affected civilian population despite the fact that symptoms of PTSD and systemic inflammation are still common and persistent. This paper aims to address this knowledge gap, using enrollees of the WTC Environmental Health Center (EHC), a federally designated treatment and surveillance program for community members (WTC Survivors) exposed to the 9\/11 terrorist attack. We conducted a mediation analysis to investigate the association between acute WTC dust cloud traumatic exposure (WDCTE) on 9\/11, chronic PTSD symptoms, and levels of systemic inflammation. The data indicate that the chronic PTSD symptoms and some specific symptom clusters of PTSD significantly mediate the WDCTE on systemic inflammation, as reflected by the CRP levels. As both chronic PTSD and systemic inflammation are long-term risk factors for neurodegeneration and cognitive decline, further research on the implications of this finding is warranted.<\/jats:p>","DOI":"10.3390\/ijerph19148622","type":"journal-article","created":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T22:57:06Z","timestamp":1658098626000},"page":"8622","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Posttraumatic Stress Disorder Mediates the Association between Traumatic World Trade Center Dust Cloud Exposure and Ongoing Systemic Inflammation in Community Members"],"prefix":"10.3390","volume":"19","author":[{"given":"Yian","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Population Health, NYU Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, USA"},{"name":"HHC World Trade Center Environmental Health Center, 462 First Avenue, New York, NY 10016, USA"},{"name":"NYU Alzheimer Disease Research Center, 145 E 32 Street, New York, NY 10016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Rosen","sequence":"additional","affiliation":[{"name":"HHC World Trade Center Environmental Health Center, 462 First Avenue, New York, NY 10016, USA"},{"name":"Department of Psychiatry, NYU Grossman School of Medicine, 550 First Avenue, New York, NY 10016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Reibman","sequence":"additional","affiliation":[{"name":"HHC World Trade Center Environmental Health Center, 462 First Avenue, New York, NY 10016, USA"},{"name":"Department of Medicine, NYU Grossman School of Medicine, 550 First Avenue, New York, NY 10016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongzhao","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Population Health, NYU Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, USA"},{"name":"HHC World Trade Center Environmental Health Center, 462 First Avenue, New York, NY 10016, USA"},{"name":"NYU Alzheimer Disease Research Center, 145 E 32 Street, New York, NY 10016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1196\/annals.1371.002","article-title":"The anatomy of the exposures that occurred around the World Trade Center site: 9\/11 and beyond","volume":"1076","author":"Lioy","year":"2006","journal-title":"Ann. 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