{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:06:12Z","timestamp":1787702772407,"version":"build-2784847793"},"posted":{"date-parts":[[2026,1,11]]},"group-title":"Epidemiology","reference-count":67,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T00:00:00Z","timestamp":1768089600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"id":[{"id":"https:\/\/ror.org\/00j4k1h63","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,6,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:p>\n                  General responders of the World Trade Center (WTC) Health Program were uniquely exposed to chemical toxicants and extreme psychological stress during the 2001 terrorist attack, and now experience unusually prevalent health outcomes for a mid-aged population, including frailty, Post Traumatic Stress Disorder (PTSD), and depression. We studied whether these conditions are linked to later-life urban environmental exposures among 18,734 responders, evaluating associations with annual fine particulate matter (PM\n                  <jats:sub>2.5<\/jats:sub>\n                  ), temperature, and Green View Index. A decile incremental increase in the overall exposure-mixture was associated with increased frailty (0.56%; 95% CI 0.14%;0.98%) and PTSD scores (0.31%; 95% CI 0.07%;0.55%). Effects were more pronounced among responders with higher WTC exposures, suggesting increased vulnerability. Here, we show that urban environmental exposures compound the chronic health burden in WTC responders, with effects possibly amplified by WTC-exposure history. This suggests that a history of trauma and toxicant exposure can create lasting biological vulnerability to subsequent environmental stressors.\n                <\/jats:p>","DOI":"10.64898\/2026.01.09.26343773","type":"posted-content","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T01:20:14Z","timestamp":1768180814000},"source":"Crossref","is-referenced-by-count":2,"title":["Urban Exposures, Frailty, and Mental Illness in World Trade Center Health Program Responders"],"prefix":"10.64898","author":[{"given":"Helena","family":"Krasnov","sequence":"first","affiliation":[{"name":"Department of Environmental Medicine, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Hung","sequence":"additional","affiliation":[{"name":"Geriatrics and Palliative Care, Icahn School of Medicine at Mount Sinai, New York, NY"},{"name":"Geriatric Research, Education and Clinical Center, James J Peters VA Medical Center, Bronx, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Knobel","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itai","family":"Kloog","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fred","family":"Ko","sequence":"additional","affiliation":[{"name":"Geriatrics and Palliative Care, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Colicino","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L.","family":"Teitelbaum","sequence":"additional","affiliation":[{"name":"Department of Environmental Medicine, Icahn School of Medicine at Mount Sinai, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan. 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