a brief(200 word APA style) description of the natural disaster or terrorist activity you selected. Then explain the scope of the impact of the disaster in YOUR community, including who and what might be impacted in YOUR community and how. Be specific.

Environmental Health Perspectives • VOLUME 116 | NUMBER 9 | September 2008 A 395

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Disaster Response Mental Health Effects among WTC Rescue and Recovery Workers The attacks on the World Trade Center (WTC) on 11 September 2001 exposed thousands of emergency responders and other recov- ery workers to a unique mix not only of airborne toxic pollutants but also psychological stressors. The physical consequences such as persistent respiratory ailments have been documented previously [e.g., EHP 114:1853–1858 (2006)]. The latest report from a 5-year study of health effects among WTC rescue and recovery workers describes a higher level of lingering mental health problems among t h e s e w o r k e r s t h a n i n t h e g e n e r a l p o p u l a t i o n [ E H P 116:1248–1253; Stellman et al.].

More than 10,000 WTC workers completed several standard mental health questionnaires 10–61 months after the attacks. About 90% of the respondents worked at the WTC site during the first 2 weeks after 9/11, and the majority remained onsite for 3 months or longer. On the basis of an analysis of their responses, and in the absence of a clinical evaluation, the researchers classified 11.1% of workers with probable post-traumatic stress disorder (PTSD), 8.8% with probable depression, 5.0% with probable panic disorder, and 62% with substantial stress reactions (such as nightmares, flash- backs, and insomnia). Overall, mental health problems declined gradually from 13.5% to 9.7% among WTC workers during the course of the study.

The incidence of PTSD in WTC workers, which parallels that reported in soldiers returning from combat duty in Afghanistan, was about 4 times higher than that for the general population in the United States. Probable PTSD was associated with having lost family members or friends in the attacks; those with probable PTSD had a 17-fold greater likelihood of reporting disruption of family, work, and social life. About half those with probable PTSD also experienced probable panic disorder, depression, or both. Workers with probable PTSD also perceived their children as

having more psychological symptoms (such as clinginess or trouble sleeping) and behavioral problems than workers without PTSD.

Alcohol-related problems also were abundant in the study group. More than 17% reported symptoms of probable alcohol abuse. Nearly half reported drinking more heavily than usual during the period they worked at rescue and recovery efforts, and months later a third were still drinking more than usual.

The authors conclude that the variety of persistent mental health problems in responders “underscores the need for long-term mental health screening and treatment programs targeting this population.” Following future environmental disasters, they write, mental health problems are virtually certain to accompany physical effects of toxic exposures. Rescue and recovery workers therefore should receive behavioral health evaluations as well as medical evaluations to reduce adverse health and social consequences. –Carol Potera

“Metal Detector” Gene May Influence Lead Absorption Variants Predict Higher Blood Lead Levels in Children An estimated 310,000 U.S. children between ages 1 and 5 have ele- vated blood lead levels despite efforts to reduce lead in the environ- ment. Research in the past decade has begun to focus on factors that could make some children more susceptible to lead poisoning even at low levels of exposure. A new study explores one such pos- sible factor—gene variants that influence lead absorption—linking variants in two iron metabolism genes to higher blood lead levels in children [EHP 116:1261–1266; Hopkins et al.].

When researchers analyzed umbilical cord blood from 422 chil- dren in Mexico, they found that the presence of two variants of the hemochromatosis (HFE ) gene—HFE C282Y and HFE H63D— predicted blood lead levels 11% higher than those in children not carrying the variants. Moreover, the presence of either HFE variant combined with a variant form of the transferrin (TF ) receptor gene—TF-P570S—predicted blood lead levels 50% higher than in children with none of the variants.

Although the HFE and TF genes normally regulate iron metabo- lism, they may also influence blood lead levels because lead—like iron—is a divalent metal. Thus, the two metals can be “mistaken”

for each other during metabolic processes. The HFE gene regulates iron-binding proteins, including TF, and variant forms of this gene sometimes induce hemochromatosis, a disease characterized by increased intestinal absorption of iron that contributes to abnormally high iron stores in adulthood.

The authors hypothesized that the HFE variants might similarly increase absorption of lead, a hypothesis supported by the results of this study. TF interacts with HFE to form a complex that down- regulates iron absorption. However, TF-P570S may interact with the HFE variants in ways that heighten metal absorption rates. Study results showed the TF and HFE variants produced higher lead levels than those predicted by either HFE variant alone.

Previously published research by these investigators has shown that having the HFE variants predicted lower blood lead levels in elderly men compared with men without the variants. The contrast- ing findings, the authors speculate, may reflect age-specific differences in body iron stores and in the variants’ effect on lead metabolism. Among children with low iron body stores and high iron needs, the variants predicted higher blood lead levels. But as iron stores accumu- late with age, the variants down-regulated iron and lead absorption, leading to progressive declines in blood lead levels. The study’s key implications are twofold: first, that children with variant iron- metabolizing genes may be especially susceptible to the effects of lead at low exposure levels, and second, that genetic variants may increase risk at one life stage and decrease it at others. –Charles W. Schmidt

Science Selections

A worker surveys the WTC site, 25 September 2001