Binge drinking among adult enrollees in the World Trade Center Health Registry

Background: On September 11, 2001 individuals in Lower Manhattan were exposed to traumatic events. To understand the consequences of 9/11 on alcohol use for those adults directly exposed to traumatic events on 9/11, we examined the relationship between specific 9/11 exposures, posttraumatic stress disorder (PTSD), and binge drinking among World Trade Center Health Registry enrollees. Methods: Data on PTSD symptoms and specific exposures were collected in surveys in 2003-04 and 2006-07. Binge drinking was defined as 5+ drinks (men) or 4+ drinks (women) on at least one occasion in the 30 days prior to the 2006-07 survey. Chronic PTSD was defined as a score of >=44 on the Civilian PTSD checklist (PCL-17) at both surveys. Analysis included enrollees aged >=18, without prior history of PTSD and reporting any drinking (N=32,565). Odds ratios and 95% confidence intervals were estimated from logistic regression models before and after adjustment for demographic characteristics. Men and women were analyzed separately. Results: Binge drinking in 2006-07 was significantly associated with chronic PTSD (aOR men=2.24; CI 2.00-2.52; women=2.21; 1.92-2.54), sustaining an injury on 9/11 (aOR men=1.34; 1.24-1.45; women=1.35; 1.18-1.54), and witnessing others being injured or falling from the WTC towers (aOR men=1.18; 1.11-1.25 women=1.17; 1.07-1.29). Conclusions: The positive relationship between PTSD, traumatic exposures and subsequent binge drinking reinforces the need for psychological and alcohol counseling after similar disasters, and suggests the need to identify co-factors elevating the risk of binge drinking several years after traumatic exposure.