Alcohol use in Polish 9/11 responders: implications for cross-cultural treatment

Our plain-English summary of Alcohol use in Polish 9/11 responders: implications for cross-cultural treatment, by C.L. Katz, D. Jutras-Aswad, M. Kiliman, et al (Journal of Psychiatric Practice, 2012).

The study

• Authors: C.L. Katz, D. Jutras-Aswad, M. Kiliman, I. Pilatowicz, E. Akerele, K. Marrone, F. Ozbay
• Journal: Journal of Psychiatric Practice
• Published: 2012;18(1):55-63
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

More than 35,000 individuals are estimated to have responded to the World Trade Center (WTC) site following the terrorist attacks of September 11, 2001. The federally funded WTC Medical Monitoring and Treatment Program (WTCMMTP) provides medical monitoring and occupational medicine treatment as well as counseling regarding entitlements and benefits to the workers and volunteers who participated in the WTC response. A major component of the WTCMMTP is the WTC Mental Health Program (WTCMHP), which offers annual mental health assessments and ongoing treatment for those found to have 9/11 associated mental health problems. In the program's 9.5 years of evaluating and treating mental health problems in thousands of Ground Zero responders, diversity in multiple domains (e.g., gender, family, profession and employment status, state of physical health, cultural identity, and immigration status) has been a hallmark of the population served by the program. To illustrate the types of issues that arise in treating this diverse patient population, the authors first present a representative case involving a Polish asbestos worker with an alcohol use disorder. They then discuss how accepted alcohol treatment modalities can and often must be modified in providing psychiatric treatment to Polish responders, in particular, and to foreign-born patients in general. Treatment modalities discussed include cognitive and behavioral therapy, relapse prevention strategies, psychodynamic therapy, motivational approaches, family therapy, group peer support, and pharmacotherapy. Implications for the practice of addiction psychiatry, cultural psychiatry, and disaster psychiatry are discussed.

In plain English

This article combined a single case report with the authors' clinical discussion of treating alcohol problems in Polish World Trade Center responders. It did not study asbestos-related disease. The patient, a 58-year-old Polish man, worked as an asbestos handler at Ground Zero from September 14, 2001 until June 2002, seven days a week, mostly on 12-hour night shifts. He began drinking alcohol to sleep. By June 2002 he was drinking up to half a liter of vodka daily. At a 2008 screening he denied having problems and refused treatment despite signs of posttraumatic stress disorder, depression and alcohol abuse. He entered treatment in 2010, after blood tests showed elevated liver enzymes, having been sober for 10 days. He responded well to education about alcohol and went on to develop relapse prevention strategies. The authors reported that in 2010, 126 (13%) of 957 patients in the program's mental health treatment were Polish. The authors concluded that the case shows how accepted alcohol treatments can be applied and modified for specific cultural groups and disaster settings.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report of one patient, followed by the authors' clinical discussion of how alcohol treatment approaches can be adapted for Polish and other foreign-born responders (a 'Practitioner's Corner' article, not a statistical study)
• Who was studied: One 58-year-old Polish man who spoke only Polish and was treated in the World Trade Center Mental Health Program in New York. For context, the authors reported that in 2010, 126 (13%) of the 957 patients who received mental health treatment in the program were Polish.
• Exposure: Work as an asbestos handler at Ground Zero from September 14, 2001 until the end of clean-up in June 2002, 7 days a week, mostly on 12-hour night shifts. He had worked as an asbestos handler since arriving in the United States in the mid-1980s. No fiber type was named. The main subject of the article is alcohol use.
• Main results:
  • The patient, who described himself as a moderate drinker before 9/11, was drinking up to half a liter of vodka daily by the time his Ground Zero work ended in June 2002.
  • At his first screening in 2008, the patient denied having problems and refused treatment, despite indicators of posttraumatic stress disorder, clinical depression and alcohol abuse.
  • He entered treatment after his second monitoring visit in 2010. By then blood tests had shown elevated liver enzymes, and he had been sober for 10 days.
  • The patient responded well to education about alcohol abuse and dependence, supported by Polish-language materials, and became able to develop relapse prevention strategies.
  • In 2010, 126 (13%) of the 957 patients receiving mental health treatment in the program were Polish.
  • The authors stated that their accumulated clinical experience pointed to alcohol use being pervasive among Polish asbestos workers compared with many other ethnic groups in the program. This was a clinical impression, not a measured rate.
• The authors' conclusion: The authors concluded that the case shows how accepted treatments for alcohol use disorders can be applied and modified in specific cultural groups and settings, such as after a disaster.

Topics

Medical terms in this study, explained in our Lexicon: Medical Monitoring.

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