On the train to New York on September 12, 2001, the day after the devastating attacks, I could see the smoke still rising from the debris that was once the World Trade Center's Twin Towers. Closer to the site, as I walked the streets littered with burned cars, the air was heavy with a metallic smell that still haunts me today.
Nearly 3,000 people were killed that day in the suicide attacks in New York, Washington D.C., and Pennsylvania, but the ruinous assault continues, in a sense. That smoke was part of the problem, and questions remain from the disaster's odious dust. Physicians and hospitals are playing key roles in determining the medical extent of the 9/11 aftermath in New York. Ten years after the attacks, continual and chronic medical conditions plague the people who worked at Ground Zero.
I was a journalist then, too, sent to cover the horrific event. As another reporter and I walked the cluster of blocks near the fallen WTC, we knew that the lingering smoke and acrid smells could only foretell hazards ahead for public health. After holding handkerchiefs to our mouths, we realized these were inadequate protection from the fumes and choking swirl of soot. We joined many others in seeking out masks. Pharmacies were selling out fast. Finally, we found a couple that would stanch the odor and, we hoped, the suspicious particles.
The following week in New York was a blur of sadness, dust, and despair. The clouds of smoke lingered, burning throats and stinging the eyes of thousands of volunteers who worked on search and rescue. We talked to people who waited in long lines scouring lists of wounded and maimed, hoping to see a husband, daughter, a friend, holding pictures of missing people and telling their stories. They, too, were exposed to the noxious air quality—but that was the least of their concerns.
First responders—people who came from all over the country to help in the cleanup and recovery efforts—are still struggling with lung conditions. Thousands have shown signs of debilitating illnesses from breathing dust at the site. Some of the symptoms are bloody noses, skin rashes, pneumonia, upper respiratory infections, and what has become known as the WTC Cough – a prolonged, severe cough accompanied by shortness of breath.
Mount Sinai Medical Center, which assisted at least 20,000 responders and volunteers, runs a World Trade Center Health Program that offers free comprehensive and confidential medical examinations, ambulatory services, and inpatient treatment for World Trade Center–related physical and mental health conditions. Created in 2002 to investigate the hazards, the Mount Sinai program began screening and treating people who provided rescue, recovery, clean-up, and restoration of vital support services at Ground Zero and related sites.
In what Mount Sinai officials have described as the first long-term study of the health impacts of the World Trade Center collapse, researchers there have found "substantial and persistent mental and physical health problems" among 9/11 first responders and recovery workers, Mount Sinai Medical Center said in a statement. The data were published this month in a special 9/11 issue of the medical journal Lancet.
The Mount Sinai World Trade Center Clinical Center of Excellence and Data Center evaluated more than 27,000 police officers, construction workers, firefighters and municipal workers over the years since 9/11 and found a high incidence of several conditions, including asthma, post-traumatic stress disorder, (PTSD), depression, sinusitis, and gastroesophageal reflux disease (GERD). More than one in five of all the responders studied had multiple physical and/or mental health problems, according to the Mount Sinai study.
The study found that 43% of patients had abnormal lung function tests, indicative of lung injury. In addition, 28% of patients had asthma, 42% had sinusitis, and 39% had GERD. The data showed that 48% of rescue workers had asthma, 38% had sinusitis. As many as 43% with GERD also were diagnosed with one mental health condition, according to Mount Sinai.
Of police officers studied, 7% were diagnosed with depression, 9% PTSD, and 8% with panic disorder. About 28% of rescue and recovery workers had symptoms of depression, 32% of PTSD, and 21% of panic disorder.
First responders had the greatest exposure to the dust and smoke, and consequently sustained the most severe health problems. They were exposed to a complex mix of toxins and carcinogens that included benzene from jet fuel, asbestos, dioxin, lead, polycyclic aromatic hydrocarbons, glass fibers, hydrochloric acid, polychlorinated biphenyls. and other caustic chemicals, according to the Mount Sinai researchers. Those were among the materials released into the air with the collapse of the towers.
In another report in the Lancet the 9/11 issue, firefighters who were at the scene were found to have developed a 19% higher risk of cancer as a result to toxic fumes. The firefighters were studied by David Prezant, MD, chief medical officer of the New York City fire department and researchers from Albert Einstein College of Medicine at Yeshiva University and Montefiore Medical Center in New York.
Mount Sinai officials say their findings show the importance of long-term monitoring and treatment. "Our study shows that these diseases may persist for years to come," Philip Landrigan, MD, principal investigator for the Mount Sinai WTC program and chair of the department of preventive medicine at the Mount Sinai School of Medicine, said in a statement. has said.
In 2009, Congress passed the James Zadroga 9/11 Health and Compensation Act, which provides financial aid to sick workers. It took eight years after the attacks for patients to receive financial support. They will need that—and more—for the rest of their lives.
Joe Cantlupe is a senior editor with HealthLeaders Media Online.
