Study Links Health Risks, 9/11
The largest study of rescue workers at the World Trade Center site has found that 70% developed breathing problems while working there and -- to the surprise of doctors -- many were still suffering years later.
As they labored on “the pile,” responders breathed in a caustic, pulverized dust that penetrated deep into their lungs and sinus cavities. The dust contained “trillions upon trillions of microscopic shards of glass,” as well as asbestos and other carcinogens, Dr. Philip J. Landrigan, co-author of the study at Mount Sinai Medical Center, said Tuesday.
“So, what’s going to be the future for these people? Will they die of the illnesses they are now suffering?” Landrigan said. “I don’t know.”
Researchers at Mount Sinai said they hoped the findings would establish a conclusive link between illness and work done at ground zero. Dr. Stephen Levin, the director of Mount Sinai’s monitoring program and a co-author of the study, complained that his patients were “being called malingerers and liars and cheats” when they sought health benefits from the government.
But even as he announced three city initiatives to study and treat health effects from the terrorist attack, Mayor Michael R. Bloomberg on Tuesday said scientific evidence had not connected specific symptoms with conditions at the site.
“You’ve got to understand that these kinds of health problems that we’re talking about here aren’t a piece of debris falls on you and you are injured,” he said. “This is something that over a long period of time develops, and you’re never really sure what the connections between cause and effect are.”
Researchers at Mount Sinai examined close to 12,000 firefighters, police officers, construction, transit and utility workers during the 21-month period covered by the study; of those, 9,500 agreed to allow their results to be published. The study, which will appear Thursday in the journal Environmental Health Perspectives, found that World Trade Center responders had double the rate of lung abnormalities expected in the U.S. population. The results, the study said, are particularly striking given that the workers who served at the site tended to be healthy at the time.
Among workers who had no breathing problems before Sept. 11, 2001, 61% developed symptoms while working on the site. The study also found that the earlier workers arrived at ground zero after the attack, the worse their symptoms. And 60% of workers still had symptoms by the time they were examined at Mount Sinai. The tests took place from July 2002 to April 2004.
The long-term health effects from working at the site are still unknown. In August, a study of 12,000 firefighters published in the American Journal of Respiratory and Critical Care Medicine showed that typical firefighters lost 9% of their lung capacity after a year at the site, 12 times the normal rate of loss that occurs as people age.
In April, a New Jersey medical examiner determined that police Det. James Zadroga, 34, died as a result of his work at the site, based on material found in his lungs that was “consistent with dust.” Although the families of at least six other responders believe they contracted fatal illnesses at the site, Zadroga’s case is the only one confirmed by a coroner.
During the week after the attack, the Environmental Protection Agency issued news releases reassuring the public that the air in Lower Manhattan was safe to breathe. Two years later, an evaluation by EPA Inspector General Nikki L. Tinsley found that the agency “did not have sufficient data and analyses to make such a blanket statement.” The review found that indoor cleanup workers “were generally not provided with respirators,” and though respirators were available to most responders at ground zero, they frequently went unused.
Some workers at the site wore paper masks to protect themselves from dust and other pollutants. Others were given respirators but did not wear them, in part because they made talking and breathing difficult. John Feal, a construction supervisor who lost part of his foot in an accident at the site, recalls driving into a cloud so dense that “it seemed like night.”
In the five days he worked on the site, “I never wore a mask once,” he said.
It many cases, it took workers months or years to connect their symptoms to the recovery effort. Jim Lapenna, an electrician who volunteered at the site, found that he was suffering from headaches, joint pain, acid reflux and sleep deprivation. His first thought was that he had a cold; then he thought he had cancer. It took three years for a friend to stumble on a website that listed health effects associated with the World Trade Center site.
Now, he said, “I’m glad I know what caused it. I’m glad I wasn’t the only one.”
Last week, the city Department of Health and Mental Hygiene released guidelines to help doctors identify “disaster-associated physical and mental health conditions.” The report identifies a “syndrome” made up of postnasal drip, asthma and gastroesophageal reflux disease.
Bloomberg on Tuesday announced the establishment of a free clinic for people who lived or worked near the Trade Center but may not qualify for existing programs, such as illegal immigrants or uninsured people. He also said he would push to reopen the Federal Victims Compensation Fund, which provided for the families of people who died in the attack.
Levin called last week’s health advisory “very welcome,” but “late.” Clinicians, he said, were observing these symptoms almost immediately.
“Those of us taking care of responders were convinced by November,” he said. “Within two weeks you could see people dragged off the pile choking for air,” he said.
Sen. Hillary Rodham Clinton (D-N.Y.), who spoke at the Mount Sinai news conference, castigated federal authorities for responding slowly to evidence of health threats. After the disaster, she said, “we quickly learned that our government was not telling the truth. The air was not safe to breathe and there was very little attention paid to what was quickly developing, which was named at that time ‘the World Trade Center cough.’ ”
She, like other lawmakers, called on the federal government to establish a funding plan to provide for sick workers and their families.
“It’s been a struggle to make the case in Washington that it’s not enough just to have photo ops or speeches about the men and women who went to the pile,” she said. “We needed to match the rhetoric with resources to help.”
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(BEGIN TEXT OF INFOBOX)
Symptoms persist in Sept. 11 teams
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About a fourth of the 40,000 workers who responded to the World Trade Center attack were examined from July 2002 to April 2004.
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Those examined...
whose symptoms persisted to the time of examination: 60%
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without symptoms before Sept. 11 developing respiratory problems: 61%
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Non-smokers with spirometry*
Responders: 27%
General U.S. population: 13%
*A measure of airflow obstruction
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Sources: Mount Sinai School of Medicine, Associated Press
