The long shadow of 9/11

The terrorists who brought down the World Trade Center towers on Sept. 11, 2001, killed 2,751 people, including 343 rescue workers of the New York Fire Department.

The health of thousands more was irrevocably damaged. This number includes firefighters, emergency medical technicians, police officers and construction workers employed at the site of devastation for weeks after the attack. As many as 500,000 residents and workers in the area may have sustained damage to their health.

Immediately after the attack, New York City and national safety officials issued reassuring statements regarding the hazards from dust and smoke generated by the attacks. Analyses of the dust had not been completed at the time. The Environmental Protection Agency made adherence to safety standards at the WTC site voluntary. Videos of rescue and recovery workers at the site showed some using respirators and gas masks, while others used simple masks. Some workers used no respiratory protection.

* The dust: Careful analysis identified more than 2,500 contaminants in dust samples taken in the immediate vicinity of the World Trade Center towers. Half of the dust consisted of non-fibrous material, predominantly concrete. Concrete is very alkaline so that inhaling concrete dust caused immediate irritation to nasal passages, mouth and lungs. Glass, assorted fibers and cellulose made up most of the rest. Asbestos contributed almost 1 percent. Traces of lead, mercury, dioxin and a variety of complex hydrocarbons made up the balance. Included in the dust were substances known to cause cancer and to interfere with kidney, liver and nervous-system function.

* The consequences: More than 11,000 NYFD workers, both firefighters and emergency medical technicians, who had been exposed to WTC dust, enrolled in a study of lung function conducted jointly by Albert Einstein College of Medicine and Montefiore Medical Center. The majority were male. The median age was 41. Each subject had undergone testing of lung function prior to their work at the WTC. Their subsequent lung function was followed with careful, periodic testing over six years following the disaster. An April article in the New England Journal of Medicine summarized the results.

Workers present on the day of attack, when the dust exposure was massive, had more severe symptoms than those exposed to lesser amounts of dust later. Three-quarters of the FDNY workers experienced cough, wheezing and other respiratory symptoms which persisted in up to one-third of subjects.

Lung function showed significant decline during the first year after the attack. Very little, if any, improvement occurred during the six-year follow-up. Decreases in lung function were 12 times greater than age-associated rates for the general public. FDNY personnel who smoked had more severe declines than non-smokers. Studies of firemen in other settings have shown that lung function may decrease after intense exposure to smoke at a fire. Typically, lung function in such circumstances returns to normal over time.

Another study looked at lung biopsies in seven FDNY workers who had worked at the WTC site and had either persistently abnormal chest x-rays or severe respiratory impairment. The lung samples showed evidence of chronic scarring and inflammation. Chemical analysis showed aluminum, calcium, and magnesium compounds; asbestos, glass shards and carbon nano-tubes. These extremely tiny structures can penetrate cell membranes to cause inflammation and cell death.

At least 75 malignant tumors among rescue workers at WTC have been attributed to dust exposure. Several instances of multiple myeloma, a bone marrow malignancy, have occurred in WTC workers at a much earlier age than usually seen in this disease.

Inhaled, toxic dust has become a permanently implanted time-bomb for thousands of FDNY and other workers at the WTC.

* Controversies: Congress initially approved benefits for WTC-related illnesses for workers who registered prior to 2004. Subsequent claims ended up in the courts. A proposal that would fund continuing study, surveillance and treatment for dust-related illness from the WTC became bogged down in Congress before passage earlier this month. Bitterly fought legal and medical issues remain unresolved, while data on WTC workers is gathered and analyzed.

The book, "City of Dust: Illness, Arrogance and 9/11," by Anthony DePalma provides a thorough investigation of this continuing tragedy.

Contact Clif Cleaveland at cleaveland1000@comcast.net.

Upcoming Events