Team Analyzes Health Effects of Inhaled Toxins on First Responders

It took first-responders several weeks to recover victims of the Sept. 11 attack on the World Trade Center and several more months to clean up the site. Now, they are coping with the health effects resulting from their work at Ground Zero.

"We think of police officers as being in physical danger from bullets and other kinds of violence, not from inhaling toxins," said Rebecca Bascom, professor of medicine at the Penn State Milton S. Hershey Medical Center. "With the threat of terrorism, we now have to worry about the lung and cardiovascular health of first-responders."

Bascom and a team from the Penn State College of Medicine are working with the Living Heart Foundation to analyze heart and lung screening test results of more than 1,760 rescue and relief workers. Volunteer medical personnel from the foundation conducted the screenings – administering electro- and echocardiograms, checking blood pressure and testing blood cholesterol. Robert Gillio, a Penn State Milton S. Hershey Medical Center physician, trained screeners and provided pulmonary function screening for rescue workers. With guidance from Bascom and National Institute for Occupational Safety and Health's Paul Enright, Gillio also created an exposure and health history questionnaire to accompany the clinical tests.

"The major problems we saw were mental stress, exhaustion, breathing difficulties, hypertension and (manifestations of coronary artery disease)," said Arthur J. Roberts, Living Heart Foundation president and chairman noted. Roberts added that follow-up studies showed that mental stress and breathing difficulties persist, but more cardiovascular research is needed to determine long-term complications.

Bascom and team members are looking for trends and information that will better prepare the medical community to respond to future disasters. One promising area is the possibility of using the data to develop a risk score for inhalation injuries, similar to the burn score (first-, second- and third-degree), Bascom said. Doctors use the burn score to quickly assess tissue damage, deliver appropriate treatment and determine prognosis. An inhalation risk score (high, medium, low) could lead to a more precise diagnosis and treatment plan, as well.

Team members presented the results of their data analysis at a conference in New York, and a narrative about the experience is in the book "Lessons Learned at Ground Zero," written by Gillio and published by iUniverse. The book has been used by social studies teachers, the U.S. Army War College and others.

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