WTC Rescue and Recovery Workers and Volunteers Suffering from Array of Health Problems

A new study finds that a substantial proportion of World Trade Center (WTC) responders and workers are suffering from new-onset and persistent upper- and lower-airway symptoms, musculoskeletal symptoms and gastrointestinal symptoms.

In the months after the9/11 attacks on the WTC, concerns grew about the health consequences of exposures sustained by workers involved in the rescue and recovery response. In addition to the estimated 10,000 Fire Department of New York (FDNY) personnel, an estimated 30,000 other workers and volunteers potentially were exposed to numerous psychological stressors, environmental toxins and other physical hazards.

These concerns prompted National Institute for Occupational Safety and Health (NIOSH) to support the WTC Worker and Volunteer Medical Screening Program, which provided free, standardized medical assessments, clinical referrals and occupational health education for workers and volunteers exposed to hazards during the WTC rescue and recovery effort.

The program evaluated 11,768 non-FDNY workers and volunteers. a report in the Sept. 10, 2004 issue of the Morbidity and Mortality Weekly Report summarizes data analyzed from a subset of 1,138 of the 11,768 participants evaluated at Mount Sinai School of Medicine. These data indicated that a substantial proportion of participants experienced new-onset or worsened preexisting lower- and upper-respiratory symptoms, with frequent persistence of symptoms for months after their WTC response work stopped. These findings, say researchers, "underscore the need for comprehensive health assessment and treatment for workers and volunteers participating in rescue and recovery efforts."

Of the 1,138 participants, 46 percent worked on WTC rescue and recovery efforts on Sept. 11, 2001, and 84 percent worked or volunteered during Sept. 11-14, when exposures were greatest. During that period, 21 percent of the workers and volunteers studied reported using appropriate respiratory protection (full- or half-face respirators). Of the 610 examinees present in lower Manhattan on 9/11, a total of 313 (51 percent) reported being directly in the cloud of dust created by the collapse of the WTC buildings, and an additional 191 (31 percent) reported exposure to substantial amounts of dust.

WTC-related lower-respiratory symptoms were reported by 60 percent of the study participants, and 74 percent reported WTC-related upper-respiratory symptoms. Participants experienced numerous other symptoms, including a substantial proportion with incident and persistent musculoskeletal symptoms, such as low back pain (16 percent) and upper or lower extremity pain (16 percent and 13 percent, respectively). Other incident and persistent symptoms included heartburn (15 percent), eye irritation (14 percent) and frequent headache (13 percent). Overall, 23 percent of the sample reported previously receiving medical care for WTC-related respiratory conditions. Nineteen percent of participants reported missing work because of WTC-related health problems, with days away from work ranging from one day to 364 days.

NIOSH recently funded a program that will provide continued medical screening of responders for an additional 5 years.

"This report underscores the need for comprehensive occupational health assessment and treatment for rescue workers and volunteers as part of all emergency preparedness programs," said the researchers. "The results described in this report suggest that disaster preparedness also should include planning for rapid provision of suitable respiratory and other protective gear and provision of medical care for first responders and nontraditional responders" such as construction contractors, utility workers and other occupational groups.

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