Large Study of World Trade Center Responders Finds Persistent Health Problems

Sept. 6, 2006
The Mount Sinai Medical Center on Sept. 5 released the findings from the World Trade Center Worker and Volunteer Medical Screening Program, the largest multi-center clinical program providing medical screening examinations for the workers and volunteers who worked at Ground Zero and other sites following the attack on the World Trade Center on Sept. 11.

The study revealed that some 60 percent of responders who participated still suffer from respiratory problems from exposure to toxins and health hazards at the site. The report has been accepted by Environmental Health Perspectives, the journal of the National Institute of Environmental Health Sciences, and will be published on Sept. 7.

The findings are based upon medical examinations performed between July 2002 and April 2004 on 9,500 WTC responders. These responders were a highly diverse group and included members of the building trades, law enforcement officers, firefighters, utilities and telecommunications workers, transit workers and many others. All received a comprehensive examination that included complete physical examination, mental health evaluation, pulmonary function tests, chest x-ray, blood tests and urinalysis. Overall, the monitoring program examined close to 12,000 responders during the 21-month period covered by the study; 9,500 of whom agreed to allow their results to be used in this report.

The report found that a high proportion of those examined became sick as a result of their World Trade Center work. It found also that illnesses have persisted in the years since Sept. 11 in a high proportion of the workers. In one area alone – pulmonary function tests - the study found WTC responders had abnormalities at a rate twice that expected in the comparable U.S. population and that these abnormalities persisted for many months and, in some cases, years after exposure.

"Many who worked at Ground Zero in the early days after the attacks have sustained serious and lasting health problems as a direct result of their exposure to the environment there," said Dennis Charney, dean for Academic and Scientific Affairs, Mount Sinai School of Medicine, which has been running a number of medical and mental health programs serving responders since July 2002. "This study scientifically confirms high rates of respiratory problems in a large number of responders – including construction workers, law enforcement officers, utilities workers and public sector workers."

The study focuses on respiratory health consequences, one of the earliest areas of concern to emerge. The study found that many responders were symptomatic, with high rates of pulmonary function abnormalities as long as 2 1/2 years after the disaster. The findings are particularly striking, in that the workers who served at the World Trade Center tended to be vigorous, healthy workers who held jobs in strenuous professions such as the building and utility trades before Sept.11. Specific findings included:

  • Almost 70 percent of World Trade Center responders had a new or worsened respiratory symptom that developed during or after their time working at the WTC;
  • Among the responders who were asymptomatic before 9/11, 61 percent developed respiratory symptoms while working at the WTC;
  • Close to 60 percent still had a new or worsened respiratory symptom at the time of their examination;
  • One third had abnormal pulmonary function tests, much higher than expected;
  • Severe respiratory conditions including pneumonia were significantly more common in the six months after 9/11 than in 6 months prior.

Rates of respiratory symptoms and pulmonary function abnormalities were positively correlated with how early the responders arrived at the World Trade Center site. Those who arrived first at the site suffered the heaviest exposures and had the most frequent respiratory problems. This represents a major public health issue as most of the responders screened by Mount Sinai were heavily exposed, with 70 percent having arrived at the site between Sept. 11 and Sept. 13.

These results highlight the continuing need for both health monitoring and treatment programs for WTC responders. The World Trade Center Health Effects Treatment Program at Mount Sinai, initiated in 2003 with philanthropic funding, has provided over 14,000 medical and social work services to more than 2000 WTC responders with persistent illnesses. Responders seen in the past year have had: upper respiratory illnesses (84 percent), such as sinusitis, laryngitis and vocal cord dysfunction; lower respiratory disorders (47 percent) such as asthma and World Trade Center cough; psychological disorders (37 percent) such as post-traumatic stress disorder and chronic depression; and musculoskeletal problems (31 percent), often from injuries that occurred while working on the pile.

The report concludes that continuing long-term medical monitoring of responders will be needed to track the persistence of the abnormalities discovered in the study and to identify late effects, including possible malignancies. Mount Sinai continues to screen responders and has tested an additional 4,000 since April 2004.

"An estimated 40,000 rescue and recovery workers were exposed to caustic dust and airborne toxic pollutants following 9/11," said Philip J. Landrigan, M.D., chair, Department of Community and Preventive Medicine at Mount Sinai. "We are continuing our monitoring and treatment program with support from the National Institute for Occupational Safety and Health (NIOSH). We encourage anyone who worked at Ground Zero, especially in the early days after Sept.11, who has not yet been screened, to come for an evaluation. It is important that those who gave so heroically in the aftermath of the disaster be assured that they will be able to get all the medical care they need."

Supported with ongoing federal funding from NIOSH, the WTC Medical Monitoring Program coordinated by the Department of Community and Preventive Medicine of the Mount Sinai School of Medicine, continues to provide free medical screening and monitoring exams. Some 16,000 initial medical screening examinations and 5,000 follow-up exams have been provided for WTC responders to date through a number of participating metro-area occupational medicine providers.

About the Author

Sandy Smith

Sandy Smith is the former content director of EHS Today, and is currently the EHSQ content & community lead at Intelex Technologies Inc. She has written about occupational safety and health and environmental issues since 1990.

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