World Trade Center Firefighters Still Coughing, Wheezing

NEW YORK, New York, May 4, 2004 (ENS) - Firefighters, rescue workers and other personnel who responded to the collapse of the World Trade Center following the September 11, 2001 attacks show increases in coughing, wheezing and shortness of breath more than two and a half years after the disaster directly related to the intensity and duration of their exposures to airborne pollutants, new research has found.

Pregnant women who were inside or near the World Trade Center buildings on September 11 gave birth to twice as many babies who were smaller for their gestational age than those of other pregnant women from a demographically similar population not known to have been in Manhattan at the time, the same study shows.

New York Fire Department Deputy Chiefs on the scene of the World Trade Center collapse. (Photo by Andrea Booher courtesy Federal Emergency Management Agency)

"Our results indicate that the environmental exposures following the World Trade Center disaster were associated with profound adverse effects on respiratory health," said principal author Dr. Philip Landrigan, chair of the Department of Community and Preventive Medicine and director of Environmental and Occupational Medicine at Mount Sinai Hospital.

"The collapse of the towers generated thousands of tons of particulate matter comprised of cement dust, glass fibers, asbestos, lead, aromatic hydrocarbons, and organochlorine compounds, many of which significantly increased the subjects' susceptibility to bronchial spasms and asthma," said Landrigan.

"These respiratory effects were most pronounced in subjects who were in or around the World Trade Center buildings during the first 12 hours of the disaster," he said.

Previous studies have documented the acute traumatic consequences of the September 11 attacks, which claimed 2,726 lives, including the lives of 343 firefighters and 60 police officers. Early clinical assessments noted a high prevalence of respiratory symptoms, including persistent cough, in firefighters and rescue workers exposed to the World Trade Center dust.

A rescue worker takes a break amidst the rubble of the World Trade Center to make a phone call on his cell phone. (Photo by Bri Rodriguez courtesy FEMA)

Analysis of the data revealed that firefighters were among the most heavily exposed populations. Of the 10,116 firefighters who were evaluated, 332 displayed persistent cough accompanied by other respiratory symptoms so severe as to require at least four weeks leave of absence.

"The prevalence of this World Trade Center cough was directly related to the intensity of the exposure," said Landrigan.

Among firefighters without the cough, many were diagnosed with bronchial hyperreactivity, a chronic condition which triggers bronchial spasms in response to ambient air pollutants such as cigarette smoke and automobile exhaust. This condition was observed in 23 percent of those with a high level of smoke exposure, and in eight percent of those with moderate exposure.

"We believe the high alkalinity of the dust was a major contributing factor to the high incidence of bronchial hyperreactivity," said Landrigan.

Among ironworkers involved in cleanup and recovery, many of whom spent several months in and around the disaster site, almost one-third experienced a chronic cough that began shortly after employment at the site, 24 percent reported new onset of phlegm production, and more than 17 percent reported new onset of wheeze.

About half of all workers reported at least one new symptom since they began working at the site.

Rescue operations continue far into the night at the World Trade Center. (Photo by Andrea Booher courtesy FEMA)

The study was funded by the National Institute of Environmental Health Sciences, one of the National Institutes of Health, the U.S. Environmental Protection Agency, and grants from The New York Community Trust and United Way of New York City. Additional support was provided by the National Institute for Occupational Safety and Health and the Centers for Disease Control and Prevention.

Revealing though it is, this is hardly the only study of the health consequences of the Wrold Trade Center collapse that is being conducted.

The largest study is associated with the World Trade Center Health Registry, a comprehensive effort to track the long-term physical and mental health effects on those most directly exposed to the fumes, dust, and debris resulting from the events of September 11, 2001.

With four months left to go until the end of the registration period, more than 33,000 people have enrolled in the voluntary registry - a collaborative effort between the New York City Department of Health and Mental Hygiene (DOHMH) and the federal Agency for Toxic Substances and Disease Registry, with funding provided by the Federal Emergency Management Agency.

"The Registry will soon become the largest project of its kind in history, and we have been pleased with the response thus far," said DOHMH Commissioner Thomas Frieden, MD. "However, we hope to enroll thousands more people - including more schoolchildren - because the more participants we have, the more valuable the Registry's findings will be."

New York Fire Department paramedic team at the World Trade Center (Photo by Andrea Booher courtesy FEMA)

Interviewers found that there are now people registered from every state. The majority of enrollees, 21,803 people, were residents of New York State on September 11, followed by New Jersey residents, of whom there are 3,024 enrolled in the registry. Pennsylvania, California and Connecticut round out the top five states of residence.

Of 4,058 enrollees who evacuated their homes following the attacks, 92 percent have returned - with most returning within two weeks after 9/11.

Commissioner Freiden is still encouraging people to enroll in Registry. "We want more people - particularly school children and residents - to enroll before the Registry closes, or we may lose a historic opportunity to learn exactly how they were directly affected by the smoke, dust and debris from 9/11," he said.

Those who enroll in the WTC Health Registry are asked to complete a 30 minute telephone survey including questions on where they were on September 11, 2001, how long they were in areas with smoke and fumes, and whether they have had any health problems since.

Registrants will be periodically contacted to answer questions about any health changes. This information will then be compared with that of the general population to identify any health problems possibly linked to 9/11.

Firefighters at the World Trade Center (Photo by Andrea Booher courtesy FEMA)

Registry staff are conducting active outreach efforts, including the development of a new media campaign; presentations at parent-teacher conferences and faculty meetings; direct mailings to all residents south of Canal Street; and distributing brochures about the Registry to over 200 businesses in Lower Manhattan.

In addition, Registry staff are now giving presentations at residential buildings, in both English and Chinese.

Still more studies are in the works. In one recently funded effort, the New York City Fire Department will receive $25 million to monitor fire and emergency personnel.

On April 6, Fire Commissioner Nicholas Scoppetta was joined by New York Senator Hillary Rodham Clinton, a Democrat, and Dr. Stephen Levin from the Mount Sinai Center for Occupational and Environmental Medicine to announce the award as part of a package of $81 million in grants from the Department of Health and Human Services National Institute for Occupational Safety and Health (NIOSH).

The eight grants will fund a five year health screening program of rescue workers involved in the rescue and recovery efforts at the World Trade Center.

The Long Island Occupational and Environmental Health Center, the Mount Sinai Center for Occupational and Environmental Medicine at the Mount Sinai School of Medicine, the NYU School of Medicine, the City University of New York’s Queens College and the University of Medicine and Dentistry of New Jersey’s Robert Wood Johnson Medical School are the other grant recipients.

“Our screening program has found high rates of persistent respiratory and psychological problems among the WTC responders, even among those examined in recent months,” said Dr. Levin. “This underscores the importance of this long term medical monitoring program for the 9/11 heroes: it will enable us to identify those men and women who have suffered persistent adverse health effects and the resources needed for their care."

“This is a tremendous step toward fulfilling our promise to the firefighters, emergency workers and volunteers who labored at Ground Zero," said Senator Clinton. "Emergency response workers and volunteers risked their own lives to help save others on September 11th. This is evidence that America has not forgotten."