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Within seconds of the collapse of the World Trade Center in the September 11 attacks, building materials, electronic equipment, and furniture were pulverized and spread over the area of the Financial District of Lower Manhattan. In the five months following the attacks, dust from the pulverized buildings continued to fill the air of the World Trade Center site. Many New York residents have reported symptoms of Ground Zero respiratory illnesses.[1]
Various health programs have arisen to deal with the ongoing health effects of the September 11 attacks. The World Trade Center Health Program, which provides testing and treatment to 9/11 responders and survivors, consolidated many of these after the James Zadroga 9/11 Health and Compensation Act became law in January 2011.[2]
More people have died from illnesses caused by 9/11 than during the attack itself.[3][4]
Exposures and conditions
 | This section needs more reliable medical references for verification or relies too heavily on primary sources. (January 2018) |  |
As of December 2017, the most common conditions certified by the World Trade Center Health Program were rhinosinusitis, gastroesophageal reflux disease (GERD), asthma, sleep apnea, cancer, posttraumatic stress disorder, respiratory disease, chronic obstructive pulmonary disease, depression, and anxiety disorder. The most common cancers were skin cancer and prostate cancer. The World Trade Center Health Program regularly publishes the most commonly certified condition on its website.[5]
Toxic dust
The dust from the collapsed towers was "wildly toxic", according to air pollution expert and University of California Davis Professor Emeritus Thomas Cahill.[6] Much of the thousands of tons of debris resulting from the collapse of the Twin Towers was pulverized concrete, which is known to cause silicosis upon inhalation. The remainder consisted of more than 2,500 contaminants,[7] more specifically: 50% non-fibrous material and construction debris; 40% glass and other fibers; 9.2% cellulose; and 0.8% of the extremely toxic carcinogen asbestos, as well as detectable amounts of lead and mercury.[8] There were also unprecedented levels of dioxins and polycyclic aromatic hydrocarbons (PAHs) from the fires which burned for three months.[9] Many of the dispersed substances (asbestos, crystalline silica, lead, cadmium, and polycyclic aromatic hydrocarbons) are carcinogenic; other substances can trigger kidney, heart, liver and nervous system deterioration. This was well known by the EPA at the time of collapse.[7] A case report funded by the National Institute for Occupational Safety and Health (NIOSH) and performed by Mount Sinai School of Medicine observed carbon nanotubes in dust samples and in the lungs of several 9/11 responders.[10] The composition of the smoke and dust in the air was not fully understood at the time; the World Trade Center Health Program's Dr. Michael Crane touched upon this issue in an interview with Newsweek stating:[11]
We will never know the composition of that cloud, because the wind carried it away, but people were breathing and eating it...What we do know is that it had all kinds of god-awful things in it. Burning jet fuel. Plastics, metal, fiberglass, asbestos. It was thick, terrible stuff. A witch’s brew.
— World Trade Center Health Program's Dr. Michael Crane, Newsweek interview
These toxic exposures have led to debilitating illnesses among rescue, recovery, and cleanup workers, and the pulmonary fibrosis death of NYPD member Cesar Borja.[12][13][14][15] Increasing numbers of cases are appearing in which first responders are developing serious respiratory ailments.[16] Health effects also extended to some residents, students, and office workers of Lower Manhattan and nearby Chinatown.[17]
Dr. Edwin M. Kilbourne, a high level federal scientist, issued a memo on September 12, 2001, to the Centers for Disease Control and Prevention advising against the speedy return to buildings in the area because of possible hazards from various toxic materials.[18]
On October 6, 2001, Associate City Health Commissioner Kelly McKinney said that proper safety protocol for WTC site workers was not being enforced.[18]
A study of 5,000 rescue workers published in April 2010 by Dr. David J. Prezant – the chief medical officer for the Office of Medical Affairs at the New York City Fire Department – found that all the workers studied had impaired lung functions, with an average impairment of 10 percent. The study found that firefighters who arrived on the Sept. 11 morning had the worst impairments, which presented themselves within the first year after the attack, with little or no improvements in the ensuing six years. 30% to 40% of workers were reporting persistent symptoms and 1000 of the group studied were on "permanent respiratory disability". Dr. Prezant noted that medication given to the victims can ease but not cure the symptoms. Dr. Byron Thomashow, medical director of the Center for Chest Disease and Respiratory Failure at New York – Presbyterian/Columbia hospital, said that "The drop-off in lung function initially is really quite significant and doesn't get better. That's not what we've generally come to expect in people with fire and smoke exposure. They usually recover."[19]
Cancer risk
A study published in December 2012 in The Journal of the American Medical Association observed the possible association between exposure to the World Trade Center debris and excess cancer risk. Over 55,000 individuals enrolled in the World Trade Center Health Registry, separated by rescue and/or recovery workers and non-rescue and/or recovery workers, were observed from 2003 or 2004 to December 31, 2008. The findings showed the overall incidence of all cancers among rescue and/or recovery workers was not significantly elevated, compared to non-rescue and/or recovery workers. Despite this, the incidences for prostate cancer, thyroid cancer, and multiple myeloma were significantly elevated among the rescue and/or recovery workers, in the final year of observation.[20]
On November 28, 2006, the Village Voice reported that several dozen recovery personnel have developed cancer – as opposed to having contracted respiratory ailments, and that doctors have argued that some of these cancers developed as a result of the exposure to toxins at the Ground Zero site: "To date, 75 recovery workers at ground zero have been diagnosed with blood cell cancers that a half-dozen top doctors and epidemiologists have confirmed as having been likely caused by that exposure."[21]
On September 11, 2018, 17 years after the attacks, a New York City law firm reported that at least 15 men were diagnosed with male breast cancer in the intervening years due to the attacks.[22]
Through the September 11th Victim Compensation Fund (VCF,) individuals who had been diagnosed with cancer as a result of their physical exposure to the toxins in the World Trade Center blast zone or the surrounding New York City area between September 11, 2001, and May 30, 2002, were able to receive financial compensation for the collateral damage they personally suffered because of the attack. Through free legal guidance, affected individuals could clarify their specific eligibility for the VCF, while receiving the necessary logistic aid in order to fulfill a compensation claim by the July 29, 2021 cut-off date for "timely" applications.[23][24]
Psychological effects
A study published two months after 9/11 found that Americans across the country experienced substantial symptoms of stress after the attacks.[25] Two subsequent studies found that exposure to the attacks was a predictor of the development of PTSD.[26][27] Additional studies also looked at the psychological effects of those who lost a family member or friend in the attacks, or viewed the attacks on television.[28][29][30]
Reactions
Dr. Larry Norton of Memorial Sloan-Kettering Hospital said "Why isn't the whole nation mobilizing to take care of the chronic health impact of this disaster?". Dr. Norton cited the 70 percent illness rate among first responders as "a wake up call." Dr. Nathaniel Hupert of Weill Cornell Medical College, quoted by Jill Gardiner of the October 4, 2006, issue of the New York Sun said that premature deaths and other ailments of dogs in the area are "our canary in the coalmine."[31] Richard Clapp and David Ozonoff, professors of environmental health at Boston University School of Public Health; Michael Thun, director of epidemiological research at the American Cancer Society; Francine Laden, assistant professor of environmental epidemiology at Harvard School of Public Health; Jonathan Samet, chairman of the epidemiology department at Johns Hopkins Bloomberg School of Public Health; and Charles Hesdorffer, associate professor of oncology at Johns Hopkins School of Medicine argue that the cancer incidence among monitored individuals cannot be called a coincidence. They assert that the Ground Zero cloud was likely the cause of the illnesses.[21] The American College of Preventative Medicine is concerned that malignant mesothelioma will develop among persons exposed to Ground Zero air.[32]
Monitoring and compensation
About 400,000 people that were directly affected by the attack are eligible to be enrolled in the World Trade Center Health Registry, and can be referred to the World Trade Center Health Program, which provides free monitoring and health care to those enrolled.[33]
There is scientific speculation that exposure to various toxic products and the pollutants in the air surrounding the Towers after the WTC collapse may have negative effects on fetal development. Due to this potential hazard, a notable children's environmental health center (Columbia University Center for Children's Health) is currently analyzing the children whose mothers were pregnant during the WTC collapse, and were living or working near the World Trade Center towers. The staff of this study assesses the children using psychological testing every year and interviews the mothers every six months. The purpose of the study is to determine whether there is significant difference in development and health progression of children whose mothers were exposed, versus those who were not exposed after the WTC collapse.[34]
Mount Sinai Medical Center is conducting an ongoing monitoring program, World Trade Center Worker and Volunteer Medical Screening Program.[35] A leader of Mt. Sinai monitoring efforts is Stephen M. Levin, Medical Director of the Mount Sinai – Irving J. Selikoff Center for Occupational and Environmental Medicine.[36] First responders met in a conference, November 11, 2006, in an effort to monitor responders' health. The event was organized by the World Trade Center Monitoring Program.[37]
An ongoing Pennsylvania State University/Monmouth University study reported that respiratory illnesses grew by more than two hundred percent in the year and a half after the September 11 attacks. (This was the first study that monitored police officers at the Ground Zero site. It was published in the "Journal of Occupational and Environmental Medicine.") In this study of 471 police officers, 19 percent of the officers in October 2001 experienced shortness of breath; 44 percent of the officers experienced shortness of breath in April 2003. The percentage of the 471 officers coughing up phlegm increased from 14 percent in October 2001 to 31 percent in 2003.[38]
A 2006 medical study of fire fighters reported that those personnel who inhaled Ground Zero air essentially lost 12 years of lung function.[38] Additionally, a Mount Sinai report found that 70 percent of recovery and rescue workers reported an increase in debilitated respiratory function between 2002 and 2004.[38][39] A 2008 report by New York City's Department of Health indicated that up to 70,000 people might have stress disorder due to the attack. The findings were the result of the city's health registry of September 11 first responders, residents, and others.[40]
Compensation
 | This article needs to be updated. (April 2018) |
Apparently, out of at least 100,000 eligible, fewer than 14,000 have registered, as reported by the National Council for Occupational Safety and Health. The final registration deadline for September 11-related workers' compensation was August 14, 2007.[41]
On July 12, 2007, Governor Eliot Spitzer extended to August 14, 2008, the filing deadline for worker's compensation claims, for people who worked or volunteered at Ground Zero. Individuals would register with the State Workers' Compensation Board.[42] New York Governor Andrew Cuomo granted a third extension for Ground Zero rescue, recovery or clean up workers to file a notice of participation for worker' compensation benefits. This applies to workers who had not yet filled or who were denied between September 2015 and September 2017, with the new deadline being September 11, 2022.[43]
In April 2022 a bill was introduced in the New York State Legislature, and was referred to the Committee on Governmental Employees. The bill aimed to provide coverage for any illness or death incurred due to the individuals participation in rescue, recovery and cleanup operations related to the attacks. Additionally, the Centers for Disease Control and Prevention World Trade Center Health Program Certification would be deemed presumptive medical evidence of a causally related diagnosis under workers compensation law.[44]
Vulnerable individuals
In 2008, the lead researcher of a New York State Department of Health study informed The New York Post of a study documenting at least 204 deaths of rescue and recovery workers since September 11, 2001. The researchers for the study confirmed 98 deaths with death certificates. The researchers showed that 77 persons died of illnesses, including 55 from lung and various other cancers. Kitty Gelberg, New York state Bureau of Occupational Health's chief epidemiologist said, "We're not saying they are all World Trade Center related; we're just saying this is what people are dying from." Many of the 55 responders who died from cancer had cancer before September 11, 2001, but most of the cancer patients developed the disease afterward.[45]
The 98 deaths up to 2008 included:
- 55 cancers
- 21 traumatic injuries (motor-vehicle crashes, gunshots and five homicides, including four cops killed in the line of duty)
- 12 heart disease, including 10 heart attacks
- 2 sarcoidosis
- 1 polyneuropathy (neorological disorder)
- 1 pneumonia
- 1 granuloma pneumonitis
- 1 alcoholism
- 1 amyloidosis (bone marrow disorder)
- 1 kidney disease[45]
First responders
In particular, first responders, New York Police Department and Fire Department of New York members that reported to Ground Zero, have asserted that they are victims of diseases associated with the toxic cloud from the pulverized buildings and equipment. NYPD Detective James Zadroga, 34, was the first 9/11 responder whose 2006 death was directly linked with toxic Ground Zero substances.[37] Gerard Breton, a pathologist of the Ocean County, New Jersey, medical examiner's office (which conducted an autopsy), reported that "It is felt with a reasonable degree of medical certainty that the cause of death in this case was directly related to the 9/11 incident."[12][46] In addition to first responders that responded to the initial attack on the World Trade Center many assisted during recovery operations.
In 2017, 24 members of the NYPD died of cancer linked to toxins from the terrorist attack. In the first five months of 2018, another 24 members of the NYPD died of the same cause.[47]
In 2020, the NYPD confirmed that 247 NYPD police officers had died due to 9/11-related illnesses. In September 2022, the FDNY confirmed that the total number of firefighters that died due to 9/11-related illnesses was 299. Both agencies believe that the death toll will rise dramatically in the coming years. The Port Authority of New York and New Jersey Police Department (PAPD), which is the law enforcement agency which has jurisdiction over the World Trade Center due to the Port Authority of New York and New Jersey owning the site, has confirmed that four of its police officers have died of 9/11-related illnesses. The chief of the PAPD at the time, Joseph Morris, made sure that industrial-grade respirators were provided to all PAPD police officers within 48 hours and decided that the same 30 to 40 police officers would be stationed at the World Trade Center pile, drastically lowering the number of total PAPD personnel who would be exposed to the air. The FDNY and NYPD had rotated hundreds, if not thousands, of different personnel from all over New York City to the pile which exposed so many of them to dust that would give them cancer or other diseases years or decades later. Also, they weren't given adequate respirators and breathing equipment that could have prevented future diseases.[48][49][50][51]
Examples of health issues
Cesar Borja, a veteran of the NYPD, died, falling ill from lung disease. He had spent 16-hour days at the smoldering wreckage of Ground Zero.[52] Detective Robert Williamson, 46, died from pancreatic and lung cancer on May 13, 2007. He worked for 16-hour days, without taking days off, in performing recovery work at the Ground Zero site. After the clean up effort, he was among individuals that lobbied Governor George Pataki to sign a bill permitting retirees suffering from Ground Zero illnesses to have their illnesses reclassified and to receive additional pension benefits. His family and union believe that his cancers were directly caused by exposure to Ground Zero dust at the World Trade Center site.[53][54] Twenty year veteran of the NYPD, Officer Kevin Hawkins, 41, died in May 2007 from kidney cancer, soon after filing for a Ground Zero disability pension. He had worked two months at the Ground Zero site.[55]
On September 3, 2007, NYPD Officer Frank Macri died of lung cancer that spread throughout his body, including to his spine.[56] Macri's lungs were filled with dust when the towers collapsed and he later spent two months working on the site. The long hours on the site gave him vomiting spells and he was diagnosed with an already rapidly progressing stage four cancer only one year after the attack, despite being a non-smoker and cancer free before the attacks.[57] In 2011, a lower court ruled that 9/11 toxins were the likely cause of Macri's death.[58] In 2012, the New York Supreme Court ruled that Macri's widow is entitled to line-of-duty death benefits of his full salary.[59] On December 12, 2017, NYPD Captain Douglas Greenwood took his own life after a long battle with lung disease, brought on by deadly chemicals in the air while working alongside other officers at Ground Zero. The pain he suffered over the years became too much to manage, causing him to take his own life by shooting himself in the chest near his home in Suffolk County, New York.[60]
General list of deceased due to health effects
| Name | Rank or Role | Organisation | Date of Death | |
|---|---|---|---|---|
| Felicia Dunn-Jones | Attorney | February 10, 2002 | [61] | |
| Thomas F. Weiner Jr. | Detective | New York City Police Department | May 3, 2003 | [62] |
| William B. Titus Jr. | Detective | New York City Police Department | August 24, 2003 | [63] |
| Edward M. Ferraro | Officer | New York City Police Department | June 6, 2004 | [64] |
| James J. Godbee | Officer | New York City Police Department | December 30, 2004 | [65] |
| Thomas G. Brophy | Officer | New York City Police Department | April 21, 2005 | [66] |
| Ronald E. Weintraub | Officer | New York City Police Department | November 16, 2005 | [67] |
| James Zadroga | Detective | New York City Police Department | January 5, 2006 | [68] |
| Sandra Y. Adrian | Detective | New York City Police Department | January 11, 2006 | [69] |
| Edward C. Gilpin | Captain | New York City Police Department | September 7, 2006 | [70] |
| Daniel C. Conroy | Officer | New York City Police Department | December 3, 2006 | [71] |
| Cesar Borja | Officer | New York City Police Department | January 23, 2007 | [72][73] |
| Louise M. Johnston | Officer | New York City Police Department | March 6, 2007 | [74] |
| Kevin Hawkins | Detective | New York City Police Department | May 7, 2007 | [75] |
| Robert Williamson | Detective | New York City Police Department | May 13, 2007 | [76] |
| Madeline Carlo | Officer | New York City Police Department | July 15, 2007 | [77] |
| Robert B. Helmke | Officer | New York City Police Department | July 28, 2007 | [78] |
| Claire T. Hanrahan | Sergeant | New York City Police Department | August 28, 2007 | [79] |
| Frank Macri | Officer | New York City Police Department | September 3, 2007 | [80][56][81] |
| William J. Holfester | Detective | New York City Police Department | January 22, 2008 | [82] |
| John E. Goggin | Detective | New York City Police Department | May 6, 2008 | [83] |
| Gary Mausberg | Officer | New York City Police Department | October 8, 2008 | [84] |
| Alex W. Baez | Sergeant | New York City Police Department | November 22, 2008 | [85] |
| Vito Mauro | Officer | New York City Police Department | December 2, 2008 | [86] |
| Richard Jakubowsky | Officer | New York City Police Department | June 7, 2009 | [87] |
| Renee Dunbar | Officer | New York City Police Department | August 25, 2009 | [88] |
| Donald G. Feser | Inspector | New York City Police Department | September 12, 2009 | [89] |
| Corey J. Diaz | Detective | New York City Police Department | October 7, 2009 | [90] |
| Robert C. Grossman | Officer | New York City Police Department | October 9, 2009 | [91] |
| Charles J. Clark | Sergeant | New York City Police Department | November 7, 2009 | [92] |
| Frank M. Bolusi | Officer | New York City Police Department | January 12, 2010 | [93] |
| Alan Hechtman | EMT | Wantagh-Levittown Volunteer Ambulance Corps | May 11, 2010 | [94] |
| David Mahmoud | Officer | New York City Police Department | November 11, 2010 | [95] |
| Robert M. Ehmer | Officer | New York City Police Department | November 21, 2010 | [96] |
| Kevin A. Czartoryski | Detective | New York City Police Department | December 5, 2010 | [97] |
| Barry Galfano | Captain | New York City Police Department | June 26, 2011 | [98] |
| Karen E. Barnes | Zdroj:https://en.wikipedia.org?pojem=Health_effects_arising_from_the_September_11_attacks