Health effects arising from the September 11 attacks

There has been growing concern over the health effects arising from the September 11 attacks in the Financial District of Lower Manhattan. Within seconds of the collapse of the Twin Towers and Building 7 of the World Trade Center, pulverized building material, electronic equipment, and furniture was spread throughout the area.

Additionally, in the five months following the attacks, dust from the pulverized buildings continued to fill the air of the World Trade Center site. Increasing numbers of New York residents are reporting symptoms of Ground Zero respiratory illnesses.

Materials in the 9/11 cloud, and potential for creating Ground Zero illnesses
The dust from the collapsed towers was "wildly toxic", according to air pollution expert and University of California Davis Professor Emeritus Thomas Cahill. The thousands of tons of toxic debris resulting from the collapse of the Twin Towers consisted of more than 2,500 contaminants, 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. There were also unprecedented levels of dioxin and PAHs from the fires which burned for three months. Many of the dispersed substances (asbestos, crystalline silica, lead, cadmium, 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.

Ground Zero illnesses
his has led to debilitating illnesses among rescue and recovery workers, and the pulmonary fibrosis death of NYPD member Cesar Borja. Increasing numbers of cases are appearing in which first responders are developing serious respiratory ailments. Health effects also extended to some residents, students, and office workers of Lower Manhattan and nearby Chinatown.

Ground zero workers and cancer

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."


Judgments and statements by leading physicians

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." 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. The American College of Preventative Medicine is concerned that malignant mesothelioma will develop among persons exposed to Ground Zero air.

2010 New York Fire Department Medical Office Study

A study of 5000 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 the impairments presented itself in the first year of after the attack with little or no improvements in the ensuing six years. 30 to 40 percent of workers were reporting persistent symptoms and 1000 of the group studied were on “permanent respiratory disability”. Dr. Prezant noted the medications that are being given ease symptoms but are not a cure. 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."

Ongoing monitoring of first responders' and residents' health

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.

Mount Sinai Medical Center is conducting an ongoing monitoring program, World Trade Center Worker and Volunteer Medical Screening Program. 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. 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.

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.

A 2006 medical study of fire fighters reported that those personnel who inhaled Ground Zero air essentially lost 12 years of lung function. 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.

A 2008 report by New York City's Department of Health indicated that up to 70,000 people might have long term health problems due to the dust. The findings were the result of the city's health registry of September 11 first responders, residents, and others.

Lack of insurance

40 percent of the World Trade Center workers being monitored by a Mount Sinai Hospital study lack health insurance.
August 2007 deadline for Ground Zero-related worker's compensation

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.

Filing extension by Governor Eliot Spitzer

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.

World Trade Center health administrators and controversies

On June 11, 2007, Mayor Bloomberg appointed Jeffrey Hon as World Trade Center health coordinator. Hon had previously worked as the spokesman for the American Red Cross September 11 Recovery Program. People have offered conflicting statements, however, regarding Hon's role. In an interview with the New York Daily News Hon said that his role was to correct inconsistencies in city agencies and to handle related pension issues. Yet, Mayor Bloomberg said that Hon's role would not involve handling pension-related issues. A press release also indicated that the coordinator will "provide a central repository of WTC health information and ensure effective communication with those who may be experiencing 9/11-related health effects."

Dr. John Howard was appointed the medical administrator of the federal James Zadroga Act fund. On July 22, 2011, Howard's report on a study of a link between particulate exposure in the aftermath and cancer was released. The report said that there was insufficient evidence of a link between particulate exposure and cancer. The report's findings meant that many first responders to the attacks would be limited in their access to funds for medical treatment. Three New York Congressional delegation Representatives, Peter T. King, Carolyn B. Maloney and Jerrold Nadler, said that they believed that further studies would intidate a link between exposures and cancer.

Early findings and muted warnings

Dr. Edwin M. Kilbourne, a high level federal scientist, issued a memo on September 12, 2001 to the Centers for Disease Control and Prevention against the speedy return to buildings in the area because of possible hazards from various toxic materials.

Associate City Health Commissioner Kelly McKinney on October 6, 2001 said that proper safety protocol for WTC site workers was not being enforced.

Political controversies
President George W. Bush's alleged manipulation of EPA statements

President George W. Bush has been faulted by the Sierra Club for allegedly interfering with the United States Environmental Protection Agency (EPA) interpretations and pronouncements regarding air quality.
Early statement by Christine Todd Whitman

On September 18, 2001, EPA administrator Christine Todd Whitman told the public, via a press release, "We are very encouraged that the results from our monitoring of air-quality and drinking-water conditions in both New York and near the Pentagon show that the public in these areas is not being exposed to excessive levels of asbestos or other harmful substances" and that "Given the scope of the tragedy from last week, I am glad to reassure the people of New York … that their air is safe to breathe and the water is safe to drink."

Alleged EPA deceptions about Ground Zero air quality

An August 2003 report by the Office of the Inspector General of the EPA claimed that the Bush administration pressured the EPA to remove cautionary information about the air quality at Ground Zero.

Numerous key differences between the draft versions and final versions of EPA statements were found. A recommendation that homes and businesses near ground zero be cleaned by professionals was replaced by a request that citizens follow orders from NYC officials. Another statement that showed concerns about "sensitive populations" was deleted altogether. Language used to describe excessive amounts of asbestos in the area was altered drastically to minimize the dangers it posed.

In September 2006, the U.S. House Committee on Homeland Security held a two day long hearing on the subject of illnesses caused by post-9/11 air quality and former EPA head Christine Todd Whitman was a frequent target of criticism.

EPA scientist Dr. Cate Jenkins appeared on CBS television on September 8, 2006 and said that agency officials lied about the air quality in the weeks following September 11, 2001. She said that in her opinion the EPA knew about the toxicity of the air, and that WTC dust included asbestos and disturbingly high PH levels. She said that some of the dust was "as caustic and alkaline as Drano." Dr. Marjorie Clarke also warned of the consequences of breathing toxic dust and fumes. Yet, agencies did not heed her warnings.

The New York State Department of Environmental Conservation conducted a study of the World Trade Center site. However, it refused to release the results of its study, saying that the results were a study of a "criminal investigation."

On September 13, 2006, Congressmen Jerrold Nadler (NY), Anthony Weiner (NY), Bill Pascrell Jr. (NJ) filed a request with US Attorney General Alberto Gonzalez to investigate whether criminal charges may be brought against Whitman for lying about air safety in the Ground Zero area.


Alleged government downplaying of health risks

Critics assert that government officials – notably Bush, Christine Todd Whitman (former head of the United States Environmental Protection Agency), and then-New York City mayor Rudy Giuliani – downplayed the health risks of the area and rushed to reopen the area around Ground Zero, although this posed a grave and immediate health risk to first responders. Many corporations were eager to hear the news of the New York Stock Exchange being reopened only a few days after the collapse. On June 25, 2007, Whitman testified before a House of Representatives committee chaired by Jerrold Nadler. She said that a White House official informed her that President Bush expected that the Financial District would reopen within three days, that is, by September 14. She said that she replied that this would be cumbersome, since the EPA was still judging the health situation in the area. Investigations after the attacks suggest that the Bush administration pressured Whitman and Giuliani to provide health reassurances in order to keep Wall Street operating.

Statements by Mayor Rudy Giuliani

Two days after the collapse of the World Trade Center, mayor Giuliani said, "The air is safe as far as we can tell, with respect to chemical and biological agents." Giuliani, in attempting to deflate New York Daily News journalist Juan Gonzalez' reportage of the 9/11 air issue, claimed that "the problems created… are not health-threatening." In the first month after the attacks, the mayor said, "The air quality is safe and acceptable."

In November 2001, Giuliani wrote to the city's Congressional delegation and urged that the city's liability for Ground Zero illnesses be limited, in total, at $350 million. Two years after Mayor Giuliani finished his term, FEMA appropriated $1 billion to a special insurance fund to protect the city against 9/11 lawsuits.

In a September 18, 2006 New York Daily News article titled, "Rudy's Black Cloud: WTC health risks may hurt Prez Bid", Sally Regenhard, mother of Firefighter Christian Regenhard, who died on September 11, is quoted, "There's a large and growing number of both FDNY families, FDNY members, former and current, and civilian families who want to expose the true failures of the Giuliani administration when it comes to 9/11." She told the New York Daily News that she intends to "Swift Boat" Giuliani.

Senator Hillary Rodham Clinton is contemplating calling Giuliani to testify before a Senate committee on whether the government failed to protect recovery workers from the effects of polluted Ground Zero air.

Congressman Nadler was quoted in a March 1, 2007 "New York Sun" article, "Potential Clinton-Giuliani Battle Brews Over 9/11 Health Issues." He said that he "absolutely" wishes to interview Giuliani administration officials regarding the environment in the aftermath of the September 11 attacks. He asked, "Who made decisions, if any, that resulted unnecessarily in a lot of people getting sick?"

Handling of cleanup procedure

A May 14, 2007 New York Times article, "Ground Zero Illness Clouding Giuliani's Legacy", gave the interpretation that thousands of workers at Ground Zero have become sick and that "many regard Mr. Giuliani's triumph of leadership as having come with a human cost." The article reported that he seized control of the cleanup of Ground Zero, taking control away from established federal agencies, such as the Federal Emergency Management Agency, the Army Corps of Engineers and the Occupational Safety and Health Administration. He instead handed over responsibility to the "largely unknown" city Department of Design and Construction. Documents indicate that the Giuliani administration never enforced federal requirements requiring the wearing of respirators. Concurrently, the administration threatened companies with dismissal if cleanup work slowed.

Workers worked without proper respirators. They wore painters' masks or no covering. Specialists claim that the only effective protection against toxins such as airborne asbestos, is a special respirator. New York Committee for Occupational Safety and Health industrial hygenist David Newman said, "I was down there watching people working without respirators." He continued, "Others took off their respirators to eat. It was a surreal, ridiculous, unacceptable situation."

The local EPA office sidelined the regional EPA office. Dr. Cate Jenkins, a whistle-blower EPA scientist, said that on September 12, 2001, a regional EPA office offered to dispatch 30 to 40 electron microscopes to the WTC pit to test bulk dust samples for the presence of asbestos fibers. Instead, the local office chose the less effective polarized light microscopy testing method. Dr. Jenkins alleged that the local office refused, saying, "We don't want you f---ing cowboys here. The best thing they could do is reassign you to Alaska."

Lawsuit against city, regarding health payments

First responders and other individuals are suing the City of New York. Lawyers are criticizing the city for failing to provide proper facial ventilators to clean-up workers. On October 17, 2006, federal judge Alvin K. Hellerstein rejected New York City's motion to dismiss lawsuits that requested health payments to the first responders.

On November 19, 2010, attorneys said that plaintiffs accepted a settlement which should lead to $625 million being paid to more than 10,000 workers experiencing problems as a result of inadequate preparation to work at Ground Zero. Not all affected participated, but those who did not would be eligible for a portion of $7.4 billion provided by the James Zadroga 9/11 Health and Compensation Act, which the U.S. House passed in September 2010. New York City Mayor Michael Bloomberg asked the Senate to do the same. The plaintiffs in the settlement would also be eligible for compensation under the Zadroga Act.

On December 22, 2010, the United States Senate passed a 9/11 Health Bill running against opposition of the Republican Party. The measure calls for providing $1.8 billion until 2015 to monitor and treat injuries stemming from exposure to toxic dust and debris at World Trade Center site. There are nearly 60,000 people enrolled in health-monitoring and treatment programs related to the 9/11 attack. The bill is formally known as the James Zadroga 9/11 Health and Compensation Act, named after a New York police detective who took part in the rescue efforts at ground zero and later developed breathing complications.

Settlement proposed in 2007

On October 28, 2007, Jim Riches reported that the City of New York and litigating first responders have shown interest in a legal settlement, to resolve lawsuits against the city. The settlement would yield a financial settlement apportioned in the following manner: forty percent to lawyers, and sixty percent to litigants.

Estimated treatment costs

The National Institute for Occupational Safety and Health issued a study on July 17, 2007 indicating that the estimates for monthly costs of treating Ground Zero workers had increased from around $6 million per month to $20 million per month by the end of 2007. The causes of the increased expense lie in the increasing numbers of workers getting sick and the worsening illnesses of workers. This indicated that the planned U.S. House appropriation legislation (of $50 million) for the sick workers, for the coming year, would be inadequate. The number of workers that have registered with area hospitals' Ground Zero programs has reached 37,000. With about 500 new workers registering each month, the institute estimated that the number of registrants could reach 65,000 in two years. (The institute is overseen by the Department of Health and Human Services.)

Disputes over plaintiffs' health claims

In June 2008, New York City argued in federal court that 30 percent of the September 11 plaintiffs did not have serious injuries. This is part of a larger debate over the number of people sickened by the collapse of the Twin Towers. ( source : Wikipedia