Lingering and longlasting effects of 9/11

According to a new report on the health effects of the terrorist attacks on the World Trade Center in New York City, 70% of the rescue personnel and workers who responded to the disaster suffered from lung problems during and after the recovery efforts.

For some those problems persisted for at least two-and-a-half years after the Sept. 11, 2001 attacks and experts are not surprised.

Five years after the 9/11 attacks many survivors have reported new or worsened sinus or nasal problems along with high levels of psychological distress.

Of the more than 8,000 who survived the collapse and escaped from damaged buildings, half have reported new or worsening respiratory symptoms, and almost all witnessed events with a strong potential for causing psychological trauma.

More than 1 in 10 screened positive for serious psychological distress.

The report which is based on medical examinations of 9,442 of the responders between July 2002 and April 2004, has found that as many as 40,000 rescue and recovery workers would have been exposed to dust and pollutants following the attacks.

Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, says the World Trade Center was now known to contain heavy metals such as nickel, titanium and cadmium which are toxic to the lungs.

Horovitz says the dust contained large and small toxic particles, and the smallest would be able to reach the deepest recesses of the lungs.

The report by the Mount Sinai Medical Center in New York City, says 69 percent of those examined reported new or worsened respiratory symptoms while working at the World Trade Center site and symptoms were still present at the time of examination in 59 percent of participants.

Mount Sinai has been the center of 9/11-related research, and of those involved in the disaster who were treated at the hospital in the past year, 84 percent have had upper-respiratory illness; 47 percent have had lower-respiratory disorders such as asthma and "World Trade Center cough"; 37 percent have had psychological disorders such as post-traumatic stress disorder; and 31 percent have had musculoskeletal problems.

It was found that 61 percent of those who had not had any respiratory symptoms before 9/11 developed symptoms while working at the site and pulmonary-function tests have revealed that rescuers and workers at the site had twice the rate of abnormalities as those experienced in the general population which persisted in some cases for years.

Severe respiratory conditions such as pneumonia were much more common in the six months following 9/11 than in the six months prior and those who arrived first at the smoldering site had the heaviest exposure and as a result more respiratory problems.

Horovitz says some problems will continue or worsen and a rise in malignancies can be expected.

The authors say the report emphasises the need to continue monitoring and treating World Trade Center responders.

The report comes at a time when public concern over the fate of Ground Zero workers has increased and one lawsuit against New York City and its contractors, on behalf of 8,000 workers and civilians, is blaming 9/11 for cancer, sinusitis and other problems.

New York City Mayor Michael Bloomberg is expected to announce programs to support those who worked at the site after 9/11 and last month the New York City Health Department released updated clinical guidelines for health-care providers on how to treat adults exposed to the disaster.

The guidelines include screening approaches to improve detection of health problems as well as advice on the treatment of respiratory disorders, along with information to help assess exposures, assist in diagnosis and treatment, provide preventive services, and refer for consultation or specialty care.

The guidelines update those previously issued to doctors on the treatment of depression, post-traumatic stress disorder, and chemical dependency as a result of 9/11.

New initiatives are also proposed to strengthen the City’s response to emerging health issues related to attacks on the World Trade Center and include the establishment of a WTC Environmental Health Center at Bellevue Hospital, the expansion of the Department of Health and Mental Hygiene’s World Trade Center Unit, and the creation of an internal Mayoral review panel to ensure maximum coordination between City agencies and assess the sufficiency of state and federal resources to address ongoing health needs.

The report is published in Environmental Health Perspectives.

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