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Public Radio's Environmental News Magazine (follow us on Google News)

The Health Legacy of Ground Zero

Air Date: Week of

(Photo courtesy of FEMA)

9/11 WORKERS’ HEALTH: Five years after 9/11, many rescue workers and volunteers at ground zero suffer extensive health problems related to their exposure to the dust and debris of the Twin Towers. Rachel Gotbaum brings us their stories from New York City. Also, a comprehensive study of illnesses affecting rescue workers at ground zero reveal that dust and other toxins have caused chronic health problems, and even death. Host Bruce Gellerman speaks with Dr. Philip Landrigan who co-authored the study and has been screening rescue workers since 9/11.


GELLERMAN: From the Jennifer and Ted Stanley studios in Somerville, Massachusetts - this is Living on Earth. I’m Bruce Gellerman. Steve Curwood is away.

Can it really be 5 years ago? 9/11 is still raw in our hearts and minds and it continues to claim victims. The plume of dust from the collapse of the twin towers flew high into the air and deep into the lungs of people living and working near ground zero. We have two updates on the health effects of the World Trade Center disaster. We begin with reporter Rachel Gotbaum.

GOTBAUM: Today ground zero is a construction site fenced off from the public. A place of silent memorials and tour guides.


GOTBAUM: Looking at the site today it’s hard to imagine that precisely five years ago, this was a scene from purgatory. When the planes hit the twin towers on 9/11 the buildings were pulverized. It’s estimated two million tons of dust containing cement, asbestos, glass, lead, PCBs and other known carcinogens rained down on lower Manhattan.


GOTBAUM: Ever since the attacks researchers have been trying to understand the health
effects of the dust and smoke that filled this area. Among them is Doctor Paul Lioy a professor of occupational and environmental health at Rutgers University. Lioy took dust samples at ground zero soon after 9/11.

LIOY: This is unprecedented. We don’t have any benchmark from which to play from. We’re looking at a material that’s a mixture that we never ever characterized before. So that I cannot say to you that exposure will lead to a long-term health effect. There’s no answer to that question at this point in time.

GOTBAUM: But for many of those who worked on the rescue and recovery at ground zero there is no question that their medical problems are due to the air they breathed at the site. John Sferazo was an ironworker who volunteered at ground zero.

SFERAZO: The smell of death was in the air. You could smell the bodies burning or what was left of bodies burning. Sometimes the smoke was so bad your eyes would burn you couldn’t open your eyes.

GOTBAUM: Sferazo says at first he says he was offered paper masks to protect against the dust and the smoke. He wasn’t worried about toxic exposure because just days after the attacks government officials said the air was safe. But he began to get sick.

SFERAZO: I was starting to cough and then I was coughing up these things that looked like silver dollars. They were silverfish gray and sometimes there was blood in it. Short after that I started getting severe lung infections and then succumbing to pneumonia. And I’ve never had pneumonia in my life. Nor have I ever had any pulmonological problems.

GOTBAUM: Today John Sferazo is 51 and can no longer do construction work. He receives workers compensation and federal disability payments because he has been diagnosed with reactive airway disease, gastro reflux disease, and posttraumatic stress disorder. More than 40 thousand people worked in the recovery and rescue at ground zero. And thousands of workers including firefighters, police, and construction crews have filed for workers compensation and disability.

City, State and Federal agencies say they provided respirators and urged workers to wear them. But less than half of the workers say they did.

HERBERT: Good deep breaths with your mouth wide open please. And again.


GOTBAUM: Doctor Robin Herbert is examining Daniel Lewis. Lewis delivered lunches to rescue and recovery workers in the days after 9/11. He is now disabled.

LEWIS: I’m taking antibiotics. They was considering steroids cause I have a hard time breathing.

GOTBAUM: Lewis is one of 16 thousand workers from ground zero evaluated at the World Trade Center treatment program at Mt. Sinai Medical Center. The patients here range from undocumented immigrants who cleaned dust out of nearby office buildings to emergency service workers to fire fighters who worked at the site for months. Doctor Herbert directs the program.

HERBERT: When we would look in people’s nasal passages it was as if the nasal tissue were just burnt out, it was bright cherry red. I mean, our patients initially couldn’t sleep through the night. They couldn’t sleep for more than an hour they were coughing so badly.

GOTBAUM: In a just-released study of 10 thousand patient’s in the Mt. Sinai program,
70 percent show signs of new and lingering health problems related to their time at the world trade center site.

HERBERT: One of the primary causes of the respiratory problems was exposure to pulverized cement and glass. The cement in particular was very alkaline, very high ph, extremely irritating, and we think that that then caused chronic inflammations in our patients.

GOTBAUM: The federal government is paying for Mt. Sinai’s monitoring of patients, but it’s the Red Cross that’s footing the bill for their medical care. Forty percent of those in the program don’t have health insurance.

WORBY: Thousands of people are going to die from this problem.

GOTBAUM: That’s attorney David Worby. Worby is suing New York City, federal agencies and private contractors who were responsible for the cleanup at ground zero.

WORBY: This case is about thousands upon thousands of people who are sick. Many of whom are dying. A lot more of whom will die because of the rush to clean up garbage after September 11 when we were not saving lives because of a governmental decision and contractors’ decisions to do everything possible to keep 50 thousand people busy, 24/7, with zero protection in the middle of the worst toxic waste site ever.

GOTBAUM: Worby represents 8,200 clients who worked ground zero. One of them is New York City police detective John Wolcott. In 2003 Wolcott was diagnosed with leukemia. He believes working at the 9/1l site caused his medical problems.

WOLCOTT: Well, when I got admitted to the hospital I was diagnosed that morning and they said you had a week to live and you had to go to the hospital. The nurses would come in and interview you, and they found out what kind of leukemia I had. I fielded about a hundred questions about were you ever in any kind of employment with chemicals? Did I ever work in the airports? Did I ever deliver jet fuel? Was I ever around benzene? And I didn’t put two and two together. I had other things on my mind at that time. And my sister said, “what do you think was burning down at the World Trade Center?”

GOTBAUM: Wolcott thinks the fuel from the jets that crashed into the towers may be responsible for his cancer and his partner in the police department needing a kidney transplant. Attorney David Worby says the connection is obvious.

WORBY: How does one partner have kidney failure and the other have leukemia and the only thing they have in common after 12 years of partnership is 9/11? Sitting in my office a week and a half ago were six cops with leukemia. These were all people who have been diagnosed in the last year. All people who had significant, at least two weeks, many of them seven months, some of them two years of exposure at 9/11.

GOTBAUM: Five years after 9/11 the question of the health effects from ground zero is
a matter for medical researchers and the courts. New York City health officials have just announced a new16 million dollar program to monitor and treat residents of lower Manhattan and 9/11 workers. The Bush administration has allocated 52 million dollars for medical treatment, but federal officials admit that’s not nearly enough for those who may seek medical care because of the effects of Ground Zero.

For Living on Earth, I’m Rachel Gotbaum.

GELLERMAN: The Mt. Sinai World Trade Center screening program that reporter Rachel Gotbaum just cited in her story was founded by Dr. Philip Landrigan. He’s chairman of the department of community and preventive medicine at the medical school there and one of the authors of the 9/11 health effects study which found the dust at Ground Zero was the cause of health problems. He joins me on the phone.

GELLERMAN: Thanks, Dr. Landrigan.

LANDRIGAN: Thank you, Bruce. It’s good to be here.

GELLERMAN: Do you expect this to be chronic problems? Are they going to be disabling problems?

LANDRIGAN: Well, those of course, are the big unanswered questions. I think the best way to give a partial answer to the question is to tell you about the composition of the dust these people inhaled. The dust was very toxic. Sixty percent or so of the material was comprised of pulverized concrete; very alkaline, very caustic, a ph of 10 or 11. In essence what this material did was it seared the upper and lower respiratory tracts. It caused burning, which progressed over time into scarring. Which, I think, is why we are now seeing evidence of restricted lung disease. So, the scarring causes shrinking and distortion of tissues and hence the functional abnormalities that we are seeing.

I’m concerned given the nature of these problems and given the type of disease that we’re seeing that the effects are going to be permanent in a substantial proportion of these people. Probably not in all, we’re learning to treat them aggressively with steroids and other approaches and we certainly get some benefit from that. But there is a high likelihood that a lot of this impairment is going to be permanent.

GELLERMAN: Now, soon after 9/11 happened, just a week actually, people went back to work. The Environmental Protection Agency said it’s safe to go down there and breathe the air.

LANDRIGAN: Yes, that’s true. And unfortunately that statement may have been a bit premature. The data that we presented make it plain that the air was not safe.

GELLERMAN: So, what happens now to these people?

LANDRIGAN: Well, first of all, we have a good continuous stream of federal funding for diagnosis and evaluation. Secondly, the federal government has made the decision to provide money for the first time for treatment. Up until now the feds have been giving money for diagnosis and evaluation. And all that was well and good the problem though was that approximately 40 percent had no health insurance or if they had it before ground zero they lost it as a consequence of the disabilities they incurred. It was clear that diagnostic and screening programs weren’t enough. And so, we’re very grateful that the feds have come through with funds for treatment.

Also, the mayor of New York, Michael Blumberg, is appropriating 16 million dollars from the city budget to establish a much enhanced diagnosis and screening and treatment program at Bellvue Hospital and that’s obviously a very important step to the good that will help a lot of people.

GELLERMAN: We’ve been talking about the health consequences, but physical health consequences, what about the mental health consequences of 9/11?

LANDRIGAN: Well, we know that there have been a lot of mental health consequences. We know that folks have suffered from PTSD, post traumatic stress disorder. Some have the full-blown syndrome, others have symptoms that move in that direction. Still more folks have suffered from depression. We’re in the process right now of wrapping up an analysis of the mental health findings, which we intend to publish within the next couple of months.

GELLERMAN: Now, your study found that 70 percent, seven out of ten, had some kind of serious health effects. Did you have any deaths that were directly attributed to the exposures of 9/11 in New York?

LANDRIGAN: There have been several deaths reported now among responders and there was a finding issued just recently by a coroner in New Jersey in which the coroner declared that a particular death was related to World Trade Center exposures. We certainly don’t have enough deaths yet to do any kind of epidemiological analysis on them. But we are very concerned about deaths. We are very concerned about cancers. We are very concerned about cases of severe lung disease of which several have been reported. And we have now in place a very aggressive tracking system for following up on cases such as those when they occur.

GELLERMAN: Dr. Phillip Landrigan, is chairman of the Department of Community and Preventative Medicine at the Mt. Sinai School of Medicine and one of the founders of the World Trade Center medical screening program. Dr. Landrigan, thank you very much.

LANDRIGAN: Thank you, Bruce. It was a pleasure.

[MUSIC: Boxhead Ensemble “Nocturne 4” from ‘Nocturnes’ (Atavistic – 2006)]



National Institute for Occupational Safety and Health – Environmental Health Perspectives Report


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