Ten Years Later: The September 11 Attacks
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Health Effects of September 11

Title: Health effects of September 11
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The collapse of the Twin Towers and Building Seven of the World Trade Center complex on September 11, 2001, produced thousands of tons of airborne debris that enveloped Lower Manhattan in a thick cloud of contaminants. Studies performed since the attacks have suggested that those exposed to this polluted air—particularly first responders and cleanup workers—are at serious risk of developing a number of potentially life-threatening medical conditions.

The toxic cloud produced by the collapse of buildings 1, 2, and 7 of the World Trade Center contained an estimated 2,500 contaminants. These included pulverized concrete, glass, silica, lead, mercury, and asbestos, as well as high levels of dioxin and polycyclic aromatic hydrocarbons (PAHs) produced by fires at Ground Zero. Many of these pollutants are known to cause respiratory illness, while others are carcinogenic or linked to deterioration of the kidneys, liver, or other organ systems.

A number of studies have been conducted in an effort to gauge the long-term health effects of exposure to this toxic cloud. A Pennsylvania State University/Monmouth University study found that rates of respiratory illness among those surveyed had risen by more than 200 percent in the year and a half following the attacks. This trend was confirmed by Dr. David J. Prezant, chief medical officer for the Fire Department City of New York (FDNY) Office of Medical Affairs, in a report published in April 2010. Prezant surveyed 5,000 rescue workers, noting that all had suffered impaired lung function, with 30 percent reporting persistent symptoms and 20 percent on "persistent respiratory disability." Doctors have noticed an increase in other illnesses, as well. One study found that more than 75 rescue and recovery workers had contracted blood cell cancers, which researchers believe were caused by carcinogens in the dust cloud. According to a 2008 report by New York City's Department of Health, as many as 70,000 individuals are at risk of developing lasting health complications.

A number of institutions are conducting ongoing monitoring programs, including the World Trade Center Worker and Volunteer Medical Screening Program at Mount Sinai Medical Center. The Columbia University Center for Children's Health is also following children whose mothers were exposed to the 9/11 dust cloud to gauge its impact on fetal development. Several health registries have been created in order to assist researchers in identifying and tracking those affected by the dust cloud. The largest of these is the 9/11 Health Registry, which includes more than 70,000 people. Established in 2002 by the Agency for Toxic Substances and Disease Registry and the New York City Department of Health and Mental Hygiene, the registry coordinates its efforts with the National Institute for Occupational Safety and Health (OSHA). For those with 9/11-related health problems living in the New York City area, low- and no-cost screening and treatment programs are available at a number of area hospitals that have been designated WTC Centers of Excellence. The WTC National Responder Health Program provides similar care for those living outside New York City.

Political action at both the local and federal levels has also been taken in response to 9/11 health concerns. In 2006, President George W. Bush appointed John Howard, director of OSHA, to the newly created position of WTC health czar. In that position until 2008, Howard was responsible for developing and overseeing the implementation of the World Trade Center Medical Monitoring and Treatment Program. In June 2007, New York City mayor Michael Bloomberg appointed Jeffrey Hon as World Trade Center health coordinator, tasked with facilitating information-sharing among patients, researchers, and other interested groups.

On February 4, 2009, New York Democratic Congressman Carolyn Maloney introduced HR 847, also known as the James Zadroga 9/11 Health and Compensation Act. The bill was named for New York City police officer James Zadroga, who died on January 5, 2006, from respiratory illness most likely caused by exposure to the dust cloud. The bill, which won final approval from Congress on December 22, 2010, and was signed into law by President Barack Obama on January 2, 2011, will provide $4.2 billion in medical care to those whose health has been impacted by the destruction of the World Trade Center.

Perhaps more disturbing than the long-term health effects of 9/11 is the possibility that local and federal officials mismanaged cleanup operations and intentionally downplayed the risks of reopening the area around Ground Zero so soon after the collapse of the World Trade Center. Then-mayor of New York City Rudy Giuliani gave the locally run Department of Design and Construction oversight of cleanup operations, sidestepping federal agencies that customarily handle such tasks, including the Federal Emergency Management Agency (FEMA), the Army Corps of Engineers, and OSHA. Giuliani has been accused of ignoring federal safety requirements, including providing respirators for cleanup workers. A total of 10,563 workers sued the city of New York for negligence during cleanup operations. In November 2010, more than 10,000 of them agreed to a $625 million settlement.

Allegations of misconduct have also been leveled against Bush and other top Washington officials, including Christine Todd Whitman, then-head of the Environmental Protection Agency (EPA). In a September 18, 2001, statement, Whitman assured New York residents that the air around Ground Zero was safe and that returning to work posed no health risks. A report issued by the EPA's Office of the Inspector General in August 2003, however, asserted that Bush and the White House Council on Environmental Quality had pressured the EPA to omit all negative or cautionary statements from its reports on air quality. Critics claim that the health of New York City residents was jeopardized in an effort to minimize the economic impact of the 9/11 attacks.

Spencer C. Tucker

Further Reading
Barry, Ellen. "Lost in the Dust of 9/11." Los Angeles Times, October 14, 2006; DePalma, Anthony. City of Dust: Illness, Arrogance, and 9/11. Upper Saddle River, NJ: FT Press, 2010; Edelman, Susan. "Charting Post-9/11 Deaths." New York Post, January 6, 2008; Garrett, Laurie. "EPA Misled Public on 9/11 Pollution." Newsday, August 23, 2003; Lioy, Paul J. Dust: The Inside Story of Its Role in the September 11th Aftermath. Lanham, MD: Rowman and Littlefield, 2010.

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