September 11 Respiratory Problems
Persist and Grow

AP 27mar2007

Nearly a quarter of the 40,000 workers who responded to the World Trade Center attack were examined between July 2002 and April 2004. Of those, 69% reported new or worsened respiratory symptoms.

Those examined. . .

whose symptoms persisted to the time of examination: 59%

without symptoms before Sept. 11 developing respiratory problems: 61%

Non-smokers with spirometry (a measure of airflow obstruction)

Responders: 27%

General US population: 13%

Source: Mount Sinai School of Medicine

9/11:
The Myth and the Reality

The World Trade Center Disaster and the Health of Workers:
Five-Year Assessment of a Unique Medical Screening Program

ROBIN HERBERT et al / Environmental Health Perspectives v.114, n.12 1dec2006

[Full paper at EHP website]

Abstract

Background: Approximately 40,000 rescue and recovery workers were exposed to caustic dust and toxic pollutants following the 11 September 2001 attacks on the World Trade Center (WTC) . These workers included traditional first responders, such as firefighters and police, and a diverse population of construction, utility, and public sector workers. 

Methods: To characterize WTC-related health effects, the WTC Worker and Volunteer Medical Screening Program was established. This multicenter clinical program provides free standardized examinations to responders. Examinations include medical, mental health, and exposure assessment questionnaires ; physical examinations ; spirometry ; and chest X rays. 

Results: Of 9,442 responders examined between July 2002 and April 2004, 69% reported new or worsened respiratory symptoms while performing WTC work. Symptoms persisted to the time of examination in 59% of these workers. Among those who had been asymptomatic before September 11, 61% developed respiratory symptoms while performing WTC work. Twenty-eight percent had abnormal spirometry ; forced vital capacity (FVC) was low in 21% ; and obstruction was present in 5%. Among nonsmokers, 27% had abnormal spirometry compared with 13% in the general U.S. population. Prevalence of low FVC among nonsmokers was 5-fold greater than in the U.S. population (20% vs. 4%) . Respiratory symptoms and spirometry abnormalities were significantly associated with early arrival at the site. 

Conclusion: WTC responders had exposure-related increases in respiratory symptoms and pulmonary function test abnormalities that persisted up to 2.5 years after the attacks. Long-term medical monitoring is required to track persistence of these abnormalities and identify late effects, including possible malignancies. Lessons learned should guide future responses to civil disasters. 

Key words: air pollution, disaster response, occupational lung disease, pulmonary function, September 11, spirometry, World Trade Center. Environ Health Perspect 114: 1853–1858 (2006) . doi:10.1289/ehp.9592 available via http://dx.doi.org/ [Online 6 September 2006]

source: 27mar2007