ILLNESS
PERSISTING IN 9/11 WORKERS, BIG STUDY
By ANTHONY DePALMA
Published: September 6,
2006
The largest health study yet of the thousands of workers who labored at ground zero shows that the impact of the rescue
and recovery effort on their health has been more widespread and persistent than
The study, released yesterday by doctors at Mount Sinai
Medical Center, is expected
to erase any lingering doubts about the connection between dust from the trade center and numerous diseases that the workers
have reported suffering. It is also expected to increase pressure on the federal government to provide health care for sick
workers who do not have health insurance.
Roughly 70 percent of nearly 10,000 workers
tested at Mount Sinai from 2002 to 2004 reported that they had new or substantially worsened
respiratory problems while or after working at ground zero.
The rate is similar to that found among a smaller
sample of 1,100 such workers released by Mount Sinai in 2004, but the scale of the current study gives it far more weight;
it also indicates significant problems not reflected in the original study.
For example, one-third of the patients in the
new study showed diminished lung capacity in tests designed to measure the amount of air a person can exhale. Among nonsmokers,
28 percent were found to have some breathing impairment, more than double the rate for nonsmokers in the general population.
The study is among the first to show that many
of the respiratory ailments — like sinusitis and asthma, and gastrointestinal problems related to them — initially
reported by ground zero workers persisted or grew worse in the years after 9/11.
Most of the ground zero workers in the study
who reported trouble breathing while working there were still having those problems up to two and a half years later, an indication
that the illnesses are becoming chronic and are not likely to improve over time. Some of them worked without face masks, or
with flimsy ones. “There should no longer be any doubt about the health effects of the World
Trade Center disaster,” said Dr. Robin
Herbert, co-director of Mount Sinai’s World Trade Center Worker and Volunteer Medical
Screening Program. “Our patients are sick, and they will need ongoing care for the rest of their lives.”
Dr. Herbert called the findings, which will
be published tomorrow in Environmental Health Perspectives, the journal of the National Institute of Environmental Health
Sciences, “very worrisome,” especially because 40 percent of those who went to Mount Sinai
for medical screening did not have health insurance, and will thus not get proper medical care. The Mount Sinai results found,
as studies done by the New York City Fire Department also have, that those who showed up in the first hours and days after
the twin towers collapsed have the worst medical problems. Seventy percent of the workers in the study arrived at the site
between Sept. 11 and Sept. 13.
Mount Sinai’s screening and monitoring
program, which excludes New York firefighters, who are tested
in a separate program, run by the New York Fire Department, covers law enforcement officers, transit workers, telecommunications
workers, volunteers and others who worked at ground zero and at the Fresh Kills landfill, where debris was taken.
Members of the New York
Congressional delegation, who have been fighting to get the federal government to recognize the scope of the health problem
created by toxic materials at ground zero, saw the Mount Sinai study as proof that the federal
government has been too slow to address the issue.
Senator Hillary Rodham Clinton, who participated
in the news conference at Mount Sinai yesterday morning, along with Representatives Jerrold
Nadler and Carolyn B. Maloney, said that the results made the need for federal assistance for treatment more critical than
ever.
“This study, I hope, puts to rest any
doubt about what is happening to those who were exposed,” said Mrs. Clinton, who was among those who pushed for $52
million in federal funding for health treatment for the ground zero workers, the first treatment money provided by the Bush
administration. “This report underscores the need for continued long-term monitoring and treatment options — they
go hand in hand,” she said.
Several members of the delegation are scheduled
to meet in Washington tomorrow morning with Michael O. Levitt,
the secretary of the Department of Health and Human Services, to press for more aid.
Mayor Michael R. Bloomberg, speaking at a news
conference at City Hall yesterday, questioned the conclusiveness of the study, saying that statistics could suggest a connection
between events, but not prove a direct link.
“I don’t believe that you can say
specifically a particular problem came from this particular event,” he said. Nonetheless, Mr. Bloomberg announced that
the city would create a screening and treatment program for anyone exposed to the trade center dust or fumes.
Skip to next paragraph The Mount Sinai study, released yesterday, which covers 9,442 workers who met the screening program’s eligibility criteria
and agreed to have their health data included, focused on respiratory problems because doctors believe those illnesses are
the first to surface. Of those studied, 46.5 percent reported symptoms like chest tightness, shortness of breath and dry cough
that generally affect the lower airways of the lungs.
And 62.5 percent reported upper-respiratory
symptoms like sinusitis and nose and throat irritations. (The study did not include cases of cancer reported by workers and
their relatives.)
The doctors said that the persistent nature
of the respiratory symptoms raised troubling questions about the workers’ long-term health. Dr. Philip J. Landrigan,
a founder of the screening program at Mount Sinai and an author of the new study, said that the toxic nature of the trade
center dust had led doctors to conclude that there would be serious health issues for years to come, especially for workers
who were exposed to the heaviest concentrations in the early days after the terrorist attack.
“This was extremely toxic dust,”
Dr. Landrigan said, noting that some samples showed the dust to be as caustic as drain cleaner. The dust also contained innumerable
tiny shards of glass, which could get lodged in the lungs, and a stew of toxic and carcinogenic substances, like asbestos
and dioxin, that could potentially lead to cancer decades from now.
With the expanding dimensions of 9/11 health
problems, concern is also growing about the cost of health care for responders, particularly the 40 percent who either never
had health insurance or who lost employer-provided coverage after they became too sick to work.
Dr. Landrigan declined to estimate what the
total cost might be, saying only “it will be very expensive.”
Dr. John Howard, who was named the federal
9/11 health coordinator in February, has already said that the $52 million the federal government has appropriated for treatment
late last year is inadequate. He said in an interview yesterday that the new study will very likely mean that the gap between
funds and the need for them is going to grow.
But he said the solid medical data from Mount Sinai would help him make the case that more needs to be done. He said that there was little doubt
that if a third of the people in the study showed abnormal breathing, similar problems exist among the entire population of
40,000 rescue and recovery workers.
“These are just the kind of facts that
are important in making a logical argument that the funding needs to be adjusted,” said Dr. Howard, who is also the
director of the National Institute for Occupational Safety and Health.
Mount Sinai officials said they would release a study of mental health effects on ground
zero workers soon. They also are planning to begin a statistical program this fall to examine the occurrence of cancer, lung
diseases and other ailments among that group. That information will then be compared to national rates to see if there is
a higher-than-expected incidence of those diseases.