Zadroga Act Reauthorized Year-End 2015Following approval of the $8.1 billion measure to renew the Zadroga 9/11 Health and Compensation Act, President Obama signed the bill into law on December 18, 2015, reauthorizing the Act.
The reauthorized James L. Zadroga 9/11 Health and Compensation Act passed in December 2015 will provide adequate funding and benefits to sufficiently care for the first responders and survivors of the 9/11 terrorist attacks throughout their lifetimes. Congressional representatives included an $8.1 billion measure to renew the Zadroga Act in the $1.1 trillion omnibus spending package that was finalized and released in mid-December 2015. The measure extends the Zadroga Act’s programs.
The expired World Trade Center (WTC) Health Program will continue to provide medical treatment and monitoring and has been extended for another 75 years to 2090 with $3.5 billion in funding to monitor and care for 73,000 responders and survivors. The Victims Compensation Fund (VCF) is no longer set to expire on October 1, 2016 and has been extended for another five years to 2021 with $4.6 billion in funding.
A published New York University (NYU) Langone Health study has found that children who were exposed to the chemicals in the toxic cloud following the 2001 terrorist attacks are now showing early signs of risks for heart disease. The research was released on September 7, 2017.
Study Reveals Children Survivors at Greater Risk for Cardiac Disease
The toxic plume hovered over lower Manhattan 16 years ago after the World Trade Centers’ Twin Towers collapsed and children who were living in the area most likely breathed in the ash and fumes from that cloud. Specifically, according to NYU Langone Health researchers, this information is the key finding of the analysis conducted on the blood tests of 308 children. Of these children, 123 likely came into direct contact with the toxic cloud on the day of the attacks. The researchers determined that children with increased blood levels of the various chemical that are known to have been in the toxic cloud also tested with increased levels of artery-hardening fats in their blood. The scientists’ report appears online in the September 5, 2017 issue of the journal Environment International at http://www.sciencedirect.com/science/article/pii/S0160412017309856.
The researchers noted that massive amounts of various chemical contaminants—including perfluoroalkyl substances (PFASs)—were released during the attacks. Meanwhile, thousands of children lived and/or attended school near the disaster site and were exposed to these dangerous substances; however, few studies have looked at the potential consequences associated with these exposures. “Since 9/11, we have focused a lot of attention on the psychological and mental fallout from witnessing the tragedy, but only now are the potential physical consequences of being within the disaster zone itself becoming clear,” said study lead investigator and health epidemiologist Leonardo Trasande, MD, MPP, an associate professor at the NYU School of Medicine.
The children researched in in the study are likely to be young adults now who were exposed to the dust cloud at the time of the attacks and who are enrollees in the World Trade Center Health Registry (WTCHR). The Registry is continually working to help track the physical and mental health of the nearly 2,900 children survivors through annual check-ups of those who either lived or attended school in Lower Manhattan on 9/11.
Dr. Trasande said that his research is the first to suggest long-term cardiovascular health risks in children from toxic chemical exposure on 9/11. He noted that, the long-term danger may have originated from exposure to certain PFASs, including perfluorooctanoic acid (PFOA), which was widely used to make plastics more flexible until its health effects—lower-than-normal birthweights, brain damage—led the United States to stop using PFOAs in 2014.
“Our study emphasizes the importance of monitoring the health consequences from 9/11 in children exposed to the dust, and offers hope that early intervention can alleviate some of the dangers to health posed by the disaster,” said Dr. Trasande.
The researchers concluded that, “This research adds to our knowledge of the physical health impacts in a large group of children exposed to the WTC disaster. Abnormal lipid levels in young adults might be an early marker of atherosclerosis and cardiovascular diseases and our findings highlight the importance of conducting longitudinal studies in this population.”
Research Finds Tie Between Increased Level of Specific Protein to PTSD in 9/11 Survivors
A study published in the Journal of Psychiatric Research in June 2017 conducted by a research team, at New York University discovered that raised blood levels of C-reactive protein (CRP) were seen in people who reported being exposed to the World Trade Center dust cloud on 9/11.
Prior research has associated increases in CRP to inflammation and higher rates of post-traumatic stress disorder (PTSD). This research involved 641 men and women whose health was being monitored at NYC Health + Hospitals/Bellevue for effects linked to the 9/11 terrorist attacks.
The researchers specifically discovered that individuals with raised elevated CRP levels experienced a 12 percent increased risk of PTSD when compared to individuals whose CRP level was not elevated.
Doctor Warns that 9/11 Death Toll May Ultimately Rise to the Millions
Dr. Raja Flores, Chief of Thoracic Surgery at Mount Sinai Hospital, NY, told 9News.com.au. “In 15-20 years we are going to see a serious health issue here in New York. We haven’t even seen the tip of this iceberg yet.” Dr. Raja Flores believes that the number of deaths due to the September 11 terrorist attacks in New York City could reach into the millions due to the toxic cloud of carcinogens and other dangerous substances that covered New York City after the Twin Towers fell.
Residents in the area are developing cancers due to the asbestos-filled ash and Dr. Flores believes that the numbers will continue to increase. “There’s (sic) almost nine million people in New York … a lot more people may have been exposed (to asbestos fibers) than we first thought. It contaminated a huge portion of the city and that entire population was exposed,” Dr. Flores told 9News.com.au.
Dr. Flores feels that the actual range of the terrorist attacks may only begin to be understood due to the dust and debris that scattered across Manhattan and Brooklyn. According to 9News.com.au. the toxic plume contained more than 400,000 kilograms of asbestos, mercury, fiberglass, and benzene, noting that the dust was inhaled, in various amounts, by nearly everyone in Manhattan during that time.
Most recently, United States hero, New York Fire Department (FDNY) firefighter, Ray Pfeifer, died due to brain and lung cancer because of his work at Ground Zero. Pfeifer was among the many emergency workers who spent over eight months clearing the World Trade Center disaster.
Dr. Flores, a New York surgeon who is considered one of the world’s leading experts in pleural mesothelioma and asbestosis, pointed out that, although lower Manhattan contained most of the dust that followed the attacks, anyone in New York City at the time of the attacks and the following days, were potentially exposed to deadly asbestos fibers. “There are a lot of people now who are having respiratory issues and we are starting to see more cancers,” he said. “People are already getting sick from the asbestos and they have died from it. If I had to bet my house, in 15-20 years we are going to see a serious health issue here. I think you will probably see double or tripling of the number of lung cancers in people who were in New York City on 9/11 and mesothelioma and people dying of pleural fibrosis from asbestosis,” he added, according to 9News.com.au.
The New York surgeon objected to reports that just first responders and those who were in the area of the World Trade Center were at risk of developing lung cancer, and warns that the United States may be just a few years from a catastrophic national health crisis, 9News.com.au reported.
When the World Trade Center was being planned, the Port Authority of New York and New Jersey initially planned to use more than five million kilograms—11,023,113.11 pounds—of asbestos in the buildings. When Dr. Irving Selikoff of Mount Sinai Hospital proved a link between asbestos fiber exposure and lung cancer, installation of the World Trade Center, considered controversial, was halted in the 1970s. By that time, nearly half-a-million kilograms—1,102,311.31 pounds—of asbestos had been sprayed as insulation in the first 40 stories of the both Twin Towers, according to 9News.com.au.
“It’s one of the most dangerous substances around. Every day I operate (I see) patients that have been affected by asbestosis. The safe amount of asbestos in the air for someone to inhale is zero. There’s no safe amount,” Dr. Flores said. “The entire city was blanketed, especially downtown and Brooklyn. You went down there months later and you still smelled it. That dust was still around for a very long time,” Dr. Flores told 9News.com.au.
Dr. Flores’ bleak prediction concerning New Yorkers and those exposed to the toxic cloud follows a comparative study he undertook in the town of Libby, Montana. It was in Libby that the asbestos used in the World Trade Center was originally mined and manufactured. The research investigated the contaminated vermiculite mines in the region and the local population’s exposure to tremolite asbestos. The study revealed that over 400 people in the town of 2,656 died from asbestos-related illnesses since the 1990s. “It’s common sense that what happened in Libby will start happening to the people in New York. That’s frightening and it’s a big deal,” he said, according to 9News.com.au.
Meanwhile, a 2012 New York City health study published in the Journal of American Medical Association dismissed that links exist between the noxious dust released from the Twin Towers’ collapse and the development of cancers. That study examined 55,700 people who were in the vicinity of the World Trade Centre during 9/11 and in the weeks that followed. The paper revealed 1,187 people (439 rescue/recovery workers and 748 general public) were diagnosed with three different types of cancers between 2007 and 2008. The research concluded that, while “the presence of carcinogenic agents raises the possibility that exposure to the WTC environment could eventually lead to cancers,” the link between the two could not be substantiated 9News.com.au. Former New York City health commissioner Dr. Thomas Farley pointed out that it was still too soon to establish a link between 9/11 and cancer during a 2012 interview. “Cancers take 20 years to develop and we might see something different 20 years down the line,” he said.
Dr. Flores warned that children who were exposed to the dust in the days following the terror attack experienced an increased risk of developing cancers and severe pulmonary diseases. “The main option you have if you’ve been exposed is to get screened. A low dose CAT (CT) scan once a year to see if you have asbestos changes in your lungs,” Dr. Flores said noting that, even with a screening there is no treatment, according to 9News.com.au.
Dr. Flores has also accused property owners and entities with vested economic interests in New York of “sowing doubt” concerning asbestos dangers and the truth about how widespread the September 11 exposure really was. “My concern is people—property owners, asbestos companies, and people that (sic) are worried about getting sued—are playing down the harms of asbestos. Asbestos kills, we know that,” he said. “They try to influence the population by sowing doubt, saying it’s ‘not that bad’ or that there are ‘safe levels’ you can be exposed to. That’s all BS and lies because they know it will take 20-30 years for it to manifest itself and kill people,” reported 9News.com.au.
While the Zadroga Bill provides medical assistance to thousands of law enforcement and emergency personnel, it does not cover the rest of New York’s general population, who, says Dr. Flores, have begun to develop asbestosis and lung cancers. He also called for an immediate change to the Zadroga Bill to manage the still-developing aftermath of 9/11. “We need legislative change to start saving some lives and I think we can save more lives with the pen than with my knife,” he told 9News.com.au.
Hospitalizations Being Seen for Asthma In Adults Exposed to Terror Attacks
According to the June 2017 issue of Journal of Asthma, a study entitled “Hospitalizations for Asthma Among Adults Exposed to the September 11, 2001 World Trade Center Terrorist Attack” sought to describe patterns of asthma hospitalization among individuals who were exposed to the 2001 World Trade Center attacks. The study assessed if attack-related exposures or comorbidities (the simultaneous presence of two chronic diseases or conditions in a patient) such as post-traumatic stress disorder (PTSD) and gastroesophageal reflux symptoms (GERS), were associated with a greater rate of hospitalization.
The researchers utilized data for adult enrollees in the WTC Health Registry, “a prospective cohort study, with self-reported physician-diagnosed asthma who resided in New York State on 9/11” and were associated with “administrative hospitalization data to identify asthma hospitalizations during September 11, 2001-December 31, 2010.” Multivariable zero-inflated Poisson regression (a statistical research tool) was also used to examine associations between 9/11 exposures, comorbid conditions, and asthma hospitalizations, according to Journal of Asthma.
The team found that, of 11,471 enrollees diagnosed with asthma, 406—or 3.5 percent—had >1 asthma hospitalization during the study period (721 total hospitalizations). Among enrollees who were diagnosed before 9/11 (6319), those with PTSD or GERS had over twice the rate of hospitalization compared to those without the disorders.
The association was not statistically significant in enrollees who were diagnosed after 9/11. Also, compared to higher educational attainment, completing less than college was tied to increased hospitalization rates among participants with both pre- and post-9/11-onset asthma. Sinus symptoms, exposure to the dust cloud, and having been a WTC responder were not associated with asthma hospitalization, wrote the Journal of Asthma.
The researchers concluded that, “Among enrollees with pre-9/11 asthma, comorbid PTSD and GERS were associated with an increase in asthma hospitalizations. Management of these comorbidities may be an important factor in preventing hospitalization.”
Five Deaths Caused by 9/11 Attacks in One Week
Five first responders died last week, according to a February 17, 2017 NBCNews.com report. Three Fire Department of New York (FDNY) and two New York Police Department (NYPD) employees died from 9/11-related illnesses this week—over 15 years after the attacks.
Since September 2016, 55 first responders have died from 9/11-related illnesses, according to first responders’ nonprofit founder John Feal of the FealGood foundation, an advocacy organization that assists first responders injured in the line of duty. Among other actions, the FealGood Foundation raised money for a massive granite memorial on Long Island. Each etched name represents a first responder who died from a 9/11-related illness. Currently, there are 800 names listed for each of the first responders who died on the day of the attacks or since 9/11. The memorial was last updated in September 2016. Since then, says Mr. Feal 55 additional NYPD and FDNY heroes have died, which includes the five who died last week. Many of these individuals died due to cancer.
Each of these heroes selflessly rushed to the twin towers in 2001 to help with the rescue and recovery effort. Now, years later, those actions of bravery cost them their lives, noted NBCNews.com.
The Long Island memorial also bears a flag that will forever fly at half-staff, according to NBCNewYork.com, and is Mr. Feal’s way of saying thank you. This was built so history is not distorted,” he said. “So that no one can take away from the heroic sacrifices these men and women did for their city and their country.”
Mr. Feal also told NBCNewYork.com that, “Every time someone passes away, a part of me dies because I have the job of researching it and collecting data on these passings” He added that, “I have been to 159 wakes and funerals.” Mr. Feal also noted that, “Most people remember two buildings coming down and people lost to senseless violence. But now, here we are 16 years later and thousand of people here in New York and across the country are sick and dying from their heroic actions.”
Among the five individuals who died last week is veteran firefighter Robert Newman, who spent his 39-year career working from a Lower East Side firehouse. He died of cancer and bunting has been draped in his honor. Of the five recent deaths, most have been laid to rest. Emergency medical technician (EMT) Rose Scott will be buried this week.
Research Reveals that Paresthesias is Higher Among Community Members who were Exposed to the World Trade Center Attacks
Paresthesia is now being seen among so-called “community members” exposed to the World Trade Center terrorist attacks and the toxic cloud that remained hovering over the site for some time. A February 2017, Journal of Occupational and Environmental Medicine study revealed a tie between WTC exposure and paresthesia, which is a nerve-related issue that leads to discomfort and painful burning or prickling sensations, including itching, numbness, skin crawling sensations, or tingling in the arms, feet, hands, and legs. Paresthesias may be the result of a number of issues, including metabolic disorders, nerve entrapment that follow repetitive motions, and hyperventilation associated with anxiety. Paresthesias may also be the result of exposure to neurotoxins, which may be the case with those exposed to the WTC toxic cloud, according to this research.
The researchers reviewed data from community members exposed to the WTC disaster to determine if exposure to the disaster was tied to paresthesias. The researchers reviewed information from 3141 patients from the WTC Environmental Health Center. Of these, 56 percent reported paresthesias at enrollment, which occurred seven to 15 years following the attacks. After controlling for potential confounders (unobserved exposures), paresthesias were associated with seriousness of exposure to the toxic dust cloud that followed those exposed to, and working in, a job that called for cleanup of WTC dust. This study suggests that paresthesias were commonly tied to WTC-related exposures or post-WTC cleaning work. The team suggests further studies to objectively characterize the paresthesias and to identify relevant neurotoxins or paresthesia-inducing activities.
Chronic paresthesia points to issues with either poor circulation or the way in which neurons function. Disabled-World.com defines paresthesia as an abnormal body sensation that may include numbness, tingling, or burning. Depending on the cause, sensations may be short-term, disappearing rapidly. Sensations may also be chronic, pointing to serious underlying conditions. Paresthesia may occur in other areas of the body; symptoms may occur with no warning; and symptoms may be painless, but uncomfortable. Chronic paresthesia is often a symptom of an underlying neurological disease or traumatic nerve damage. The various causes of paresthesia may include certain poisoning, including lead and mercury poisoning.
Paresthesia may cause crawling skin sensations; dysarthria (slurred or slow speech that may be difficult to understand); foot drop (a walking abnormality involving a dropping of the forefoot); itching; limbs feeling as if “falling asleep,” including hand, foot, arm, and leg; muscular atrophy (muscle wasting); numbness; ocular dysmetria (a form of dysmetria [lack of coordination, movement] involving the continuous under- or over-shooting of the eyes when focusing, indicating lesions in the cerebellum, the brain region responsible for coordinating movement); restless leg syndrome; and tingling.
Neuropathic Reactions Seen in 9/11 Attack Survivors
Studies have linked exposure to the toxic dust cloud following the 9/11 terrorist attacks to, among other health issues, neuropathic symptoms. A growing body of research continues to show that exposure to the site at the time of the attacks is tied to serious health problems. A WTC-related study published in the Journal of Occupational and Environmental Medicine in November 2015 involved a review of neuropathy symptoms that were greater among 9/11 responders and survivors. The research involved administration of a survey-based study using the Michigan Neuropathy Screening Instrument (MNSI). Study authors found neuropathic symptoms to be much more common among those exposed to the WTC dust cloud; risk increased with greater exposure and the findings suggested that WTC is associated with neuropathic symptoms, the authors wrote.
The research provides more proof of what is already known namely, that toxic dust exposure is associated with significant health problems in many responders and survivors and that, over time, responders and survivors continue to develop 9/11-related conditions, suffer from illnesses, and die. For example, brain, lung, colon, and breast cancers, as well as lymphoma/myeloma are among the most popular cancers being seen. Brain cancer is showing up more frequently, but was previously considered a rare cancer. Deaths have been ongoing.
Research Reveals Airway Disease in 9/11 Rescue and Recovery Workers
A recent study published in the January 2017 issue of Current Allergy Asthma Reports entitled “Airway Disease in Rescue/Recovery Workers: Recent Findings from the World Trade Center Collapse” endeavored to summarize airway disease literature published since September 11, 2001 with a focus on research published since 2011 in WTC-exposed rescue and recovery workers. Since 2011, research has confirmed relationships between initial WTC exposure intensity, symptom severity, airway disease diagnoses, and biomarkers of disease progression. Research is ongoing and documents continuing morbidity in rescue and recovery workers over the 10 years following the September 11th attacks. Future research is expected to continue to identify correlates of symptom persistence and new diagnosis of airway disease. The researchers note that the unique characteristics of the airway diseases in this particular population call for ongoing research.
Research Finds WTC Exposure Impacts Timing of Aerodigestive Disorders
Recent research published in the February 2017 issue of the journal Frontiers Public Health looked at “The Effect of World Trade Center Exposure on the Timing of Diagnoses of Obstructive Airway Disease, Chronic Rhinosinusitis, and Gastroesophageal Reflux Disease.”
The research team reviewed a cohort of rescue and recovery workers who were exposed to the toxic dust cloud that was the result of the World Trade Center (WTC) collapse. The researchers looked at how a an obstructive airway disease (OAD) diagnosis impacted the chance of a future diagnoses of chronic rhinosinusitis (CRS) or gastroesophageal reflux disease (GERD). The researchers also assessed if OAD performed as a mediator for a tie between exposure to the WTC rescue and recovery effort and diagnoses of CRS and GERD, according to Frontiers Public Health.
The research was a prospective cohort in which the researchers analyzed Fire Department of the City of New York (FDNY) physician diagnoses of OAD, CRS, and GERD initially documented from September 11, 2001 and September 10, 2011 and involving 8,968 9/11 terrorist attack firefighters. The researchers used what is known as piecewise exponential survival models to determine if OAD was a risk factor for CRS or GERD and to determine if OAD is a potential mediator. Piecewise exponential distribution is an easier and more flexible distribution method for modeling time-to-event data.
The FDNY source population consisted of male firefighters who were active employees on September 11, 2001 and who arrived at the WTC site for rescue and recovery effort on or before September 24, 2001. The men gave informed consent for research and visited the FDNY Bureau of Health Services (FDNY-BHS) at least one time for treatment of any medical condition after exposure. After excluding firefighters with pre-WTC exposure evidence of OAD, CRS, or GERD in their FDNY-BHS medical records, the final analysis cohort consisted of the 8,968 participants, noted Frontiers Public Health. Demographic data—age, race, and retirement status—was taken from the FDNY employee database. WTC exposure intensity was obtained from participants’ first post-9/11 health questionnaire. Since 1996, FDNY-BHS used an electronic medical record system containing in-house physician diagnoses and data from diagnostic testing, including endoscopy, spirometry, methacholine challenge tests, and chest CT scans.
The researchers discovered that a diagnosis of OAD significantly increased risks for future CRS and GERD diagnoses and that 21 percent of the effect of WTC exposure on GERD and 13 percent on CRS were mediated by a previous diagnosis of OAD. The researchers also concluded that an OAD diagnosis was associated with increased risks for future diagnoses of CRS or GERD and that some of the effects of WTC exposure on CRS and GERD diagnoses is mediated by an earlier OAD diagnosis. The OAD mediation effect possibly reflects biological pathways or healthcare utilization practices, according to Frontiers Public Health.
According to the research, WTC exposure adverse respiratory effects have been widely documented and point to consistent dose–response relationships. The researchers also indicated an increased post-exposure health burden of aerodigestive conditions. Aerodigestive conditions are in a medical category that includes lower respiratory diseases such as asthma, chronic bronchitis, and chronic obstructive pulmonary disorder (COPD)/emphysema, which together are categorized as obstructive airways disease (OAD); upper respiratory diseases that were predominantly chronic rhinosinusitis (CRS); and gastroesophageal reflux disease (GERD).
Since the attacks, a sub-group of exposed workers have been diagnosed with chronic inflammation at mucosal surfaces in the nose, sinuses, and lungs, which leads to CRS, a reactive airway disease. Exposed workers have also been diagnosed with GERD, which is potentially due to caustic esophageal exposure by accidental ingestion. The researchers note that the common pathway for these conditions may be post-exposure airway inflammation and hyper-responsiveness. By 2015, about 30 percent of FDNY WTC rescue and recovery workers were diagnosed with CRS, 28 percent with GERD, and 24 percent with OAD. Frontiers Public Health also notes that high comorbidity rates of WTC-related digestive conditions have been reported and the percentage of WTC rescue and recovery workers who are diagnosed with all three aerodigestive conditions ranged from approximately 10–30 percent. The clinical cause for the comorbidity is still not known.
GERD may lead to lower and upper respiratory diseases or worsen persistent airway irritation. OAD or CRS may lead to or worsen GERD through mechanically induced inflammation such as cough, postnasal drip, and mucous; drug effects such as theophylline, corticosteroids; or neurological pathways. Previously, the researchers reported that FDNY WTC rescue and recovery workers were more frequently diagnosed with OAD than CRS in the months and years following the attacks; however, in that time, CRS diagnoses have increased. Also, some six years post-exposure, GERD diagnoses, which had the lowest immediate post-9/11 incidence of the aerodigestive conditions, began increasing, Frontiers Public Health wrote.
The intensity of the exposure to the WTC site was categorized by when one arrived to the site. For those who arrived on the morning of September 11, 2001, the intensity was rated as high. For those who arrived on the afternoon of September 11, 2001 or any time on September 12, 2001, the intensity was rated as moderate. For those who arrived any time between September 13, 2001 and September 24, 2001, the intensity was deemed as low.
Most of the study participants—71 percent—were in the moderate-exposure group. More than one-third—37 percent—were ever smokers. GERD fell into the highest post 9-11 incidence (27 percent). Those in the OAD group totaled about 23 percent and CRS at 10 percent. About 96 percent of those diagnosed with post-9/11 GERD underwent at least one endoscopy. Among those with incident OAD, 87 percent underwent at least one of a number of pulmonary assessments: Pulmonary functions testing with bronchodilator response, methacholine challenge tests, or chest CT scans. Among those with incident CRS, 100 percent either had an abnormal sinus CT or ENT laryngoscopy. At least one abnormal diagnostic test was mandated for the research definition, according to Frontiers Public Health.
The combined effects of upper and lower airways disease and GERD have resulted in persistent adverse symptoms, which continue to have a negative impact on the quality of life. Study findings support continued medical monitoring of WTC-exposed individuals as well as long-term monitoring and treatment for future disasters with high-intensity exposures.
Research Reveals Correlation Between the 9-11 Terrorist Attacks and Extensive Medical Conditions and Injuries
Significant injury research related to the 9/11 attacks reveals how extensive medical conditions and injuries have impacted New York Police Department (NYPD), Fire Department of New York (FDNY), emergency medical services (EMS) responders, and other rescue and recovery workers and volunteers. Information was released December 2016.
FDNY and EMS Workers
Short-term Impacts: 1-4 Years after 9/11
FDNY first responders began experiencing adverse health effects soon after the attacks, some within the first week. In fact, 99 percent of exposed firefighters reported no less than one new respiratory symptom while working at the WTC that they had not experienced before, according to NYC 911 Health. Within the first six month following the attacks, “World Trade Center cough” was diagnosed in three percent of firefighters who performed WTC rescue and recovery work and were enrolled in FDNY’s WTC monitoring program, as well as in eight percent of those present during the Twin Towers’ collapse. In the year following, firefighter pulmonary function dropped at a rate 12 times greater that the average decline seen with aging, according to NYC 9/11 Health. Of 10,378 firefighters enrolled in the FDNY WTC Medical Monitoring and Treatment Program after 9/11 and who were evaluated yearly in the first four years, cough and sore throat declined from 54 to 16 percent and 62 to 36 percent, respectively. Other respiratory symptoms-dyspnea, wheeze, nasal congestion, or Gastroesophageal Reflux Disease (GERD)-was stable at 45 – 35 during this time. Initial arrival time at the site was associated with increased risk of respiratory symptoms at each exam. Individuals evaluated at year one and year four experienced symptoms tied to earlier arrival time and longer work duration at the site with every additional month increasing the likelihood of symptoms by eight to 11 percent.
NYC 9/11 Health noted that, of 8,487 firefighters enrolled in the FDNY Program, 12 percent tested positive for probable post-traumatic stress disorder (PTSD) symptoms in the first six months following 9/11. Some 28 percent who screened positive for PTSD received counseling in the first 2.5 years following the attack; a five-fold increase over those prior to 9/11. Elevated PTSD risk was significantly associated with counseling use, functional job impairment, and mental health-related medical leave during this period, NYC 9/11 Health wrote.
Prior to 9/11, one study revealed a less than expected number of sarcoid cases among FDNY firefighters, suggesting that firefighting presented a potential increased risk for the disease; however, after 9/11, another study revealed 13 cases of new-onset sarcoidosis or sarcoid-like diseases among FDNY firefighters, representing an increase some six times greater than pre-9/11 levels. Thirteen additional cases were identified over the next four years, according to NYC 9/11 Health.
Mid-term Impacts: 4-9 Years after 9/11
Eight years after the attacks, the number of several physician-diagnosed respiratory conditions among 10,999 WTC-exposed male firefighters increased when compared to men in the general population. NYC 9/11 Health noted that firefighters 44 years of age or younger were likelier to report sinusitis/rhinitis, bronchitis, and COPD/emphysema. Firefighters 45-65 years of age were much more likelier to be diagnosed with sinusitis/rhinitis, current asthma, bronchitis, and COPD/emphysema. Sharp, often disabling, declines in pulmonary function were first seen among firefighters and EMS workers within one year of the attacks and persisted among never smokers. Chronic airways disease was the main lung injury seen in firefighters with respiratory symptoms referred for evaluation within seven years after the attacks. Some were diagnosed with interstitial fibrosis.
The prevalence of probable PTSD among over 11,000 firefighters in the FDNY Program nine years after the attacks was four times greater that what was seen in the general population. Early arrival at the site and exercising less and drinking more alcohol were tied to the continuance or onset of PTSD symptoms. The same was seen with co-occurring respiratory or GERD symptoms.
Surveys of 12,000 firefighters and EMS workers between 2005-2008, revealed that more than 36 percent were at high risk for obstructive sleep apnea (OSA). The earlier they arrived at the WTC site and suffering from acid reflux, upper respiratory, and PTSD symptoms were associated with increased risk for new-onset OSA.
Substantial co-morbidity of physical and mental health conditions was seen among firefighters. A study of 11,000 firefighters seven to nine years after the attacks revealed that nearly half reported probable PTSD and also self-reported a physician diagnosis of obstructive airways disease (OAD)- asthma, bronchitis, or COPD/emphysema-with probable PTSD or depression and a self-reported physician diagnosis of OAD, according to FDNY researchers. FDNY researchers also found that, among those with depression alone, nearly one-third self-reported OAD. Similar results were found when medical records were used.
FDNY researchers confirmed 263 new cases of cancer from September 11, 2001 through 2008 among 8,927 male firefighters responders, which is 25 greater than should have been seen in men of similar age, race, and ethnicity in the general population, the National Cancer Institute Surveillance Epidemiology and End Results (SEER) reference population indicated. When researchers compared WTC-exposed firefighters to unexposed firefighters, they discovered a 19 percent increase in cancer overall. NYC 9/11 Health notes that it is unlikely that any cancer would develop within two years of the attacks.
A review of FDNY retirement pensions discovered that, in the seven years before the attacks, nearly half of the pensions were for accidental disability; however, in the seven years after the attacks, accidental disability pensions made up 66 percent of the total with 47 percent (1,402 pensions), associated with the attacks and typically due to respiratory illness. The FDNY study estimated that WTC-related FDNY pensions added $826 million in increased costs to the system, according to NYC 9/11 Health.
According to NYC 9/11 Health, a longitudinal study of some 3,000 police responders enrolled in the WTC Health Registry revealed the prevalence of probable PTSD doubled from 2003/2004 to 2006/2007, with female officers significantly likelier to report PTSD symptoms in the first survey. The gender difference disappeared by the second survey. PTSD risk factors included post-9/11 unemployment and disability.
The New York/New Jersey WTC Consortium assessed some 8,500 police responders who pursued services from 2002 through 2008. The Consortium discovered PTSD prevalence during the prior 30 days was similar to that found in other studies of police responders and a significantly increased rate of what is known as “subsyndromal” PTSD-a condition involving similar, but not sufficient symptoms to fulfill PTSD criteria. This was tied to a five times increased need for mental health services, including one-on-one counseling, stress management, or psychotropic medication, when compared to those who did not meet criteria for either full or subsyndromal PTSD. Also, a longitudinal study of some 11,000 responders enrolled in the WTC Health Program (formerly known as the New York/New Jersey WTC Clinical Consortium) reviewed responder mental health at three, six, and eight years after the attacks, NYC 9/11 Health reported.
Other Rescue and Recovery Workers
Short-term Impacts: 1-4 Years after 9/11
Research involving over 1,400 New York State employees-including staff from the State Police, National Guard, and Department of Transportation (DOT)-discovered that, while these workers arrived later and experienced less intense exposure at the WTC site, state employees report increased mental and physical health effects, NYC 9/11 Health pointed out. Mental health symptoms included excessive fatigue, sleep disturbance, and irritability; physical ailments included respiratory symptoms such as dry cough. State employees trapped in the toxic dust cloud were likelier to report mental and physical health issues. Construction workers involved in the cleanup effort-truck drivers, heavy equipment operators, laborers, and sanitation workers-experienced a three-fold greater likelihood of respiratory illness when compared to individuals who did not work at one of the WTC sites. Cleanup start date, worksite location, and participation duration may be tied with increased respiratory symptom risks. Other research of rescue and recovery workers in the Consortium revealed a significant tie between worsened respiratory symptoms and early WTC arrival.
An review of blood samples from about 500 New York State employees and members of the National Guard who worked at the WTC site on 9/11 and December 2001 revealed concentrations of perfluorochemicals-manufactured chemicals used to make heat-, oil-, stain-, grease-, and water-resistant products-that were two-fold the amount found in the general population. Chemical blood levels were similar between those who did and did not report symptoms; however, levels were higher in those reporting increased levels of exposure to dust or smoke. The blood samples were taken May 2002-November 2003; the potential health effects of these chemicals are unknown.
Another study, involving 136 rescue and recovery workers diagnosed with WTC-related atopy (allergies) between 2003 and 2005 revealed that these individuals may be at increased upper airway disease risk, including sinus or nasal congestion, when compared to individuals not diagnosed with atopy. Workers diagnosed with atopy were diagnosed with more serious airway disease symptoms.
Studies of the mental health impacts on police officers and firefighters involved in the WTC response revealed that over two-thirds reported experiencing at least one disaster-related stress symptom 15 to 27 months after the attacks, according to NYC 9/11 Health. Meanwhile, two studies of over 3,000 mostly male utility workers screened for mental health conditions at their place of work revealed key information concerning early traumatic stress among WTC recovery workers. Ten to 22 months after 9/11, a number of 2,960 workers suffered PTSD symptoms, depression symptoms, anxiety, and panic disorder. The significant PTSD predictor was a belief that their life was in danger. Workers with trauma symptoms who did not meet criteria for full- or sub-threshold PTSD within the first two years of 9/11 were screened at one and two years after the attacks and nearly 30 percent met the criteria for sub-threshold or full PTSD at “Time 2”; almost one-quarter met the criteria at “Time 3.” Workers diagnosed with sub-threshold PTSD reported impairment levels some four-fold greater than workers with no PTSD symptoms.
Probable PTSD among rescue and recovery workers enrolled in the Health Registry increased from just two-three years following the attacks at the five-six year mark. Probable PTSD was late onset for a number of workers, meaning symptoms increased between the two time frames. Among the risk factors for developing probable PTSD involved arrival at the site on 9/11 or working there for longer than 90 days, according to the research, wrote NYC 9/11 Health.
Mid-term Impacts: 4-9 Years after 9/11
Injuries-broken bones or burns-were related to increased risks for chronic disease five-six years later, according to a study involving over 14,000 enrollees. Participants reported no previous diagnosis of heart disease, respiratory disease, diabetes, or cancer and enrollees who reported more than one injury-some 2,000 people-were two times as likely to report respiratory illness when compared to the uninjured. Those with multiple injuries and probable PTSD experienced a three-fold likelihood of reporting heart disease when compared to those with no injuries and no PTSD diagnosis, according to NYC 9/11 Health.
A review of verified cancer diagnoses among 21,850 rescue and recovery workers enrolled in the Health Registry revealed small increases in the rates of three types of cancer in 2007-2008-prostate, thyroid, and multiple myeloma-when compared to non-exposed New York State residents during the same time. A review of confirmed cancer cases since the attacks among 20,984 rescue and recovery workers enrolled in the Health Program revealed an increase of cancer cases greater than the expected. overall. When restricted to cancer cases diagnosed after six months of enrollment in the program, additional cancer was discovered. Both analyses revealed more thyroid and prostate cancer cases than expected.
Another clinical study involving more than 3,000 workers who were reviewed twice at least 18 months apart between 2002 and 2007 at the Consortium revealed that weight gain between exams-not the degree of WTC exposure-was tied with the ongoing loss of pulmonary function. Another risk factor seen on the first exam for continued pulmonary function loss included abnormal bronchodilator response, a potential asthma indicator. Most experienced pulmonary function within the normal range; however, the incidence of reduced pulmonary function at the second exam continued to be higher than the general population. Also, over 12 percent of 25,000 workers enrolled in the Registry reported developing new-onset asthma in the five-six years since working at the site, a rate higher than was is expected in the adult population during that time. New rates of new asthma were highest in workers who arrived at the toxic site on the day of the attack or who worked more than 90 days at any WTC site, NYC 9/11 Health wrote.
A prospective study of some 21,000 rescue and recovery workers who sought care at the Consortium reviewed asthma self-reports. The prevalence of ever having asthma remained consistent from 2000 to 2007 in the general population. Responders were twice as likely to report asthma during the past year when compared to the general population. Meanwhile, clinical studies of WTC rescue, recovery, and cleanup workers who voluntarily enrolled in a monitoring program at the Consortium revealed that respiratory problems remained for some and often co-occured with other diagnoses. A study of 42 sequentially selected patients diagnosed with GERD suggests the disease may be related to abnormal lung function and, of 172 randomly selected workers, 10 were diagnosed with vocal cord dysfunction (VCD), which may cause hoarseness or pain when breathing. Workers all had GERD and chronic rhinitis. Early findings suggest VCD may be part of the growing WTC-related respiratory disorders spectrum.
The New York State Department of Health discovered that responders with moderate exposure were likelier to report persistent lower respiratory symptoms-cough, wheeze, shortness of breath, chest tightness-not asthma, in the five years after the attacks when compared to a control group. Those with prior asthma and who were most exposed to the toxic cloud were likelier to report more significant asthma symptoms.
Consortium researchers found an increased incidence of sarcoidosis among nearly 20,000 rescue and recovery workers who received care for 9/11-related health problems when compared to other published background rates. The highest incidence occurred two-three years after the attacks. Using biopsy results, WTC Health Registry researchers confirmed 43 sarcoidosis cases among adults in its cohort of rescue and recovery workers, Lower Manhattan residents, area workers, and passersby, according to NYC 9/11 Health. A so-called “nested case control study” revealed that working on WTC debris significantly increased the sarcoidosis risk for rescue and recovery workers.
Research involving rescue and recovery workers who snored and received diagnoses for respiratory disease, acid reflux symptoms, or a mental health condition during 2003-2006 revealed that 62 percent suffered from obstructive sleep apnea. Researchers investigating obstructive sleep apnea (OSA) at the Consortium compared a group of 50 workers with aerodigestive symptoms who also reported habitual snoring 6-7 years following the attacks to a similar group of men without WTC exposure, but who snored habitually. Two small studies of rescue and recovery workers who received care at the Consortium revealed that the workers, specifically those exposed to the toxic cloud on 9/11, were less likely to detect nasal irritation or odors more than two years later and were also less likely to detect odors seven years later.
A NYS Department of Health study of 43 WTC responders discovered that their blood contained increased rates of chemicals typically released when solid municipal waste is burned when compared to the general population.
A longitudinal study of more than 27,000 rescue and recovery workers who sought treatment at the Consortium conducted detailed physical examinations on each worker and assessed workers’ self-reports of physician diagnoses from 2002 to 2010. Nine years after the attacks, among those in treatment, 1,893 still had active asthma; 2,042 had sinusitis, and 3,195 had GERD, which were all tied to increased levels of WTC exposure among workers, according to NYC 9/11 Health.
Spirometry, which measures functioning of the lungs’ large airways, validated respiratory symptoms in nearly 19,000 rescue and recovery workers monitored at the Consortium. Workers reported persistent cough, wheezing, or difficulty breathing upon exertion and were likelier than workers with no symptoms to experience lower lung function and increased rates of bronchodilator responsiveness during initial clinical visits between 2002 and 2008. The nine-year cumulative incidence for spirometric abnormalities seen in 5,769 responders at risk in the Consortium was about 42 percent with most abnormalities involving low forced vital capacity. This is a measurement taken when the responders exhale the air in their lungs as forcefully as possible. NYPD researchers found, in a longitudinal study of 139 NYPD emergency service workers who responded to the disaster, evidence of mild lung function declines six years later. Abnormal spirometry was tied to earlier arrival and longer duration at the site. The greatest declines were seen in smokers and workers without respiratory protection, noted NYC 9/11 Health.
A study of over 10,000 workers monitored at the Consortium from 2002 to 2007 indicated that some may have alcohol problems, met the criteria for probable PTSD, had probable depression, and had probable panic disorder. PTSD was significantly tied with loss of family members and friends, disruption of family, work and social life, and higher rates of behavioral symptoms in their families. Studies of WTC rescue and recovery workers revealed trauma either before or after the attacks increased vulnerability to PTSD or led to greater symptom severity:
Another study of more than 1,000 WTC rescue and recovery workers suggests that disaster workers with increased anger levels may benefit from early intervention to prevent chronic PTSD. Individuals with low anger levels experienced fewer PTSD symptoms over a one-year period compared to those with high levels. Workers with higher anger levels had increased symptoms of depression and other psychiatric problems. Nine years after 9/11, rescue and recovery workers reviewed in the Consortium-excluding police responders-continued to screen positive for high PTSD rates, depression, and panic disorder. Police responders tested with lower rates, according to NYC 9/11 Health.
Rescue and recovery workers who sought treatment at the Consortium from 2002-2010 reported significant co-morbidity. For example, in a clinical population of over 27,000 workers, about half diagnosed with asthma reported at least one mental health condition, as did over one-third of workers with either sinusitis or GERD. Also, most workers who reported PTSD, depression, or panic disorder reported a physician diagnosis of at least one physical disorder. A study based on the initial screening data of nearly 21,000 rescue and recovery workers in the Consortium from 2002 to 2008 suggests PTSD may contribute to the continuation of respiratory symptoms.
A longitudinal study of nearly 5,000 adult volunteers enrolled in the WTC Health Registry revealed differences between affiliated and lay volunteers. Compared to affiliated volunteers, lay volunteers were likelier to have been present in lower Manhattan, experienced the toxic cloud, witnessed dreadful events, experienced an injury on 9/11, and reported unmet health care needs. The group was also twice as likely to have reported an early post-9/11 mental health or asthma diagnosis or reactive airways dysfunction syndrome and were more that twice as likely to be diagnosed with chronic or late-onset PTSD, or new or worsening lower respiratory symptoms, according to NYC 9/11 Health.
A longitudinal study of 9,296 rescue and recovery workers enrolled in the WTC Health Registry who worked no less than one shift at the debris pile provides new insights concerning use of respiratory protective equipment (RPE), including that less than 20 percent of workers reported use of standard respirator models on 9/11; half wore no facial covering of any kind on 9/11. Also, the greatest predictors of adequate RPE use were affiliated with construction, utilities, or environmental remediation organizations, as well as previous RPE training. Workers who reported not using respiratory protection were likelier to report recurrent respiratory symptoms and some respiratory disease, noted NYC 9/11 Health.
Study: Increased Prostate Cancer among WTC Responders
In 2016, an increased incidence of prostate cancer was reported in three cohorts of WTC respondents. It remains unknown if the increase is due to WTC-related exposures or heightened observation. Prostate cancer cases 2002-2013 were received from the WTC Health Program. Age, race, and so-called “Gleason” score distribution were compared with New York State Cancer Registry cases during the same time frame, according to the National Center for Biotechnology Information (NCBI)
Models involving two or more variable quantities were adjusted to accommodate for age and race. Review of the clinical characteristics of prostate cancer cases in the cohort were conducted and were adjusted for age, race, and WTC exposure categories, NCBI noted. Significant WTC exposure was tied to advanced clinical stage and respondents continue to experience increased prostate cancer rates when compared with New York State populations. The study found that respondents with increased WTC exposure level may have had a more advanced clinical stage of prostate cancer.
Study Ties PTSD and Cognitive Issues and Dementia with WTC Attack Exposure Trauma
Research of the first responders to the 9/11 terror attacks on the WTC in New York City have confirmed a link between PTSD and cognitive impairment, according to a late August 2016 UPI report. Researchers say this impacts how first responders, military veterans, and others diagnosed with PTSD may be treated.
For example, researchers at Stony Brook University of Long Island, New York, say that patients diagnosed with PTSD should be monitored for signs of cognitive impairment, based on research that constantly revealed that the one condition could be predictive of the other, especially following deeply traumatic experiences, according to the UPI. Prior research linked PTSD, major depressive disorder (MDD), and cognitive impairment; however, the new study, published in the journal Alzheimer’s and Dementia: Diagnosis, Assessment and Disease Monitoring, is the first that found an increased incidence of impairments in civilians who responded to the terror attacks and had not sustained head injuries.
The U.S. Centers for Disease Control and Prevention (CDC) began the program in 2002 to monitor the health of police, firefighters, and other officials involved in search, rescue, and cleanup efforts following the 9/11 attacks, according to UPI. Of the over 33,000 responders enrolled in the WTC Health Program, about one-fifth developed PTSD, which, according to UPI, makes the research results “significant and far-reaching.”
“This is a problem we must solve,” Dr. Maria Carrillo, chief science officer at the Alzheimer’s Association, indicated in a press release. “The silver lining in these troubling new findings is that they will help us better understand the relationship between PTSD, cognition, and dementia. More research is needed in this area. This is crucial so that we can provide better care for all individuals who experience PTSD.”
Researchers screened 818 responders at Stony Brook University who reported for annual monitoring visits for cognitive impairment and dementia, UPI noted. About 12.8 percent of the study responders revealed signs of cognitive impairment and 1.2 percent revealed signs of potential dementia. The researchers deduced these figures estimate that, overall, between 3,740 to 5,300 responders may suffer from cognitive impairment and another 240 to 810 may suffer from dementia. “These numbers are staggering, considering that the average age of responders was 53 during this study,” said Dr. Sean Clouston, an assistant professor of public health at Stony Brook University. “If our results are replicable, doctors need to be aware of the impact of cognitive impairment among individuals who have experienced traumatic events leading to PTSD. For example, cognitive impairment can compound the course of PTSD and depression, impairing the person beyond the impact of PTSD itself,” he noted, according to UPI.
COPD Covered As An Independent Injury Under the Zadroga Act
In September 2016, chronic obstructive pulmonary disease (COPD) became an independent injury under the Zadroga Act. This means that COPD is covered independently and without a prior diagnosis or tie with any other respiratory illness, such as asthma, when making a claim under the Zadroga Act.
In July 2016, the September 11th Families Association explained that, when new-onset COPD became a covered injury under the Zadroga Act, only pre-September 11th COPD cases worsened by the attacks were covered. Meanwhile mounting recovery workers and survivors of the September 11th terrorist attacks have struggled with new-onset COPD for years.
Now, COPD is covered under the Zadroga Act without prior diagnosis or association with another respiratory illness.
According to the U.S. Department of Health and Human Services (HHS)/National Institutes of Health (NIH)/National Heart, Lung, and Blood Activity, COPD is a progressive lung disease that makes breathing difficult and worsens over time. COPD may lead to coughing with large amounts of mucus, shortness of breath, tightness in the chest, and wheezing, among other symptoms. In the United States, the term “COPD” includes both emphysema and chronic bronchitis and is known by names such as chronic bronchitis, chronic obstructive airway disease, chronic obstructive lung disease, and emphysema.
In patients diagnosed with COPD, less oxygen flows in and out of the lungs’ airways because the airways and sacs lose their elasticity (emphysema), the walls between air sacs are destroyed (emphysema), the airway walls thicken or become inflamed (chronic bronchitis), and/or, the airways make more mucus than normal, potentially causing clogs (chronic bronchitis), which adversely impacts breathing.
COPD is a major cause of disability, the third leading cause of death in the U.S., and has no cure. Millions of people are diagnosed with COPD and many more may be unaware that they have COPD because of how slowly it develops.
WTC Health Program Adds New-Onset Chronic Obstructive Pulmonary Disease and WTC-Related Acute Traumatic Injury to the List of WTC-Related Health Conditions
On July 5, 2016, the Health and Human Services Department (HHS) issued a final rule that followed a WTC Health Program review of published, peer-reviewed epidemiologic research concerning potential evidence of chronic obstructive pulmonary disease (COPD) and acute traumatic injury among those individuals who were responders to, or survivors of, the terrorist attacks, according to The Federal Register.
The WTC Health Program Administrator found that these studies offer extensive evidence to support a causal association between these health conditions and exposure to the WTC site, The Federal Register indicated. Because of this, the Administrator is publishing a final rule to add both new-onset COPD and WTC-related acute traumatic injury to the List of WTC-Related Health Conditions eligible for treatment coverage in the WTC Health Program.
Concerning new onset COPD, in the past the patient required either a worsening of existing COPD or other certified respiratory injury tied to the COPD for eligibility. Under the new rule, new onset COPD will also be considered a covered injury, in addition to the existing, related injuries.
Acute traumatic trauma will include eye and head injuries, burns, fracture, tendon tears, etc. and the patient must have received treatment by September 11, 2003. A diagnosis, however, is not required as of the September 11, 2003 date. In addition, the injury must be tied to a so-called “energy source,” such as a fall, an object hitting an individual, and/or heat and/or chemical exposure and does not include repetitive motion injuries, such as back pain tied to lifting as these fall under musculoskeletal injuries that are already covered.
Study: 9/11 Attack Workers Suffer from Weight Gain, Obesity
In June 2016, researchers discovered an elevated prevalence of obesity and weight gain in former WTC workers and volunteers, according to an online report on the National Center of Biotechnology Information website, which appears in advance of publication in the Archives of Environmental Occupational Health.
The researchers surveyed 220 participants at the WTC Clinical Center to assess obesity, current employment and disability status, WTC occupational exposure level, medical comorbidities, and dietary and exercise habits. Bivariate (two variables) and logistic regression multivariate (multiple variables) analyses were conducted to review associated risk factors. Researchers discovered that obesity was associated with active employment status. The study also revealed that other significant covariates included non-Latino African American race, a high number of comorbid chronic diseases, low frequency exercise level, and not drinking any juice on a daily basis, according to NCBI.
Study: Lung Function Decline Persists 13 Years After 9/11 Attacks
As of June 2016, researchers reveal lung function decline among firefighters who responded to the 9/11 terrorist attacks 13 years after the attacks took place. Responders continue to suffer health problems due to the toxic dust exposure to which they were subject during and following the attacks.
A study published in CHEST found that WTC-exposed firefighters suffer from reduced lung function, with the greatest decline found among smokers and those who had the greatest exposure to the toxic dust cloud. “We showed in this latest follow-up that smoking worsened lung function in this group of World Trade Center responders, which is not really a surprise,” said study author Thomas Aldrich, MD, of Montefiore Medical Center and Albert Einstein College of Medicine in New York City, according to MedScape. “But we also showed that stopping smoking makes a major difference, and the earlier the better in terms of lung function.”
MedScape noted that this study is the longest of pulmonary function in rescue workers involved in a major environmental disaster and included 10,641 New York City firefighters who underwent a baseline measure for forced expiratory volume in one second (FEV1). This is a test of lung function and was conducted before 9/11. After 9/11, additional FEV1 measurements were taken. During previous follow-ups of one and seven years following exposure, FEV1 decreased an average of 10 percent among those who were WTC-exposed. Over 10 percent of the cohort developed new obstructive airway diseases.
“There was little recovery over the first six years,” the authors stated, according to MedScape. “Follow-up into the next decade allowed us to determine the longer-term exposure effects and the roles of cigarette-smoking and cessation on lung function trajectories.”
Some 15 percent of the cohort responded to 9/11, and 65 percent were never smokers. The findings revealed that lung function continues to be worse among firefighters who arrived the morning of the attacks when compared to those who responded a few days later.
Legal Action for Zadroga Act Claimants
Parker Waichman vows to continue its efforts to safeguard these heroes and ensure that they receive their deserved Zadroga Act compensation. Please fill out the form at the right for a free case evaluation or call 1-800-YOURLAWYER (1-800-968-7529) today for a free case review by one of our qualified Zadroga attorneys.
Legal Action for Zadroga Act Claimants
Parker Waichman vows to continue its efforts to safeguard these heroes and ensure that they receive their deserved Zadroga Act compensation. Please fill out the form at the right for a free case evaluation or call 1-800-YOURLAWYER (1-800-968-7529) today for a free case review by one of our qualified Zadroga attorneys.
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