The 'lingering sick'

Nine years after the Sept. 11 attacks, many rescue workers continue to struggle with illness

Nearly a decade has passed since the Sept. 11 terrorist attacks in New York, but rescue workers still are struggling with illnesses they acquired at ground zero.

During a June 29 hearing before the Senate Health, Education, Labor and Pensions Committee, Sen. Tom Harkin (D-IA) said thousands of responders to the World Trade Center attacks were exposed to a “toxic brew” of gases and particulates. In the aftermath of the attacks, the government set up programs to address various health needs of rescue and recovery workers, but the senator said those efforts may not be enough.

“We are learning that the health effects of the 9/11 disaster are far more extensive, and more wide-ranging, than many people initially athought,” said Harkin, who chairs the committee.

Persistent illness

A study published in the New England Journal of Medicine (Vol. 362, No. 14) suggests firefighters responding to the WTC attacks suffered more severe lung damage than other firefighters. Of the nearly 13,000 firefighters and emergency responders who worked at the WTC site, many experienced a severe and persistent decline in lung function following the attacks, according to researchers from the Albert Einstein College of Medicine of Yeshiva University in New York.

Over a nearly seven-year period, rescue workers experienced no meaningful recovery of the lung function, compared with typical firefighter lung damage. The unusual nature of the WTC dust cloud and repeated exposure is to blame, researchers suggested.

Another study, published online May 18 in the journal Environmental Health Perspectives, found 22 percent of WTC site workers and volunteers experienced decreased sensitivity to odors two years after the attacks. Conducted by the Monell Chemical Senses Center, an independent scientific institute in Philadelphia, the study also found 75 percent of workers and volunteers had an impaired ability to detect irritants. Most of these people were aware of their impairment.

Sense of smell is critical to human health and safety, as it can be the first line of defense against airborne toxic chemicals, according to Pamela Dalton, lead author of the study and Monell environmental psychologist.

Caring for the ill

As of March, more than 52,667 responders have been enrolled in the Department of Health and Human Services’ World Trade Center Health Programs, according to John Howard, NIOSH director and program coordinator. The program is made up of several clinical centers that provide patient tracking, clinical and mental health screening, and treatment.

Patients with chronic WTC-related conditions need long-term health care – something that is not possible with the current year-to-year funding structure for the programs that provide the care, according to Dr. David Prezant, the New York City Fire Department’s chief medical officer and co-author of the Yeshiva University study.

Prezant also is co-director of the FDNY WTC Medical Monitoring and Treatment Program, a $35 million program that provides monitoring and treatment for WTC-exposed responders. The program provided treatment to more than 7,000 patients in a recent one-year period, and will conduct more than 10,000 monitoring exams by the end of this year. However, funding issues may threaten treatment, Prezant told senators at the June 29 hearing.

“Without continued funding, we will have to stop clinical services in late spring to early summer of 2011,” Prezant said. “Clearly, we need a long-term solution.”

Sen. Kirsten Gillibrand (D-NY) testified that legislation she introduced last year would provide such a solution. If passed, the James Zadroga 9/11 Health and Compensation Act of 2009 (S. 1334) would create a transparent, long-term health program administered by a third party to set rates, track expenditures and enforce eligibility requirements. A House version of the bill (H.R. 847) failed to garner the two-thirds majority necessary to pass out of the chamber in a July 29 vote.

Martin Fullam, a 9/11 responder, told the Senate committee about his daily struggle with an autoimmune disease he developed after the attacks and expressed his support for “any legislation that will guarantee” medical care for WTC responders.

“I pray that those here who have the opportunity to pass legislation to care for us, the lingering sick, will answer their call and pass the necessary legislation that will allow us to live as best we can without the additional hardships of financial worries and medical bills,” Fullam said. “We responded for those in need, and we are counting on you to do the same.”