9/11 workers highly vulnerable to Asthma

According to a study conducted by the New York City Health Department, rescue and recovery workers involved in rescue operations at the World Trade Centre disaster were 12 times more susceptible to asthma than the normal population. The study has indicated that 70% of the rescue workers from 9/11 have increased respiratory problems.

The study was conducted by Katherine Wheeler and her colleagues at the NY City Department of Health and Mental Hygiene in 2003 & 2004. The results were published in the September issue of Environmental Health Perspectives, a monthly journal published by the National Institute of Environmental Health Sciences.

The study included 25,748 rescue workers registered at the World Trade Centre Health Registry. The workers included firemen, policemen, construction workers, and volunteers. These hailed not only from New York City, but from various parts of the country.

Various respiratory problems have been seen in rescue workers who were involved in rescue missions at the WTC. These problems include reactive airway diseases, persistent cough, and decreased pulmonary function. The prevalence of asthma among workers who responded early to the tragedy and continued working at ground zero was 3.6 percent as compared to 0.3 percent for the general population.

Increased rates of respiratory dysfunctional problems have also been witnessed in people who live or work near the site. These problems could be attributed to the high exposure to increased levels of airborne dust and debris. The authors of the report have considered early arrival time & increased duration of work as two significant factors, along with lack of usage of protection.

According to authors of the study, "workers who arrived closer to the time of the collapse were more likely to experience respiratory symptoms and reduced pulmonary function after September 11, 2001". The authors have also added, "the onset of asthma was not only associated with acute exposure to high levels of respiratory hazards, but also with chronic exposure to presumably lower levels of airborne contaminants."

Those workers who began work directly after the towers collapsed on September 11, and worked for more than 90 days are those who have reported the highest rate of prevalence of asthma, i.e. 7%. Workers who were caught in the dust cloud and worked on the debris pile also reported high rates, i.e. 4.9% and 4.5% respectively.

The study analyzed the effects of early arrival time, duration of exposure, and delayed use of protection such as masks and respirators. Though masks did not provide absolute protection, workers who wore masks and respirators reported lower rates of asthma-4% & 2.9% respectively. This, when compared to workers who did not use any protection and indicated a rate of 6.3% of the prevalence of asthma, shows that the usage of even minor protection proved to be beneficial.

This can also be proved by another piece of statistics. Workers who delayed using protection for one day made themselves susceptible to a 63% higher risk. Workers who delayed protection for 16-40 weeks were at a 244% higher risk of asthma. The authors say that, “We conclude that the use of masks and respirators at the WTC site did not eliminate the risk of newly-diagnosed asthma in the study population; however we did observe evidence of a protective effect, even given the limitations already documented.”

According to Dr. Thomas Friedman, New York City Health commissioner, “The dust from the World Trade Center collapse appears to have had significant respiratory health effects at least for people who worked at the site. These findings reflect the critical importance of getting appropriate respiratory protection to all workers as quickly as possible during a disaster, and making every effort to make sure workers wear them at all times. The events of 9/11 were unprecedented, and with the urgency of rescue operations and the difficulty of prolonged physical exertion with most types of respirators, there are no easy answers, even in retrospect.”

To reduce the impact of airborne dust and debris on the respiratory functions of the workers, control of exposure to pollutants needs to be achieved. This demands a reduction or elimination of the source of pollution through processes such as ventilation. Protective masks and respirators are considered to be secondary measures. Tragically though, in the 9/11 disaster, workers did not have access to the primary or secondary measures of protection.

The results of this particular study corroborate what several other scientific studies have found regarding first responders’ declining respiratory health conditions. According to a Mt. Sinai research conducted in 2006, roughly 10,000 of Ground Zero’s 40,000 first responders were studied. It was found that 70 percent of those tested between 2002 & 2004 reported respiratory problems while working at the site. Of those, 60 percent reported persistent respiratory problems.

The World Trade Center Health Registry is the largest public health registry in U.S. history. It was launched in 2003 to track the health of people exposed to the collapse of the World Trade Center and those who worked at the WTC site, and is a collaborative effort involving the Health Department, the CDC's Agency for Toxic Substances and Disease Registry (ATSDR), with funding from the Federal Emergency Management Agency (FEMA).

The Health Department is surveying all 71,000 registrants to learn more about their current health status. The Health Department is conducting a separate study of respiratory health among registrants, and is analyzing records to see whether the disaster has affected cancer incidence. The Health Department -- along with the Fire Department, Mount Sinai Medical Center and Bellevue Hospital -- is also updating last year's guidelines for treating adults with WTC-related illness. A similar group of experts is developing guidelines for treating affected children.

New York politicians, including Sen. Hilary Rodham Clinton, have pushed a $1.9 billion program to treat the affected workers.