Toxic After-Effects Still Haunt 9/11
WEDNESDAY, Sept. 7 (HealthDay News) -- Sean Callan, a stone
mason in New York City, was working just seven blocks from the
World Trade Center when he heard the explosion of the first plane
hitting the North Tower on Sept. 11, 2001.
He and other workers dropped their tools and raced toward the
sound. Callan soon found himself in the South Tower, steering
fleeing workers from the crippled building hit by the second plane.
When the structure started to groan and creak, he ran for the exit,
feeling rubble and debris -- some of it human bodies -- raining
down on him as the tower collapsed.
For the next 31 days Callan volunteered at what became Ground
Zero, the site where nearly 2,800 people were killed. And over a
two-year period, he spent a total of 19 months at "The Pit,"
slicing steel, cutting concrete, hauling away debris in buckets --
and inhaling volumes of toxic dust.
In 2003, Callan was diagnosed with mesothelioma, a type of lung
cancer normally associated with exposure to asbestos. Two men
working alongside him at Ground Zero were also diagnosed with the
cancer. Both have died.
Ten years after the terrorist attacks, cancer is still not on
the government's official list of ills caused by exposure to the
Twin Towers debris. Experts note that a decade is too short a time
period to link a disease like cancer -- which can have many causes,
both genetic and environmental -- to such a specific source as 9/11
But while mesothelioma usually has a longer latency period,
Callan, now 59, was told by health experts that "for the initial
period I was down there as a volunteer ... I was exposed to a
lifetime of toxins."
Prior to 9/11, Callan added in a gravelly voice bearing the
sound of his native Northern Ireland, he had been "blessed with
The health effects of the Twin Towers' collapse was the focus of
research published last week in
The Lancet that showed first responders and workers at the
site continue to suffer physical and mental problems. And, for the
first time, the research showed a possible increase in their risk
Seven years after 9/11, male firefighters who were at the World
Trade Center site after it was attacked had a 10 percent increased
risk of cancer compared with the general population, and a 19
percent increased risk compared to firefighters who hadn't been
sent there, researchers reported.
Their study also detected a slightly increased risk for certain
types of cancer, including stomach, colon and non-Hodgkin lymphoma.
But, curiously, people who had been near the disaster site had a 58
percent decreased risk of lung cancer -- probably because of the
good health typical of most first responders, the study authors
So, while a decade isn't enough time to make a definitive link
to cancer, the study authors believe the increased incidence is
likely a result of carcinogens in the dust that filled the air
after the attacks.
Responders don't qualify for federal aid for health problems
The conclusion is in marked contrast to a report issued by the
federal government in July that found there still wasn't enough
evidence to determine whether the dust and smoke caused cancer in
rescue or recovery workers or New York City residents who lived
near the site. The finding means that people -- such as first
responders -- with cancer diagnoses that they attributed to the
9/11 attacks don't qualify for federal benefits to treat or
compensate them for their illness.
Part of the reason for the July finding was that there had been
only 18 published research studies on the World Trade Center attack
that mentioned cancer, and only five of those were peer-reviewed
and they yielded mixed findings, said Dr. John Howard, director of
the National Institute for Occupational Safety and Health. A second
review of a possible link between cancer and the World Trade Center
attack will be done next year, he added.
A decade, however, is enough time to track the various other
illnesses that have developed since the Twin Towers crumbled.
"At the 10-year point after 9/11, we're still seeing a great deal of persistent disease in the first responders, the police, the firefighters, the construction workers," Dr. Philip Landrigan, senior author of one of the Lancet studies and chairman of preventive medicine at Mount
Sinai Medical School in New York City, told
Landrigan's examination of more than 27,000 rescue and recovery
workers found that nearly 28 percent had asthma, 42 percent had
sinusitis and 39 percent had gastroesophageal reflux disease, or
GERD. The respiratory and digestive troubles are likely the result
of the noxious cloud that hung over the disaster site, entering
people's airways, causing inflammation and scarring, and burning
its way into the esophagus, the study concluded.
"These people swallowed that very, very caustic dust which ... was extremely alkaline. It was described as inhaling Drano in powdered form," Landrigan said.
Earlier this year, Mount Sinai researchers noted an increase in
"sarcoid-like" granulomatous pulmonary disease in first responders
after 9/11. This disease causes inflammation in various organs,
including the lungs, and is thought to be precipitated by
Many suffer from permanent lung damage, experts say
Another recent study -- this one by the chief medical officer of
the New York City Fire Department -- found that respiratory
conditions accounted for the lion's share of increased disability
retirements among city firefighters in the seven years following
Then there are these findings from the World Trade Center Health
Registry, maintained by the New York City Health Department. Five
to six years after the attacks:
- 10 percent of adult enrollees in the registry reported they had
developed asthma, with most diagnosed in the first 16 months after
9/11. The rate of new asthma was highest (12 percent) among rescue
and recovery workers who worked on the "debris pile" on 9/11.
- 19 percent of adult enrollees reported post-traumatic stress
symptoms -- about four times the rate typically seen among U.S.
- Six to seven years after the attacks, four times as many
firefighters and twice as many emergency medical service workers
had below-normal lung function for their ages as they did before
Many rescue workers also suffer from gastroesophageal reflux
disease, in which acid and other contents of the stomach spill up
into the esophagus.
"[Damage] was not limited just to the respiratory tract but also to the gastrointestinal tract," said Dr. Marilynn Prince-Fiocco, associate professor of internal medicine at Texas A&M Health Science Center College of Medicine.
That could be the result of actually swallowing "particulate
irritants." Or the infamous "World Trade Center cough" could make
people reflux, added Prince-Fiocco, who is also a
pulmonologist/critical care physician at Scott & White Hospital
in Temple, Texas.
First responders also have experienced a dramatic decline in
lung function -- declines that persist to this day. This, added to
the expected decline in lung function with age, could presage more
problems down the line, said Dr. Len Horovitz, a pulmonary
specialist with Lenox Hill Hospital in New York City.
"I would be worried into the future about an increased incidence of COPD [chronic obstructive pulmonary disease], chronic bronchitis, emphysema and maybe even other inflammatory lung disorders," he said. "These people are already vulnerable."
When it comes to gauging the health effects of exposure to the
Twin Towers debris, Dr. Michael Crane, director of the World Trade
Center health program at Mount Sinai Medical Center in New York
City, said, "We can't rule anything out."
As for Callan, the stone mason, he is still working. And though
he lives in New York City, he's constantly on the road -- going
where the jobs are. And he's on chemo -- a pill a day.
"It's been tough to come to terms with the debilitating impact this has had on my ability to work," he said. "I have difficulty breathing, moving. I just don't have the stamina any more."
Then he added, "There are days -- never mind getting out of bed
-- I don't want to turn my head. I live my life literally one day
at a time."
Coming tomorrow: How the 9/11 attacks affect, to this day,
To learn more about the health effects of the 9/11 attacks,
World Trade Center Health Registry.
To read HealthDay's story on the psychological toll of 9/11,
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