Hundreds Troubled by 'World Trade Center Cough'

NYC firefighters, school workers have 9/11 breathing problems, new studies say

MONDAY, Sept. 9, 2002 (HealthDayNews) -- In the two days following the World Trade Center attacks, most New York City firefighters at Ground Zero developed a cough.

Soon, 90 percent of the more than 10,000 firefighters evaluated at the site complained of acute cough, often with nasal congestion, tightness or burning in the chest.

Considering the firestorm of pollution and debris, understandable. Amazingly, only three required hospitalization at the time for cough.

But now, a year later, it's become the cough that won't quit.

During the six months after the terrorist attacks, 332 firefighters and one emergency worker had coughs severe enough that they required more than four consecutive weeks of medical leave, said Dr. David Prezant, deputy chief medical officer of the New York City Fire Department.

Prezant reported the findings today at a press briefing hosted by the federal Centers for Disease Control and Prevention. His report of illnesses among firefighters and rescue workers also appears in this week's CDC Morbidity and Mortality Weekly Report as well as this week's New England Journal of Medicine.

"We call this the World Trade Center-related cough," Prezant said.

The cough is more complex than the type that accompanies a cold.

"Fine particles [at Ground Zero] went into the nose and throat and were swallowed and inhaled," Prezant said. The WTC cough includes sinusitis, throat problems, airway trouble and problems in the esophageal tract. "It affects both the digestive and respiratory tracts," Prezant said.

As a result, treatment must be "multisystem," Prezant said, including decongestants, anti-acid agents and bronchodilators to open up the airways.

The high incidence of World Trade Center cough is blamed on the lack of adequate respiratory protection during the first day of rescue operations. During the Twin Towers' collapse, 52 percent of the firefighters didn't wear respiratory protection, such as a respirator, and 38 percent didn't wear it for the entire day, Prezant said.

Also a problem was the type of respirators used. "The New York City Fire Department has the best respirators on the planet," Prezant said. But they are designed for short-term firefighting, not long-term rescue work, he added.

And the respirators "last only eight to 15 minutes and are incredibly heavy," Prezant said.

Eventually, respirators from the CDC's National Institute for Occupational Safety and Health were provided. But by then, firefighters had been working without adequate protection for days.

Long-term observation of the rescue workers affected with World Trade Center cough is crucial, Prezant said. "Because they were there, 25,000 people were evacuated from the World Trade Center. We owe them long-term medical monitoring," he added.

The cough isn't affecting only firefighters, another study in this week's Morbidity and Mortality Weekly Report finds. Researchers surveyed workers at four sites: a high school and a college near Ground Zero, and a high school and a college more than five miles away. Coughs and other respiratory problems were more prevalent among those workers in the two closest schools.

Up to 30 percent of workers at the nearby schools still had physical symptoms four to six months after September 11. When surveyed in January and March, 55 percent of those at the nearby schools still reported a cough, compared to 23 percent at the more distant schools.

On a positive note, many firefighters have experienced improvement in the cough with medical management, Prezant said.

"Life is becoming a little more bearable," he said. "But many are a long way off from the physically active, athletic firefighters" they were.

What To Do

For information on air quality and lung health, see the American Lung Association. For information on protecting workers at the World Trade Center site, see the Centers for Disease Control and Prevention.

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