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Lung Problems for 9/11 Rescuers More Widespread: Study

70% of responders reported pulmonary trouble and twice the rate of abnormalities as the general population

TUESDAY, Sept. 5, 2006 (HealthDay News) -- Almost 70 percent of rescue personnel and workers who responded to the Sept. 11, 2001, terrorist attacks on the World Trade Center in New York City suffered from lung problems during and after the recovery efforts.

Some of those problems persisted for at least two-and-a-half years after the attacks, according to a new report, the largest study to date on the health effects of the disaster.

"It wasn't surprising to me to see these effects from a toxic exposure that goes on for that length of time, even for several days or weeks, with deposition of metals in the lung and no way for the lungs to clear it," said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City.

World Trade Center dust, according to Horovitz, was now known to contain heavy metals such as nickel, titanium and cadmium. "These are some of the heavy metals found in cigarette smoke which we know is toxic to the lungs," Horovitz said. The dust also contained large and small particles, the smallest able to reach the deepest recesses of the lungs.

About 40,000 rescue and recovery workers -- including firefighters, police officers and construction and public-sector workers -- were exposed to caustic dust and toxic pollutants following the attacks, according to the study. The findings were based on medical examinations of 9,442 of these responders that were done between July 2002 and April 2004.

Sixty-nine percent of those examined reported new or worsened respiratory symptoms while working at the World Trade Center site. Symptoms were still present at the time of examination in 59 percent of participants.

Sixty-one percent of those who had not had any respiratory symptoms before 9/11 developed symptoms while working at the site.

Pulmonary-function tests revealed that World Trade Center responders had twice the rate of abnormalities as those experienced in the general population. These abnormalities persisted for months and sometimes years, the report found.

Severe respiratory conditions such as pneumonia were much more common in the six months following 9/11 than in the six months prior.

Those who arrived first at the smoldering site had the heaviest exposure and, consequently, more respiratory problems.

The report, released Tuesday by Mount Sinai Medical Center in New York City, is scheduled to be published Thursday in Environmental Health Perspectives.

It seems likely that some problems will continue or worsen. "It's not clear whether we're going to see a rise in malignancies but one would suspect that that certainly is possible," Horovitz said.

The report underscores the need to keep monitoring and treating World Trade Center responders, the study authors stated.

Mount Sinai has been the center of 9/11-related research. Of responders treated at the hospital in the past year, 84 percent have had upper-respiratory illness; 47 percent have had lower-respiratory disorders such as asthma and "World Trade Center cough;" 37 percent have had psychological disorders such as post-traumatic stress disorder; and 31 percent have had musculoskeletal problems.

According to the Associated Press, the report was released as public concern over the fate of Ground Zero workers has increased. One class-action lawsuit against New York City and its contractors involves 8,000 workers and civilians who blame 9/11 for cancer, sinusitis and other problems.

New York City Mayor Michael Bloomberg is expected to announce programs to support those who worked at the site after 9/11.

On Aug. 31, the New York City Health Department released updated clinical guidelines for New York City health-care providers on how to treat adults exposed to the disaster. The guidelines also include screening approaches to improve detection of health problems.

More information

The New York City Department of Health has more information on the aftermath of the World Trade Center attacks.

SOURCES: Len Horovitz, M.D., pulmonary specialist, Lenox Hill Hospital, New York City; Mount Sinai Medical Center, New York City, Sept. 7, 2006, Environmental Health Perspectives; Aug. 31, 2006, New York City Department of Health press release; Associated Press
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