Wednesday, September 13, 2006

9/11's Grim Toll on Health Continues

(HealthDay News) -- Five years after the terrorist attacks of Sept. 11, 2001, many of those at or near the World Trade Center site carry grim reminders of that day in their minds, hearts and even their lungs.
Thousands of workers who toiled for months on the smoldering pile that was Ground Zero continue to complain of respiratory illness, including a chronic, soot-laden hacking known as "World Trade Center Cough." At the same time, researchers are keeping tabs on the development of hundreds of children, born early and underweight, to women living in Lower Manhattan. And psychologists worry that the anniversary day itself could reawaken mental woes for those once traumatized by the devastation.
In short, the health problems that have emerged over the last five years will become a lasting legacy of 9/11, and one that will continue to grow, experts say.
The potential cost of treating the long-term health effects of 9/11 is daunting. Most pressing are the needs of 40,000 first-responders and clean-up workers who experts say inhaled a toxic soup of lead, mercury, dioxin, asbestos, benzene and other contaminants from the debris of the collapsed towers.
New research released last week by Mount Sinai Medical Center in New York City found that 69 percent of these workers developed new or worsened respiratory symptoms after working at the site, with 59 percent still showing evidence of symptoms today. Those who arrived first on the scene tended to have the worst symptoms, the researchers said.
"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," Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, told HealthDay.
Horovitz added that things could possibly get worse for some of those affected, especially in terms of workers' long-term risk for cancer.
"It's not clear whether we're going to see a rise in malignancies, but one would suspect that that certainly is possible," he said.
Doctors have already attributed one death -- that of 34-year-old NYC police detective James Zadroga -- to respiratory problems caused by Ground Zero exposures. Last Friday, Zadroga's father, Joseph, told a House subcommittee hearing that the government has spent too much time studying the health issues and not enough time treating those who were sickened or still at risk.
Last Thursday, the first federal funds for treating 9/11-linked health issues were announced by U.S. Health and Human Services Secretary Mike Leavitt. The amount was $75 million.
Critics called it too little, too late.
"They seem to be running from the people who are sick, not standing with them and helping them," Rep. Carolyn Maloney, a New York City Democrat, told the New York Times last week.
The terrorist attacks on the World Trade Center and the Pentagon also left many Americans across the country with deep and lingering emotional scars.
A team led by Dr. David Spiegel, a professor of psychiatry at California's Stanford University, conducted surveys of New York City residents in the six months after the attacks.
"Initial rates of post-traumatic stress disorder (PTSD) involved large proportions of the population," Spiegel said. "We found that 7.5 percent of people in the New York City metropolitan area initially met criteria for PTSD, and 20 percent of people south of Canal Street -- right where the WTC is -- met the criteria."
While studies on national rates of PTSD following 9/11 haven't been done, "our research shows that just witnessing somebody else getting injured or killed can induce PTSD-like symptoms," he said. That includes witnessing horrific scenes via television, the Stanford expert said.
But there is some good news, he noted.
The number of people with symptomatic PTSD linked to 9/11 has subsided over time, he said. People who were less isolated and able to talk over their fears and feelings with others tended to recover more quickly, he added.
The jury is still out, however, on the youngest potential victims of the attacks.
Beginning soon after the disaster, a team led by child health expert Dr. Federica Perera, of Columbia University's Mailman School of Public Health, has tracked the birth outcomes and long-term development of more than 300 babies born to women living near the site. All of the women were at some stage of pregnancy on Sept. 11, 2001.
"Babies born to women who had been living with a two-mile radius of the World Trade Center site during the months following 9/11 weighed significantly less at birth -- about a third of a pound less -- compared to infants born to other women living further away," Perera said. The study also found that nearly all women, regardless of their proximity to the site, gave birth slightly earlier than usual -- probably the result of an increase in stress linked to 9/11.
However, the tendency toward smaller birth weights continued even after Perera's team adjusted for this prematurity. "So, we infer that there was [also] a potential effect of the pollutants themselves," she said.
Blood tests on newborns' umbilical cords confirmed relatively high levels of combustion-linked toxins called polycyclic aromatic hydrocarbons (PAHs) in babies born to mothers living in Lower Manhattan, she added.
These "children of 9/11" are now 4 and 5 years of age, and Perera said her team intends to soon publish findings on the impact of the disaster -- if any -- on their ongoing health and development. "This is to help the families who are concerned, to reassure where we can do that, and to take note of any potential risk where that is appropriate," she said.
More information
There's more on post-9/11 health issues at the New York City Department of Health and Mental Hygiene.

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