One year after September 11th, experts believe that the collapse of the World Trade Center towers and the ensuing fires triggered one of the worst air pollution episodes in New York City's history.
Of course, the pollution-induced respiratory impacts from the trade center terrorism have been rightly overshadowed by the horrific toll of more than 2,800 lives that were lost as a direct result of the attacks. Moreover, the contaminants released from the World Trade Center's collapse and fires did not create a disaster comparable to the 1984 toxic gas leak at a Union Carbide plant in Bhopal, India, which killed over 3,000 and seriously injured 20,000 more. And significantly, outdoor air quality in Lower Manhattan has returned to pre-September 11th levels.
But the public health and environmental consequences from the September 11th attacks in New York have had disturbing short-term impacts for many thousands of New Yorkers. Concerns about indoor air pollutants remain among some who live and work in the area. And it is almost certain that a portion of those who have suffered sort-term health problems from inhaling pollutants on or after September 11th, or who were otherwise exposed to 9/11 contaminants, will experience mid-term or long-term respiratory conditions or disease.
The collapse of the two 110 story towers released an avalanche of debris and pollution that roared down adjacent streets in Lower Manhattan. Intense fires, fueled initially by thousands of gallons of jet fuel, sent billowing smoke over large areas of the financial district. Prevailing winds carried some of the pollution across the East River into Brooklyn. Huge volumes of pulverized cement, fiberglass and particulate matter of all sizes, along with hundreds of toxins (including asbestos, dioxins, and volatilized metals such as lead and mercury) were rocketed into the environment. The fires at Ground Zero, which continued for more than three months, emitted noxious gases; a sickening, acrid odor often pierced the air.
AT HIGHEST RISK
Public health risks from environmental assaults such as the one that began on September 11th are related directly to the intensity and duration of the pollution exposure.
Not surprisingly, then, the first short-term health impacts were seen am ong the first-responders, including thousands of hero firefighters who developed respiratory symptoms that were dubbed the "World Trade Center cough." Today, the New York City Fire Department reports, several hundred members are still suffering from significant respiratory problems. Indeed, some firefighters who came from across the country to assist in recovery efforts also returned to their homes with a variety of pulmonary and related symptoms.
Police, emergency personnel, construction workers and others who spent significant time at the pile are also among those who also may have received high exposures. More than one hundred ironworkers have been treated by occupational health physicians at Mt. Sinai's Selikoff Center for Occupational and Environmental Medicine. And according to the Center's Director, Dr. Stephen Levin, two of three still have persistent coughs and other signs of respiratory distress.
The several thousand largely untrained workers who were hired to clean out dust and pollution inside commercial buildings in the immediate vicinity of Ground Zero constitute another high risk group. A medicinal team headed by Dr. Steve Markowitz from the Center for Biology Systems at Queens College, supported by the September 11th Fund, set up a mobile van to provide free medicinal screening to such workers. In cooperation with the New York Committee for Occupational Safety and Health, the physicians saw 415 workers over a five week period. Almost all had persistent respiratory irritation and/or systemic symptoms such as headache, dizziness and poor appetite -- even though they had completed their work assignments four to six weeks prior to the medical examinations.
OTHER EXPOSED POPULATIONS
Another at risk group includes those office workers and others who were caught in the extraordinary cloud of pollution and debris on September 11th. Little information on the health impacts of this group has been developed to date.
Residents who returned several weeks later to their apartments faced lower risks than groups such as those mentioned above, most experts believe. Nevertheless, sensitive subpopulations, such as those with pre-existing lung diseases, are more likely to have suffered adverse respiratory reactions when they returned to their homes or offices. (And many of the returning residents have been understandably frustrated by the pace and scope of the long-delayed indoor clean-up program which is still -- one year later -- in the design stage.)
Lower Manhattan is also the home to a handful of public schools and other learning institutions, and some students also experienced short-term health problems in the aftermath of 9/11. At Stuyvesant High School, the first local school to reopen, some students (as well as faculty members and staff experienced a variety of adverse heath reactions, which were probably exacerbated by the debris-hauling barge operation that was located across from the school.
In total, approximately 10,000 to 30,000 people or more suffered some short-term respiratory problems associated with the terrorist attacks on the World Trade Center, according to a forthcoming report by the Natural Resources Defense Council (where I work). (This estimate is limited to pollution-related illnesses and does not include those who have experienced or may still be experiencing mental health problems in the aftermath of September 11th.)
There is much we still do not know about the environmental health consequ ences of the trade center's collapse and the subsequent fires. And the synergistic impacts of exposure to multiple pollutants makes the September 11th exposures extremely difficult to assess. For such reasons, it is essential that on-going health studies such as those underway at Columbia's Mailman School of Public Health (tracking pregnant women and their offspring), and at Mt. Sinai, New York University, Johns Hopkins medical schools be fully funded.
The September 11th attacks on the World Trade Center, in addition to their unspeakable loss of life and huge economic dislocations, also constituted an unprecedented attack on New York's environment. Thousands have suffered or are still suffering adverse health impacts. And much work still remains to be done to provide indoor clean-ups in residences and small businesses in the World Trade Center vicinity and to insure follow-up medical care to all those who were exposed.
But even as the recovery process continues, New Yorkers can once again stand outside in Lower Manhattan and breathe freely.
How did government agencies perform in response to the environmental health challenges posed by the September 11th attacks?
What lessons can be learned from their actions?
And what steps should government take now to address remaining environmental health concerns and be better prepared to handle future environmental health emergencies in New York?
These questions will be addressed in Part II of this article, in October.