15 years ago, the World Trade Center was hit in a terror attack by two large airplanes full of fuel causing the Twin Towers and other buildings to melt and fall apart into gazillions of tiny little pieces. Was anybody able to predict on 09/11/2001 what this horrific event would mean longterm for New York City, the United States of America? The World? Thousands of individual people? Probably not. Let’s leave politics and economy out. Let’s just think about the health of the people that were right there Lower Manhattan when it happened.
Most importantly, close to 3,000 people died. They were working early in the morning in the twin towers or trying to help, firemen and other emergency helpers (343 deaths). These are the people whose lives were acutely affected and we will never forget how horrible the last moments of their lives must have been. But what about those who inhaled the dust and the dirt that was set free due to the impact?
The dust cloud could be seen for weeks from miles away in all directions including the space. The dust was caused by pulverized and powderized building material and consisting of an estimated 2,500 contaminants producing a humongous toxic dust cloud (Anita Gates for The New York Times). The clean up took a year to be completed. I was at Ground Zero more than 3 months after the attack and the streets still looked like it just happened. Crazy! You had to see it to believe it.
What can dust and dirt mean to the health of individuals?
In order to stay healthy, human beings need a reasonably clean environment with clean air and water. If we are exposed to dust and pollution even at a lower level, we cannot escape from it and over time our body is not able anymore to compensate and detoxify once a certain threshold is reached. Literally dirt can accumulate in our bodies especially in our lungs and in tissues surrounding it. It might start with difficulties to breath developing to asthma and COPD within days, weeks or months depending on the individual. What about long-term – years?
At 9/11, the impact was so strong that one day might have been enough for many victims to reach their threshold. Some construction workers and firemen were exposed for days and weeks while cleaning up. If the extent of the threat to their health was not known right away, chances are they were not protected sufficiently at all times.
Many experts of highly reputed hospitals and research institutes in New York and surrounding states have expressed their concern and initiated studies to monitor the long-term effects in rescuers, New Yorkers living in lower Manhattan and women who were pregnant at the time and close to the Twin Towers and their children who were born shortly after. Can we estimate the entire extensive health effect that this attack had and still has on New Yorkers between 9/11/01 and today and in the future? Probably not.
What has been found until today is that rescuers and New Yorkers of the surrounding neighborhoods were diagnosed in higher numbers and alarmingly fast with long-term impaired lung function that would not go back to normal even several years after the attack. Severe illnesses like pulmonary fibrosis, prostate cancer, thyroid cancer, multiple myeloma and other blood cancer increased in the years after 9/11 more so in rescuers and exposed victims compared to not exposed people (Li’s study published in JAMA).
One great concern is that the building substance of the World Trade Centers contained asbestos. When those buildings were built, asbestos was used widely. Today, it is well known that asbestos can cause a fatal disease called mesothelioma. Mesothelioma is not defined as lung cancer like small or non-small cell lung cancer discussed in blog posts prior but this type of cancer develops from the thin layer of tissue, the mesothelium, which covers internal organs including the lungs. >80% of mesothelioma is caused due to asbestos exposure. People who have been working in industrial environments using or extracting asbestos e.g. mines, construction sites for buildings and ships are at very high risk. But also people with secondary exposure like house wives cleaning their husbands working clothes for years are at risk.
It can take a long time between first exposure and diagnosis of the disease, up to 40 years. The symptoms include difficulties to breath, shortness of breath due to fluid that builds up around the lungs, pain, coughing and fatigue. The 5 year survival rate is extremely low – just 8% in the US. In 2013, the incidence was 50,000 and 34,000 deaths due to the disease. Question is if these numbers will increase due to the 9/11 attacks over the next 20 years …..
Treatment includes surgery if the disease is not too far progressed, chemotherapy and radiation therapy. But the therapeutic possibilities are limited. Currently, there are several studies ongoing testing immunotherapy in mesothelioma patients including antibodies targeting PD1, PD-L1 and CTLA-4 – as discussed in blot posts prior.
Clearly, without any hesitation, (like for all other suffering patients) anything that is developed in the years to come needs to be accessible for all the brave rescuers and victims from 9/11.
- Anita Gates, “Buildings Rise from Rubble while Health Crumbles”, The New York Times, September 11, 2006, reporting on the documentary by Heidi Dehncke-Fischer, “Dust to Dust: The Health Effects of 9/11”
- Li J. et al. “Association between World Trade Center exposure and excess cancer risk.” (2012) Journal of American Medical Association. 308 (23): 2479-88.