   |  | | Health issues continue to linger, almost 7 years later | By Mike Magee, MD
As 9/11 approaches its 7th anniversary, it is a fading memory to some. But for many it remains a day-to-day challenge. This includes thousands who lost loved ones, witnessed the events, or participated in the recovery efforts. Increasingly, federal and state officials are acknowledging a significant disease burden in these survivors which will last their lifetime. Physical and mental ailments are now beginning to be reported in careful follow-up studies. For example, the National Institute of Environmental Health Sciences, a branch of the National Institutes of Health, recently published an article measuring the mental health and social functioning of World Trade Center Rescue, Recovery and Cleanup Workers. Having closely followed over 10,000 citizens for one to five years, they found that 11% suffered from Post Traumatic Stress Disorder, which normally is present in approximately 3% of our population. In addition, 9% were clinically depressed, 5% suffered panic disorders, and 62% had substantial stress reactions.1
None of this is news to the police or firefighters in New York City. They've been fighting an uphill battle for years, watching responders decline. Two years ago I attended the wake of a police responder who had committed suicide. His partners told me he was not the first, and that there were several others, physically disabled by the events, and increasingly depressed by prospects for their futures, who they knew would likely end up the same way. Their view was that public denial compounded the problem. That is changing. On May 7, 2008, Mayor Bloomberg and Police Commissioner Kelly publically honored 11 police officers who had fallen in the line of duty. Eight of the 11 honored, were reported in a press release to have died of a "9/11 related illness." 2 That was a first.
The challenge that lies ahead is not a small one. Official studies, funded by the federal government and conducted at New York's Mount Sinai Medical Center, predict problems for years to come.3 Dr. Robin Herbert, co-director of the hospital's program monitoring afflicted workers, told lawmakers in 2006 that new patients are still arriving at Mount Sinai to be treated for 9/11-related illnesses and thousands probably will need lifelong care.4 And it's not just New Yorkers. The U.S. Department of Health and Human Services (HHS) estimates up to 6,000 volunteer responders from outside New York need to be monitored as well. In February, 2008, New York City announced a $100 million effort to stay on top of the crisis. Part of that effort is a new study to assess respiratory function in some 900 non-smoking New Yorkers exposed to dust-laden air tied to the catastrophe.
Christie Todd Whitman, then head of the EPA, issued a press release on Sept. 13, 2001, reassuring the public that the air around the disaster site was relatively safe. On Sept. 16, 2001, Whitman noted that measurements of air contaminant levels "cause us no concern." On Sept. 18, 2001, she again reassured New York and Washington residents that their air and water were safe. That was then. In 2006, she stated, "We agreed then, and I reiterate now, that the air on the site was not clean ... We were emphatic that workers needed to wear respirators, a message I repeated frequently. But I did not have the jurisdiction to force workers to wear them _ that was up to their superiors." 4
So what was in the air? Pretty much everything that had been in two 100-story buildings - but in vaporized form. That is why Rep. Christopher Shays, R-Conn., who chaired the hearing in 2006 on air quality post 9/11, said Whitman's September 2001 statements "defied logic and everybody knows that." 4 Even if we were measuring the air and communicating those results properly, it is possible we were not measuring the right things. For example in May of 2008 in the journal Nature Nanotechnology a study reported the effects of injecting nanotubes, micro-miniaturized rolled up sheets of carbon that may be of future use in electronics, into mice. Nanotubes are not yet in common use and there has been controversy over safety concerns. This study revealed that mice exposed to the substance responded with cancer development in the same way as when exposed to asbestos. Asbestos-laden dust, when inhaled, draws a response from protective macrophage cells which attempt to ingest the particles and remove them. The asbestos fibers are too long to remove, become stuck in place and ultimately form tumors around them.5,6 Nanotubes may involve the same process. There were no nanotubes in the Twin Towers, and asbestos measures at the time were supposed to be OK. But what about all the other vaporized computers, electronics and building materials we’d never expect to be in our air under normal circumstances?
What exactly was in that air, or why exactly some were vulnerable to mental illness and others not, we may never know. What we do know is this - that large numbers of Americans developed chronic disease from direct exposure to 9/11; that adequate protective measures were not taken by those involved at the site; that significant ongoing support will be required for many years by those affected; and that denying any of the above simply adds to the disease burden of those affected. We can do much better!
References:
1. Enduring Mental Health Morbidity and Social Function Impairment in World Trade Center Rescue, Recovery and Cleanup Workers: The Psychological Dimension of an Environmental Health Disaster. National Institute of Environmental Health Sciences, NIH. 20 May 2008.
2. Mayor Bloomberg and Commissioner Kelly Honor 11 Police Officers Killed in the Line of Duty. Office of the Mayor. 7 May 2008.
3. Department of Health and Human Services. Centers for Disease Control Plans to Fund Monitoring and Treatment for Responders Outside New York. 9/11 Health. 19 March 2008.
4. Barrett, D. AP Release. The Washington Post. EPA, NYC Blamed for 9/11 Health Problems. 8 Sept. 2008.
5. Stone V, Donaldson K. Nanotoxicology: Signs of Stress. Nature Nanotechnology 1, 23 - 24 (2006) doi:10.1038/nnano. 2006.69
6. Chang K. In Study, Researchers Find Nanotubes May Pose Health Risks Similar to Asbestos. 21 May 2008.
| | |
|
|  I think we should have health care paid for by the government for everyone. It doesn't have to be elaborate, but a socialized medical system like Canada has."  Hard for the insured, too  Keep health care private!  Work to stay healthy  Testing is important  Please keep it affordable  Everybody deserves a chance  | Dr. Tom Linden's Health Blog | | |  Without the Wilderness, There Can Be No Wilderness Medicine Don't go to the Hospital Without these Ten Safety Tips Ain’t Nobody’s Fault But Mine Can Health Plans Explain Why They Aren't Re-Empowering Primary Care? Post-Election Healthcare Reform Yearning for Universal Coverage Is Not Universal Is America's Health Care System Failing? Probiotics: Hope or Hype? |
|
