Air Today . . . Gone Tomorrow Article|
Some Near Ground Zero
Have Breathing, Other Health Problems from Dirty Air
By The Philadelphia Inquirer, Knight
Ridder Newspapers, October 17, 2003
NEW YORK - There are nights when David
Rapp wakes up gasping for air. His days are largely confined to watching television in a
small room in his family's Queens, N.Y., apartment. Just walking up a flight of stairs
leaves the former construction worker out of breath.
"I don't want to live like this," he said. "I can't stand this."
Rapp, 42, hasn't been able to work since April 2002, when the dizziness, shortness of
breath and itchy rashes he had been experiencing for months forced him off the job. He
believes the five months he spent working at the site of the World Trade Center, exposed
to dust and smoke from the terrorist attacks, damaged his lungs so badly that they only
take in half as much air as they used to.
More than two years after the World Trade Center was leveled in a terrorist attack,
thousands of New Yorkers have ongoing health problems that they - and their doctors - say
are related to exposure to the fire and dust they encountered near Ground Zero.
New York is only beginning to study whether the terrorist attacks damaged the physical
health of residents as badly as it did their psyches. The questions are especially acute
for rescue and cleanup workers who inhaled caustic smoke from fires that smoldered into
early 2002. Residents of Lower Manhattan, however, also worry that dust from the collapse
may have left their homes unsafe to inhabit.
A federal government report in late August that said the Environmental Protection Agency
falsely reassured New Yorkers that it was safe to return to Lower Manhattan just after the
Sept. 11, 2001, attacks has only aggravated those fears. Documents released last week in
connection with that report show that the discussions between the EPA and the White House
over what to tell the public about air quality in Lower Manhattan were heated.
"I think it was a public health failure in many respects," said Dr. Robin
Herbert of the EPA's efforts. Herbert is co-director of the World Trade Center Worker and
Volunteer Medical Screening Program at Mount Sinai Medical Center in New York, where Rapp
is being treated.
Scientists from both the EPA and universities collected thousands of samples of air and
dust in the days and weeks following the attacks, but they disagree on what conclusions
can be drawn from that research. They also disagree about whether the EPA had done enough
testing when it told city residents during the week after the attacks that it was safe to
return to Lower Manhattan.
What they do agree on is that the medical evidence points to significant health problems
caused by inhaling smoke and dust. Mount Sinai Medical Center says it has treated
thousands of patients for symptoms ranging from coughs, to severe bronchitis and asthma,
and lung damage. Doctors there and at other hospitals worry that these symptoms may only
be the harbinger of more serious future illnesses, such as cancer.
"People who were down there particularly on September 11, and even more so people who
were down there when the towers collapsed, were exposed to a toxic soup of
chemicals," Mount Sinai's Herbert said.
Of 3,500 Ground Zero workers seen at Mount Sinai, half still experience health problems,
including coughing, asthma attacks when exposed to what had been minor irritants such as
smoke, and mental-health problems. The respiratory symptoms signal a disease called
Reactive Airways Dysfunction Syndrome, or RADS.
No one knows what the long-term effects will be, including whether exposures will cause
emphysema or cancer, Herbert said.
"Our hope is that what we're seeing won't turn into longer latency diseases, that
take 15-20 years to appear," she said. "The bottom line is we really just don't
Trying to get its arms around the problem, the city has established a registry for people
exposed to the dust and smoke of Sept. 11, and intends to track their health over several
David Rapp helped shore up the wall that kept river water from flowing into the World
Trade Center site. He worked there for two weeks immediately after Sept. 11 as a volunteer
and then returned as a paid worker in November. By January, he experienced trouble
breathing. Medical personnel at Ground Zero gave him oxygen. He felt better and returned
to work because the work he was doing required four men.
"It's not safe for the team with only three, so I went back," he said.
He tells his story matter-of-factly. He's grateful for the help he has received so far,
including gifts from charities and help with rent from the Federal Emergency Management
Agency. He lives on $400 a week in workers' compensation, plus money from his wife's
catering job. He takes about 12 medications, mostly to help him breathe. When he goes out,
he carries an oxygen tank, just in case.
"I'm fighting," Rapp said. "I'm not going to let it beat me."
Doctors and scientists believe the towers collapsed so rapidly that they were pulverized
into particles small enough to penetrate the lungs. These tiny pieces of concrete and
glass were highly acidic, burning people's airways and causing RADS.
"The lung's defenses are compromised at exactly the time when the nose throat and
lung are being assaulted with this very fine, caustic dust," said Thomas Cahill, a
professor emeritus of physics and atmospheric science at the University of California at
Cahill tested the air around the World Trade Center after Sept. 11 and found it filled
with dangerous particles. But because hot air rises, they cleared the area quickly, he
said. As a result, he believes recovery workers were at much greater risk than residents
and others in Lower Manhattan.
Even so, residents worry that exposure to dust that landed in their apartments may harm
them. Some dust samples contained asbestos, which has been linked to cancer.
The EPA has tested or cleaned more than 4,000 homes, but some people who live near the
site fear that their apartments have not been cleaned thoroughly.
EPA spokeswoman Mary Mears said she was confident her agency had responded appropriately
to the thousands of requests for testing and cleaning in the area.
"We believe our cleaning was effective," she said. Only a small number of
residents whose homes EPA cleaned have complained.
An atmosphere of distrust pervades Lower Manhattan on these issues. The EPA never did
widespread testing of indoor dust and air, a step some scientists said was necessary.
Testing and cleanup of offices was voluntary, so many workers don't know whether they were
exposed or continue to be exposed to dangerous chemicals.
Safety and health issues have been simmering for two years but exploded into national
controversy in late August when the EPA Inspector General, an internal agency watchdog,
concluded that then EPA administrator Christine Whitman lacked adequate scientific
evidence when she reassured the public on Sept. 18, 2001, that the air downtown was
"safe to breathe."
The Inspector General also said that the White House Office of Environmental Quality had
influenced the EPA to leave out statements that included guidance for cleaning indoor
spaces and cautious statements about the potential health effects from trade center
James Connaughton, who heads the White House Office of Environmental Quality, disagreed
with the inspector general's characterizations of his office's actions.
"There was no such thing as the White House directing EPA to do things ..." he
said. "There was discussion and consensus around what we knew and what we could say
Press releases were only one source of communications, he added. The EPA and the city
communicated with Lower Manhattan residents directly in meetings and in cleaning
information sent to homes.
But the Inspector General's report continues to stir controversy. New York Sen. Hillary
Clinton and U.S. Rep. Jerrold Nadler are holding up the nomination of Michael Leavitt as
head of the EPA until Congress investigates the EPA's actions after the attacks.
Clarke and others believe the federal government intentionally misled people.
"From the very beginning they just wanted to tell the world, tell the country, tell
New Yorkers, everything is OK," she said.
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