High Rate of Respiratory Symptoms in Police at World Trade Center Site
By Newswise, February 13, 2004

More than three-fourths of New York City police officers responding to the September 11, 2001 terrorist attack on the World Trade Center developed a cough or other respiratory symptoms, reports a study in the February Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).

Officers who arrived at the site before the towers collapsed were most likely to have abnormal results on lung function testing, according to Dr. Steve H. Salzman and coauthors of Beth Israel Medical Center.

After September 11, Dr. Salzman and colleagues offered respiratory health assessments to members of New York Police Department's special Emergency Services Unit (ESU), one of the first units to respond to the World Trade Center attack. Of 350 officers in the ESU, four percent died when the towers collapsed. Two hundred forty officers were evaluated about two months after the attacks, on average.

Overall, 77.5 percent of the officers developed respiratory symptoms, most commonly a cough, after working at the World Trade Center site. By the time they were evaluated, the symptoms had resolved in three-fourths of affected officers.

In the remaining one-fourth, respiratory symptoms persisted or got worse. None of the ESU officers took medical leave from work because of their respiratory symptoms.

Even when symptoms were present, few of the officers had abnormalities on physical examination, including chest x-rays. Twenty-nine percent had abnormal results on spirometry—a test of lung function—although the abnormalities were generally mild.

Officers with previous respiratory disease or symptoms were more likely to have abnormal spirometry results, as were those with more intense exposure to conditions at the World Trade Center site. The abnormality rate was about 40 percent for ESU officers who arrived before the first tower fell, compared with 25 percent for those who arrived after both towers collapsed.

People near the World Trade Center site on or after September 11 were exposed to "a complex mixture of particulates and gases" resulting from fire and the collapse of the towers. A previous study found respiratory abnormalities in firefighters working at the site, including a three percent rate of "WTC cough" severe enough to require medical leave.

As was found in the study of firefighters, this study of police responders to the September 11 attacks also finds a high rate of respiratory symptoms. The symptoms soon resolved in most cases, although a substantial minority of officers still had symptoms months later. Rates of lung function abnormalities appear highest for officers with the most intense exposure: those who were at the site when the towers collapsed. Dr. Salzman and colleagues emphasize the need for long-term follow-up of rescue workers and others exposed to the World Trade Center site.

ACOEM, an international society of 6,000 occupational physicians and other healthcare professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments.

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