Public-health officials had high hopes when they launched an effort last September to track the impact of the World Trade Center terrorist attacks on the health of as many as 1.2 million people who were in lower Manhattan on Sept. 11, 2001.

The project, funded with $20 million from the Federal Emergency Management Agency, was hailed as a chance to hunt for patterns in the nagging coughs and other ailments among those most exposed to the smoke and debris from the attacks, as well as to note future cancer and disease rates over 20 years.
But the World Trade Center Health Registry is turning out to be a big disappointment Only 47,000 of the estimated 400,000 people considered most heavily exposed have signed up so far.

The New York City Department of Health and Mental Hygiene, which is overseeing the effort with the federal government, expects total enrollment to reach only 60,000 to 75,000 people by the Aug. 31 deadline, short of an original target of about 100,000.

Tracking down potential participants for the study can't be done as simply as going door to door, as public-health officials did to chart radiation exposure following the 1979 nuclear accident at Three Mile Island. Many of the people caught in the 9/11 dust cloud had commuted from distant suburbs; some of their businesses never returned.

Some medical experts complain that low participation in the registry means scientists and the general public may never get a complete picture of the long-term physical and psychological aftermath of the World Trade Center attacks. "If you're going to detect increased rates of illness, you need a large population with high rates of participation," says Stephen Levin, a physician who runs a screening program at New York's Mount Sinai Hospital for Ground Zero workers and volunteers. Nearly half the 11,500 Ground Zero workers screened at Mount Sinai suffer from persistent respiratory problems, and 60% have psychological distress.
The World Trade Center Health Registry, drawn from a much wider pool, needs to enroll 60% to 80% of those eligible if it is going to accurately detect changes in various illness rates, Dr. Levin and other experts say.

The registry collects medical information from participants in a 30-minute telephone interview and provides them with a resource guide for medical assistance. The registry itself doesn't offer medical exams or treatment for those who are ill. Registry officials plan to contact participants periodically during the next 20 years.
 
Write to Betsy McKay at betsy.mckay@wsj.com2 and Christopher Windham at christopher.windham@wsj.com3
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