Waiting to Inhale: Six Months Later, Thousands of New Yorkers Still Suffer Health Ills
By Francesca Lyman, MSNBC, March 11, 2002

    It took months to arrive at a realistic estimate of the number of dead at Ground Zero, but it will take years to assess the damage to people's health from the World Trade Center attacks, say medical experts. Six months after Sept. 11, though, a picture is emerging of thousands still suffering from persistent respiratory ailments, headaches and more serious illnesses. Although some are healing, others fear they never will.
    Gone is the smoke that once pervaded downtown Manhattan. But, as spring approaches, fires still explode out of the massive wreckage where thousands of workers sift through rusted remains. Workers at "the pile" are still strained by battle fatigue, says Sgt. David Duffy of the New York Police Department. "We just pulled out another two bodies, and those families are going to have to relive those traumas in more funeral services," he says, pausing to cough. "Yes, everyone at the PD has some kind of nagging cough, with some worse than others — young guys hacking like two-pack smokers, and some cases of pneumonia."
    The air is far cleaner and the dust largely gone today, but many people living and working downtown feel that the neighborhood is far from back to normal. Some continue to stay away until their health fears are resolved. "There's no way you can say that the air is clear here. You see particles everywhere, and there are still things flying in your eyes," says Dana Conte, an asthma sufferer.
    Conte is looking forward to returning to her job as a bartender/server, when the Marriott Financial Center Hotel reopens its lobby cocktail lounge on Monday. But she is also fearful. "I'm playing with fire going to work here," she says. Her allergies, chronic sinusitis and asthma worsen as soon as she comes downtown.
    Just as people once traded tragic stories about lives lost in the terror attacks — the secretary who went back to her office to get her flats so she wouldn't have to run in heels, then never returned; the man who escaped the building only to find out that his sister was in the plane that hit his building — New Yorkers now circulate stories about people whose health has been injured in the line of duty.
    One of the most poignant is the tale of Carolyn Rogers, a case worker for the New York Coalition for the Homeless, at Chambers Street near the World Trade Center, who was taken to Beekman Hospital by ambulance and treated for acute asthma on Sept. 11. Her dedication drove her back to work within a few days, says Mary Brosnahan, director of the nonprofit group. Rogers collapsed on the floor of an asthma-induced heart attack and died, Brosnahan says.
    Public health specialists are just beginning to study the impacts of the most devastating attack on American soil since the Battle of Antietam — and New York City's worst environmental calamity — but the first reports reveal widespread health effects affecting thousands.
    In a new report, the Natural Resources Defense Council, a non-profit environmental organization, estimates that the huge cloud of debris and dust that engulfed Lower Manhattan released hundreds, if not thousands of contaminants into the air — with "short-term health impacts for at least 10,000 persons." That estimate comes from looking at health reports from three downtown neighborhoods, records from area hospitals and firefighter and other worker registries, says lead author Eric Goldstein. "We think this is almost certainly an undercount and that [the health toll] could well be double that," he says.
    Doctors still see patients for a wide variety of ills related to the events. "They're still coming in at regular rate. While it's not a flood, I see at least several people a week with respiratory problems that date back to Sept. 11," says Neil Schachter, medical director of respiratory care at Mount Sinai Hospital in New York. "Besides physical symptoms, there's a lot of anxiety," says Schachter. "My patients are afraid of what it might mean. Is that a cough or is a sign of something deeper?" Even untrained people know that a respiratory condition should only last a few weeks, not months, he says.
    Part of the anxiety may derive from the fact that the Ground Zero air pollution was so unique. Because of the unusual mix of chemicals and their synergistic effects, even environmental medicine specialists can't say low long some illnesses may last. Sensitivities may be different for children, elderly and workers, says Marjorie Clarke, an adjunct professor of environmental science at Hunter College.
    Another aspect of some people's anxiety, say some, is lost faith in the agencies that were supposed to protect them. For example, some say that the government declared too soon it was safe for people to return to the area without having sufficiently tested indoor dust.
    "The agencies are now acknowledging some of the problems they overlooked," says Joel Kupferman, director of the New York Environmental Law and Justice Project, referring to the fact that the Environmental Protection Agency is setting up a task force to look more carefully at indoor environments, following concerns expressed by downtown residents at a hearing held by Sen. Hillary Clinton in February. "But the agencies shouldn't have said, ‘Everything's okay' [as quickly as they did]," he says. "Because people went back to work in offices not properly cleaned, in apartments covered in dust." "The credibility gap played into people's worst fears," agrees Joel Shufro, director of the New York Committee for Occupational Safety and Health. Now, says Shufro, residents aren't sure if their apartments are clean enough, or even what the standard should be.

EPA MORE CAUTIOUS NOW

    The EPA's New York regional office, which had declared downtown Manhattan safe to reinhabit, now is a bit more cautious. "What we've been saying is that based on all our readings there are no significant long term hazards here," says EPA's Bonnie Bellow. "But workers must wear respirators, and people returning to dusty apartments and offices need to take special precautions, like getting them professionally cleaned or using special gear, like masks and HEPA vacuum cleaners. We're working with other local authorities and agencies to address people's ongoing concerns."
    Bellow said that EPA administrator Christie Whitman has set up a task force to address indoor environments so that people can get help evaluating whether their homes and offices are safe. EPA's monitoring has found that about 35 percent of the outdoor dust samples contained asbestos, she adds.
    The largest group affected are those already suffering from pre-existing allergies, asthma and respiratory problems, says Dr. Clifford Bassett, an allergist affiliated with Long Island College Hospital who operates an office at Liberty and Broadway, located across the street from the former World Trade Center.

ON THE SCENE

    But worst afflicted, say doctors, are those working directly at Ground Zero — firefighters, police officers, rescue workers and volunteers. Dr. Suhail Rahoof, chief of pulmonary and critical care medicine at Nassau University Medical Center in East Meadow, N.Y., is partly finished with a study to look at the health of these so called "first-responders."
   His initial findings reveal that the first signs of an asthma-like disorder caused by exposure to irritants are beginning to show up in people who worked as little as an hour at Ground Zero. Rahoof, who has so far studied 60 rescue workers who put in as many as 400 hours at the site, says more than half have had abnormal pulmonary tests results. More than 85 percent failed to wear protective gear.
    Today, more of the ironworkers, electricians, salvage workers and others at Ground Zero are trying to wear respirators, says NYPD's Duffy. "But it's hard to do," says Duffy, "because with all the heavy machinery, front-end loaders, tractor-trailers, cutting saws, you can't be heard and can't leave your respirator up all the time."
    Totally unprotected by respirators were many day laborers hired by landlords, says Dr. Steven Markowitz, director of the Queens College Center for the Biology of Natural Systems, Latin American Workers Project and NYCOSH, who ran a mobile van offering health care. "We were surprised by how many flocked to use for free medical advice, many of whom were sick months after having stopped cleanup work," says Markowitz. He says he treated 400 workers for nearly identical symptoms: upper respiratory irritations, headaches and dizziness.
    As for the general public, some doctors say that downtown residents are healthier than expected, considering the scale of the destruction and sheer volume of dust. And many say at least a few of their patients are getting better. "It could have been Bhopal — where they was a high percentage of very hazardous chemicals — terrible eye injuries, burns and blindness and a chronic lung diseases," says Mt. Sinai's Schachter. "What we've seen here is nothing by comparison."

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