15 Years Later, 9/11 Is Still Killing People

Cancer. Lung Disease. PTSD. Years after the horrific attacks, the heroes and victims of 9/11 are still suffering

American flag flies near the base of the destroyed World Trade Center — (REUTERS)
Sep 09, 2016 at 10:26 AM ET

It’s hard to pinpoint just how many Americans were killed in the horrific terrorist attacks of September 11, 2001. On 9/11 itself, the official death toll was 2,974, including deaths at the World Trade Center and the Pentagon. But one year later, a civil rights lawyer who had worked in the World Trade Center succumbed to lung disease caused by the fumes. And since then some estimates suggests that up to 1,400 rescue workers have died from complications directly linked to 9/11.

Now, a special issue in the American Journal Of Industrial Medicine chronicles the cancer clusters, heart and lung disease, and mental health problems that have emerged in the aftermath.

More These Post-9/11 War Films Combined Made Over $900 Million

Despite occasional hiccups, the United States government has done a reasonably good job of covering the long-term health costs of 9/11. After a high-profile 2010 lobbying battle that involved Jon Stewart, President Obama finally signed the Zadroga Act in early 2011, allocating $4.2 billion to create the comprehensive World Trade Center Health Program. The Program continues to provide free medical monitoring and treatment for those who stood in the line of fire in the days after 9/11.

Through the program we’ve learned that 1,140 survivors and rescue workers have been diagnosed with cancer and that thousands suffer from heart disease, lung disease and mental health problems. Fifteen years later, here’s what we know about the lingering health effects of 9/11:

The WTC Cancer Cluster

Physicians now believe that nearly 70 types of cancer may be linked to Ground Zero fumes. That’s because cancer-causing material continued to billow across Lower Manhattan as a cloud of carcinogens drifted across the carnage. “We will never know the composition of that cloud, because the wind carried it away, but people were breathing and eating it,” Michael Crane, also of the WTC Health Program, told Newsweek. “What we do know is that it had all kinds of god-awful things in it. Burning jet fuel. Plastics, metal, fiberglass, asbestos. It was thick, terrible stuff. A witch’s brew.”

But cancer can take decades to develop and, even 15 years later, it remains unclear just how serious the situation will become. One study by the New York City Fire Department found that firefighters who worked at Ground Zero were at greater risk of cancer than the average firefighter. Another study from the WTC Registry found small increases in the rates of prostate cancer, thyroid cancer and blood cancers among nearly 34,000 registered rescue workers. And a third study from the WTC Health Program itself found increased rates of prostate and thyroid cancer among the 21,000 rescue workers enrolled in their program. “This research suggests that long-term monitoring of cancer occurrence among WTC-exposed individuals is warranted,” the Program says.

The special edition of the American Journal Of Industrial Medicine includes a handful of cancer studies and  the most comprehensive one included an overview of cancer rates among World Trade Center Health Registry enrollees between 2001 and 2011. Echoing prior research, the study found significantly higher rates of prostate, skin, thyroid, breast, blood, and bladder cancers among those who were living and working in Lower Manhattan in the days following the attacks. Nonetheless, the study concludes that the evidence for a link between these cancers and 9/11 itself remains weak. It’ll take many more studies to definitively establish a link between the attacks and cancer cases.

Choking On The Aftermath Of 9/11

The link between 9/11 and heart and lung disease is much better-established. The WTC Program claims an astonishing one in 10 enrollees developed asthma within six years of 9/11 — three times higher than the national average. Most of that is likely due to the dust cloud that hovered over Ground Zero for weeks. Indeed, the highest rates of asthma cluster around clean-up workers and Lower Manhattan residents who returned to their offices and homes before the thick coating of dust had lifted from their buildings. Among rescue workers, one study found four times as many Ground Zero firefighters now have below-normal lung function, compared to the general population.

Breathing tends to be tied up with heart function, and studies have shown that those who sustained injuries on 9/11 now have a threefold increased risk of heart disease. One small study of hospital records also found that 9/11 rescue workers stand at increased risk of heart-related hospitalization.

In the American Journal Of Industrial Medicine, the most interesting heart and lung study examined firefighters who were exposed to the World Trade Center dust cloud. They found that specific biomarkers known as cytokines can predict which rescue workers are at the highest risk of developing lung disease. While follow-up studies will be necessary, the new research could already be used to help the Program identify high-risk enrollees, and intervene before lung disease strikes.

PTSD: The Hidden Wounds Of 9/11

In 2011, a New York Times article described some of the mental health challenges that survivors and rescue workers face: “They cannot sleep. They replay the disaster in their minds, or in their nightmares.  They have trouble concentrating. They are jittery and overreact to alarms or loud noises. They feel helpless, hopeless, guilty and cut off from the people who are close to them. They avoid anything that reminds them of that terrible day.”

Indeed, one study estimates that 10,000 firefighters, police officers, and civilians exposed to the attack have since been diagnosed with post-traumatic stress disorder, a disease that afflicts survivors of terrorism, war, violence, and abuse with flashbacks and depression, often in response to certain “triggers” that remind victims of the horrors they witnessed. Studies suggest roughly 45 million people around the world — and eight percent of Americans — are living with PTSD. Survivors of 9/11 are four times more likely to suffer from PTSD than the general population, and the WTC Health Registry suggests at least 20 percent of adults who were on scene experience some form of PTSD.

PTSD can have odd effects on the shape of our recovering nation. For instance, a new study of 7,662 survivors published in the American Journal of Industrial Medicine sheds light on some of the economic impacts of a workforce stricken by PTSD. The study suggest that 9/11 survivors with PTSD are significantly more likely to lose their jobs, draw lower income, or choose to retire early.

“Disaster-related health burden directly impacts premature labor force exit and income,” the authors conclude. “Future evaluation of disaster outcome should include its long-term impact on labor force.”

The Heroes Behind The Suffering

Even 9/11 decayed into more disease and destruction came, heroes emerged from the ashes. John Soltes, a retired cop for the Port Authority of New York and New Jersey, spent nine months clearing debris and searching for human remains at Ground Zero. He has since been diagnosed with skin cancer, lung disease, and the often pre-cancerous condition Barrett’s esophagus. Yet Soltes adamantly told Newsweek that he has no regrets. “If I’d had to watch that on TV without doing anything, it would have driven me out of my mind,” he said. “It was better for me to be down there.”

“I know each and every one of us would do it again tomorrow.”