Health Care and 9/11--Nine Years Later

On a bright, sunny day on September 11,2001, just a short nine years ago, the world changed forever at 8:46 a.m. Eastern Time when the first of four passenger planes were highjacked by terrorists. According to 911Timeline.net, American Airlines Flight 11 impacts the north side of the North Tower (1 World Trade Center) of the WTC between the 94th and 98th floors. American Airlines Flight 11 was flying at a speed of 490 miles per hour (MPH), killing everyone on board. Minutes later, at 9:02:54 a.m., United Airlines Flight 175 impacts the south side of the South Tower of the WTC between the 78th and 84th floors at a speed of over 500 MPH, killing everyone on board. Parts of the plane including an engine leave the building from its north side, to be found on the ground up to six blocks away.

According to 911Timeline.net, what happened next was another horrific scenario taking place in Washington, DC, only a few minutes later. At 9:37 a.m., American Airlines Flight 77 is lost from radar screens and impacts the western side of the Pentagon, erupting in a huge fire ball and killing everyone on board. The section of the Pentagon hit consists mainly of newly renovated, unoccupied offices. Next, the unthinkable happens. At 9:59:04 a.m., the south tower of the World Trade Center suddenly collapses, plummeting into the streets below. A massive cloud of dust and debris quickly fills lower Manhattan. Several hundred miles away over the verdant green pastures in Southwestern Pennsylvania, another tragedy in this ongoing story is about to happen. About four minutes after the first collapse of the Twin Towers in New York, at 10:03 a.m., according to the FBI, the cockpit voice recorder stops and United Airlines Flight 93 crashes near Shanksville, Pennsylvania, in Somerset County, about 80 miles southeast of Pittsburgh.

Now, finally, as inconceivable as it was incredible the final blow happens only a short few minutes after the fourth airliner is down. At 10:28 a.m., the North Tower of the World Trade Center collapses. As the world watches in stunned amazement and disbelief, the lives of over 3,000 individuals had been snuffed out like a candle by the worst terrorist attack ever to take place on American soil. Over and over and over all day long, the images of these tragic events were played by every TV station on the planet while Americans sat in utter horror and despair. What had happened? How could this have taken place, and who was responsible? What would the nation do to recover? Questions lingered for days and weeks like the heavy smoke over the debris in lower Manhattan.

Since those events took place, America has been in a protracted war on terror against enemies both foreign and domestic. The lives of thousands of service men and women have been lost in the conflict, but the health of the nation they protect has been kept secure. However, the health of individuals affected by 9/11 has been studied over the past nine years has had some significant medical implications for those who were involved. According to NYC.gov, more than 400 New York City firefighters and police officers lost their lives as a result of the terrorist attack on the World Trade Center (WTC). Many other people at the scene that day and in the weeks that followed also witnessed horrific events at close range, including the loss of colleagues and the gruesome recovery and removal of body parts. In addition, more than 91,000 rescue, recovery and clean-up workers, and volunteers—including virtually all of the Fire Department of New York (FDNY)—were exposed to the environmental hazards at Ground Zero during their work on “the pile” and at other WTC-related locations in the days and months that followed.

Nearly 4 percent of the 25,000 rescue and recovery workers enrolled in the World Trade Center Health Registry report developing asthma after working at the WTC site according to a survey conducted in 2003 and 2004, according to NYC.gov. This rate is higher than what normally would be expected for the adult population during such a time period. Analysis of survey data indicated that arriving soon after the buildings collapsed, or working on the WTC pile over a long period, increased the workers’ risk of developing asthma. Workers who arrived on September 11, 2001, and worked more than 90 days reported the highest rate of new asthma (7%). FDNY members, nearly all of whom responded to Ground Zero within the first week of the attacks, suffered the most intense degree of exposure to the toxic mix of dust and chemicals at Ground Zero.

On September 11, 2001, approximately 25,000 children were living or attending school in lower Manhattan, some in close proximity to the WTC, according to NYC.gov. Within hours of the disaster, the New York City Board of Education provided principals and teachers with guidance on addressing the immediate needs of students. The Board recognized, however, that children in public schools needed immediate, expanded mental health services—including grief counseling, early intervention for post-traumatic stress disorder, and assistance managing fear, anxiety and anger—that could not be provided by the existing staff of school-based mental health professionals. Additionally, more than 400,000 people were in lower Manhattan the morning of 9/11, including thousands of office workers, small business owners, city employees, visitors and others. They fled at different times after the attacks. Some found their offices and stores buried under dust and debris when they returned. Others worked for months where the dust was less visible. Because of different exposures, it has been more difficult to determine how this group’s health was affected by 9/11.

According to MedicalNewsToday.com, since the 9/11 event, a cough has been developed by people working at and near ground zero. They thought the cough would eventually go away - unfortunately, they have intensified and the number of victims is growing. It seems the cause of these respiratory conditions is simply being in or near the area where the buildings collapsed. The scale of the consequence of breathing in the asbestos-laden dust is still unclear, although the complaints are in the thousands of individuals, including several thousand firefighters with various respiratory complaints. Not only was there asbestos in the air. There was lead from smashed computers as well.

According to Mesotheliomasos.com, first responders and New York City residents are now dying of mesothelioma and being sickened with other asbestos-related disease. Doctors and scientists have long predicted that, in years to come, the nation would be seeing an onslaught of mesothelioma cases in greater New York City, caused by the tons of asbestos that rained down on fire fighters, police officers, paramedics, and those who lived and worked near the World Trade Center. At the time of the disaster and for some time afterwards, most of Lower Manhattan was covered with a grayish dust--what’s been reported as a frightening combination of substances such as glass shards, asbestos, fiberglass, pulverized concrete, lead, mercury, cadmium, dioxins, and PCB’s. Many first responders suffered almost immediate health problems, and those who’ve studied the potential hazard of asbestos caused by the collapse of the World Trade Center estimate that more than 110,000 people may have suffered serious exposure. These same reports show that in the haste to clean up the debris, proper precautions were not taken to protect workers from harm nor were standard and necessary asbestos abatement procedures followed. This resulted in even more exposure.

Currently, Congress is debating health care legislation that will help to compensate these victims of 9/11, especially in the collapse of the WTC towers in New York. Although the events were tragic and life-altering, the need to provide assistance to these families and individuals should not be overlooked. A House version failed to pass during the summer, but with renewed support from the White House, a revised bill may be introduced this fall for passage.

Since September, 2001, Americans have fought to keep their lives normal. But those who witnessed the events in New York, DC, and Pennsylvania will always be affected on a personal level for the rest of their lives. According to the National Institutes of Health, in addition to hazardous chemical and physical environmental exposures, the working conditions at the WTC involved exposures to serious psychosocial stressors, including long hours and arduous work, treacherous and chaotic working conditions, fear for personal safety, and handling body parts and personal effects of victims, or working in close proximity to such operations. Post Traumatic Stress Disorder (PTSD) prevalence has been comparable to that seen in returning Afghanistan war veterans and was much higher than in the U.S. general population. Comorbidity has been found to be extensive and included extremely high risks for impairment of social function. PTSD was significantly associated with loss of family members and friends, disruption of family, work, and social life, and higher rates of behavioral symptoms in children of workers; and psychological distress and psychopathology in WTC workers greatly exceed population norms.

As America observes the ninth anniversary of 9/11, the country has rebounded with a spirit that has kept the spiritual and emotional levels intact. Of course, the nation struggles daily with the war between good and evil. Religious tolerance is still an ongoing battle as the division between Christianity and Islam continues to widen, even though many are working toward resolution of ideological differences. The eternal conflict between the forces of darkness and the forces of light is not going away. The US armed forces are still in a protracted effort to maintain peace in areas of the world that hate America and all for which it stands--freedom, love of country, national pride, capitalism, and family values. Although the long term effects have yet to be determined, enough time has elapsed to show that the physical health of those most closely associated has been profoundly affected. Also, the mental stress has had lingering effects on everyone who experienced the events first hand on that day. The nation is dealing with the ongoing nature of an event that changed the way people function--travel, security, healthcare, finance, and more.

As long as there are Americans, the nation will remember what happened on September 11, 2001. We will never forget!

Until next time. Let me know what you think.