Health consequences of the September 11 World Trade Center attacks: a review

Our plain-English summary of Health consequences of the September 11 World Trade Center attacks: a review, by J. Moline, R. Herbert, N. Nguyen (Cancer Investigation, 2006).

The study

• Authors: J. Moline, R. Herbert, N. Nguyen
• Journal: Cancer Investigation
• Published: 2006;24(3):294-301
• Type of article: Review
• Cited by: 22 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

In the aftermath of the September 11 World Trade Center (WTC) attack, a large number of people sustained potential exposures to smoke, dust, particulate matter, and a variety of toxins, including asbestos, pulverized concrete, glass fibers, polycyclic aromatic hydrocarbons (PAHs), and polychlorinated furans and dioxins. Additionally, many had exposure to psychological traumatogens. The most common effects seen to date are respiratory and mental health consequences. The long-term consequences of exposures are not yet known, and there remains concern about the potential for late-emerging diseases such as cancers. This article reviews WTC-related health effects, the spectrum of exposures and how they were documented, and discusses future preventive efforts.

In plain English

This article was a review of published research on the health effects of the September 11, 2001 World Trade Center (WTC) attacks. It covered the exposures involved, how they were documented, and future prevention. It reported no new data. The authors cited an estimate of 250,000–400,000 people with WTC-related exposures in New York. Settled WTC dust contained pulverized cement, glass fibers, asbestos and other substances. Among the studies reviewed, one found that 90 percent of New York City firefighters working at the site in the first 48 hours had an acute cough. Another found that 33 percent of screened workers and volunteers had abnormal spirometry, a breathing test. A report on one firefighter with acute eosinophilic pneumonia found large numbers of asbestos fibers in fluid washed from the lungs. Studies of nearby residents and office workers found respiratory and mental health symptoms. The authors noted that cancers that might be related to the WTC were not expected to appear for 20 years or more. They concluded that people who worked or volunteered at the site should have periodic screening examinations.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Review of published literature on WTC-related health effects, exposures and prevention; no new data collected
• Who was studied: People with WTC-related exposures in New York (estimated 250,000–400,000), as covered by studies of firefighters, police, other rescue and recovery workers and volunteers, nearby residents, office workers and pregnant women
• Exposure: Smoke, dust and particulate matter from the collapse and fires. Settled dust contained pulverized cement, glass fibers, asbestos, PAHs, PCBs, and polychlorinated furans and dioxins. The article does not specify the asbestos fiber type. The article also covers psychological trauma.
• Main results:
  • A reviewed study (Prezant et al.) found that 90 percent of New York City firefighters working at the site in the first 48 hours complained of an acute cough
  • In reviewed research, firefighters present on September 11 were 7.8 times more likely to show airway hyperreactivity at 6 months than firefighters with lower WTC exposures
  • In reviewed health assessments of rescue, recovery and restoration workers and volunteers, 33 percent had abnormal spirometry
  • A reviewed single-patient report (Rom et al.) found that lung fluid from a firefighter with acute eosinophilic pneumonia contained large numbers of asbestos fibers, along with other particles
  • In a reviewed study of WTC-area residents, new-onset cough, wheeze, chest tightness and shortness of breath occurred at rates 3–6 times those of unexposed controls
  • In a reviewed study of lower Manhattan office workers (Trout), 32 percent of the New York City workers had depressive symptoms and 25 percent had PTSD symptoms
  • Only 18 percent of FDNY responders wore respiratory protection on September 11, 2001
• The authors' conclusion: The authors concluded that, because the WTC disaster produced a complex mixture that included known carcinogens, people who worked or volunteered at the site should undergo periodic screening examinations
• Limitations the authors state:
  • Cancers that might be related to the WTC were not expected to appear for 20 years or more, so long-term effects were not yet known
  • The healthy worker effect may make it difficult to estimate the full extent of WTC health effects

Related studies

• The legacy of World Trade Center dust — J.M. Samet, A.S. Geyh, et al. (2007)
• Health and environmental consequences of the world trade center disaster — P.J. Landrigan, P.J. Lioy, et al. (2004)
• Assessing truck driver exposure at the World Trade Center disaster site: personal and area monitoring for particulate matter and volatile organic compounds during October 2001 and April 2002 — A.S. Geyh, S. Chillrud, et al. (2005)
• Development of an exposure assessment method for epidemiological studies of New York State personnel who responded to the World Trade Center disaster — M.L. Herdt-Losavio, M.P. Mauer, et al. (2008)
• Characterization of the dust/smoke aerosol that settled east of the World Trade Center (WTC) in lower Manhattan after the collapse of the WTC 11 September 2001 — P.J. Lioy, C.P. Weisel, et al. (2002)
• Potential carcinogenic effects of world trade center dust after intratracheal instillation to Sprague-Dawley rats: first observation — M. Soffritti, L. Falcioni, et al. (2013)

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