The World Trade Center Disaster and the Health of Workers: Five-Year Assessment of a Unique Medical Screening Program

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Background. Approximately 40,000 rescue and recovery workers were exposed to caustic dust and toxic pollutants following the September 11, 2001 attacks on the World Trade Center (WTC). These workers included traditional first responders such as firefighters and police and a diverse population of construction, utility, and public sector workers...
Results. Sixty-nine percent of 9,442 responders examined between July 2002 and April 2004 reported new or worsened respiratory symptoms while performing WTC work. Symptoms persisted to the time of examination in 59%. Among those who had been asymptomatic before 9/11, 61% developed respiratory symptoms while performing WTC work. Twenty-eight percent had abnormal spirometry. FVC was low in 21% of our population. Obstruction was present in 5%. Among non-smokers, 27% had abnormal spirometry vs. 13% in the general U.S. population. Prevalence of low FVC among nonsmokers was five-fold greater than in the U.S. population (20% vs. 4%). Respiratory symptoms and spirometry abnormalities were significantly associated with early arrival at the site.
Conclusion. WTC responders had exposure-related increases in respiratory symptoms and PFT abnormalities that persisted up to 2.5 years after the attacks. Long-term medical monitoring is required to track persistence of these abnormalities and identify late effects, including possible malignancies. Lessons learned should guide future responses to civil disasters.