Debate Lingers on Air Quality After 9/11
By Amanda Gardner, HealthDay Reporter, September 11, 2003

Soon after the Twin Towers collapsed on Sept. 11, 2001, environmental scientist Paul Lioy took a sample of dust and debris from the windshield of a car near the ruins.

"It was nine or 10 centimeters thick, powerfully deep," he recalls.

At about the same time, Christine Whitman, then head of the Environmental Protection Agency (EPA), reassured the public that the air in downtown Manhattan was safe to breathe.

Today, two years after the terrorist attack on New York City, scientists still know little about the long-term, lingering health effects of the air. Quite clearly, though, that air was not safe to breathe.

A report issued by the EPA's inspector general in August found the White House had pressured the EPA to downplay the threat. Moreover, evidence is mounting that thousands of rescue workers had -- and continue to experience -- respiratory problems.

Why all the confusion?

Part of the problem is that environmental monitoring was simply not a priority in those first terrible days. "This was no simple event. The magnitude was overwhelming and the response was chaotic," says Lioy, who is deputy director of the Environment and Occupational Health Sciences Institute at the University of Medicine and Dentistry of New Jersey in Piscataway, N.J.

Monitoring devices were not immediately installed simply because the first priority was to rescue thousands of people who were thought to be alive in the rubble. "Environmental health was secondary to the immediacy of trying to rescue 15,000 people," Lioy says.

There were also vastly different levels of exposure. "Concentrations dropped off dramatically with distance," says George Thurston, an associate professor of environmental medicine at New York University School of Medicine. Also a factor was the time people spent at or near Ground Zero.

Another problem has been the lack of data for comparison. "The baseline data didn't exist, and of course the first question is how much worse is it now," says Sebastian Bonner, an educational psychologist with the Center for Urban Epidemiologic Studies at the New York Academy of Medicine. "You have to know how it was before, and we don't have that." Bonner is doing research into the prevalence of asthma and other respiratory problems in children between 3 and 5 years old in communities south of 14th Street in Manhattan.

One exception is that certain firefighting units had implemented databases monitoring lung function even before Sept. 11. "Now we know that this could be helpful in the future," says Dr. Ghulam Saydain, a pulmonologist and critical care physician at Nassau University Medical Center in East Meadow, N.Y.

Lioy and his colleagues have also developed a mathematical model to estimate exposure for different locations in Manhattan and Brooklyn. They are hoping that government and medical officials will make use of the model in trying to ascertain a variety of health effects.

Short-term effects have been easiest to see in rescue workers who spent extended periods of time at Ground Zero. Saydain is researching respiratory problems in just these people. Since 2001, his group has seen more than 600 people, mostly uniformed officers, who were at the ruins in the days and months after the attack. The individuals have accumulated from 200 to 1,500 hours or more at the site spread over months. Saydain estimates that only about 10 percent used the appropriate respiratory devices all the time. The rest took them off intermittently because of technical difficulties or because it was too hot.

About 75 percent of the individuals screened have complained of a cough (the infamous World Trade Center cough), half have reported shortness of breath, and there have also been complaints of wheezing, chest discomfort, sinusitis and non-respiratory symptoms such as fatigue and eye irritation, some lasting the entire two years.

"There were definitely short-term effects that we have seen and documented," Saydain says. "The long-term effects need to be seen. This is the kind of disaster that has happened for the first time."

And hopefully the last, although experts do believe the knowledge they are gaining will help with other types of disasters.

Meanwhile, researchers at the University of California at Davis found the debris at Ground Zero was a "chemical factory" that emitted fine pollutants into the lungs of people working there.

The debris was "brutal" for rescue workers who didn't have some sort of respiratory protection, study author Thomas Cahill says in a statement. "It cooked together the components of the buildings and their contents, including enormous numbers of computers, and gave off gases of toxic metals, acids and organics for at least six weeks," he notes.

"Officers who will be the first responders need to be prepared for this kind of disaster. They need to know the importance of respiratory protective devices and that they have to be used constantly and properly and those devices have to be available to them," Saydain says. "I think there is going to be research on producing devices which are more user-friendly so that they can be used for long-term purposes, and it should not be difficult to put them on and take them off."

In one sense, the work for researchers is just beginning. "We're going to have residual consequences so we can't minimize the time we study people," Lioy says. "It's a very interesting experiment in complex chemistry."

For more on environmental exposures after 9/11, visit the World Trade Center Environmental Contaminant Database. For more on the federal screening program, go to the World Trade Center Worker and Volunteer Medical Screening Program. You may also want to read the EPA Inspector General's report.

SOURCES: Ghulam Saydain, M.D., pulmonologist and critical care physician, Nassau University Medical Center, East Meadow, N.Y.; George Thurston, associate professor, environmental medicine, New York University School of Medicine, New York City; Sebastian Bonner, Ph.D., educational psychologist, Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York City; Paul Lioy, Ph.D., deputy director, Environment and Occupational Health Sciences Institute, University of Medicine and Dentistry of New Jersey, Piscataway, N.J.; University of California, Davis, news release

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