NEW YORK – A cloud of dust gripped Carl Sedler near the East River, drying his clothes and hair as he searched his way out of Manhattan after fleeing his office at the World Trade Center.
Gray powder from the open windows and ceiling door of Maryma James’s downtown apartment is going into her carpets and children’s bedroom furniture.
Barbara Burnett, a police detective, spit mascara from her mouth and throat for weeks as she worked on a pile of burning debris without a protective mask.
Today, these three are among the more than 111,000 people enrolled in the World Trade Center Health Program, which provides free medical care to people with health problems.
Two decades after the fall of the Twin Towers, people are still coming forward to report diseases that may be related to the attacks.
To date, the United States has spent 11 11.7 billion on care and compensation for those exposed to dust – about 4. 4.6 billion more than the families of those killed or injured on September 11, 2001. Compensation from government funds for people with possible attack-related illnesses.
Scientists cannot yet say how many people have developed health problems as a result of tons of polarized concrete, glass, asbestos, gypsum and God knows what happened to Lower Manhattan when the tower collapsed.
Many of the people involved in the health program have common conditions, such as skin cancer, acid reflux or sleep apnea. In most cases, there is no test that can tell if someone’s illness is related to trade center dust, or the result of other factors, such as smoking, genetics or obesity.
Over the years, this has caused some friction between patients who strongly believe they have 9/11-linked disease, and doctors who suspect it.
“Most people thought I was crazy at the time,” says Mariama James.
She initially had a hard time convincing doctors that she had a chronic ear infection, bone problems and asthma that was bothering her children, or that she was out of her apartment because of her own shortness of breath. It has nothing to do with dust.
Years of research have produced partial answers to health problems such as 9/11. The largest number of people enrolled in the Federal Health Program suffer from chronic inflammation or reflux disease of their sinuses or nasal cavity, a condition that can cause symptoms including irritation, sore throat and chronic cough. Are
The reasons for this are not well understood. Doctors say it could be related to their bodies being caught in a cycle of chronic inflammation that is initially caused by burning dust.
Post-traumatic stress disorder has emerged as one of the most common, permanent health conditions, affecting approximately 12,500 people entering the health program. About 19,000 registrants have a mental health problem that is thought to be linked to the attacks. More than 4,000 patients have some form of chronic obstructive pulmonary disease, a family of potentially debilitating breathing difficulties.
Time has helped cure some physical ailments, but not others. Many of the first responders who developed a chronic cough later got rid of it, or disappeared completely, but others showed little improvement.
According to fire department research, about 99% of firefighters suffer from dust, which is a persistent cough. About 22 percent report shortness of breath. About 40% to 40% have chronic bone problems or acid reflux.
Tests of fire department personnel who spent time on the ground zero found that their lung function was usually 10 to 12 times lower than expected due to aging in the first year after 9/11.
Encouragingly, doctors say their worst concerns about a possible 9/11 deadly cancer wave have not been met.
Not yet, at least.
In the last two decades, about 24,000 people have been diagnosed with mall dust cancer. But for the most part, this has been at the rate that researchers expect to see in the general population. The most common cause is skin cancer, which is usually caused by sunlight.
Rates for certain types of cancer – including malignant melanoma, thyroid cancer and prostate cancer – have been found to be moderately high, but researchers say this is due to more cases being caught in medical surveillance programs. Can be from
“We don’t really have a high level of cancer that I was afraid of,” said Dr. Michael Crane, director of the World Trade Center Health Clinic in Mount Sinai. “I was afraid we were going to get lung cancer.”
A study shows that city firefighters and paramedics who are exposed to trade center dust have a lower cancer mortality rate than most Americans, possibly because of repeated medical screenings. Caught quickly.
Beneficiaries of the screening include people like Burnett, who was initially treated at the Mount Sinai Clinic for a lung disease.
During one of those visits in 2017, a scan wound up detecting lung cancer.
“If I hadn’t been to the program, or seen Dr. Crane, I don’t know if he’d got it,” Burnett said. Since then, she has undergone two rounds of chemotherapy. It has not cured him, but it has kept cancer at bay.
In the early years of the Federal Health Program, many of the registrants were police officers, firefighters and others working on the rubble. Recently, though, most of the requests have come from people who worked or lived in Lower Manhattan – people like Carl Sadler, who were in Morgan Stanley’s 76th floor office in the South Tower of the Trade Center when he The hijack was hit by a plane. .
“Millions of pieces of paper were flying. Credentials. Computers,” says Solder. “We saw the chairs fly as if they had people in them.”
He worked his way down the stairs and escalators, then walked away with the crowd. “When we got to Water Street, just a block from Fulton Fish Market, there was a huge explosion and the clouds and everything turned to black ash and gray and we were covered with mascara,” he says.
At first, Sadler’s health looked fine. But a few years after the attacks, he began exercising and suffering from recurrent bronchitis. In the 60’s, he had to give up some outdoor activities like skiing and football.
“I just had trouble breathing,” he says, “but I never knew what they were.”
Now in his 80s, he was diagnosed with acid reflux disease, asthma, and thyroid cancer and skin melanoma for many years, for which he was successfully treated. He thought it was only part of his approaching old age in 2017, when a friend suggested that he register with the World Trade Center Health Program.
“He said, ‘You have a lot of health problems. You have a lot of health problems. You have to register,'” Sadler said.
Another 6,800 people joined the health program last year. Not all of its members are currently ill. Many people have signed up to be diagnosed with cancer in the future. Some have clarified their terms. According to program statistics, last year, the program treated about 1,000 patients and about 30,400 outpatients.
The Affected Compensation Fund, which pays for people suffering from attacks-related illnesses, has an unlimited Congress budget, but the medical program has grown so much that it could run out of money. Members of Congress have introduced a bill that would provide an additional 2. 2.6 billion over 10 years to cover the expected funding gap starting in 2025.
Under the program, anyone who worked or lived in Lower Manhattan or a small piece of Brooklyn is eligible for free care if they develop certain illnesses. The list includes about a dozen types of airway or digestive disorders, 10 different psychiatric disorders and at least two dozen types of cancer.
Research is also underway to add to the list of possible coverage situations. Dr. John Howard, the program’s administrator, says the conditions being studied now include autoimmune diseases such as rheumatoid arthritis.
An initial estimate was that it could cover a maximum of 490,000 people, in part because people do not have to prove that their illness was linked to the 9/11 attacks. If a person has a condition on the list, he or she is considered eligible.
“We cover lung cancer, regardless of attribution issues,” Howard said. “If you have lung cancer, we don’t go through the analysis of how many pack years you have been smoking.”
Looking through the lens of public health, what could happen to the next 20 years after 9/11 for those who were there this morning, and in the days and weeks that followed?
The average age of enrollment in the Federal Health Program is close to 60, and Dr. Jacqueline Mullen, director of the World Trade Center Health Clinic at Northwell Health Medical Systems, is concerned that people’s health problems may worsen with age. Will Cancer caused by asbestos, he noted, can take up to 40 years to develop after exposure.
“We’re just getting to the point where we can start seeing things,” Mullen said. He is also deeply concerned about the long-term effects of post-traumatic stress disorder.
In addition to psychological damage, there is a risk that persistent shocks of adrenaline and other stress hormones that come with PTSD can worsen heart problems or weaken the immune system. And with that, the emotional and physical waves of a day in September 20 years ago can strike in new and weak ways.
Crane, who has been treating Ground Zero respondents since the beginning, says one thing is clear based on the constant flow of new patients: the problem is not going away.
“They keep coming,” he says. “They keep coming to the door.”