20 Years Later, 9/11 First Responders Face Long-Term Lung Conditions

This year marks the 20th anniversary of September 11, 2001. The physical and emotional effects have lingered for many of the people who were at ground zero on the day of the attacks as well as those who arrived at the site in the days of search, rescue, and cleanup that followed.

Researchers are still trying to identify the long-term health consequences of being at the World Trade Center (WTC) during those first few days. The police, firefighters, emergency personnel, volunteers, and people who worked or lived at the scene, were all exposed to intense smoke, thick dust, and chemical fumes that were released when the Twin Towers and other buildings collapsed.

Conditions were at their worst during the first 48 hours after the attack. Now, new data shows that the people who were there during that time might be experiencing the most severe health consequences 20 years later.

The research was presented on September 7 at the ERS International Congress.

High Risk for COPD

The study looked at data from nearly 18,000 people who are part of the World Trade Center Health Program, which provides medical monitoring and treatment of WTC-related health conditions for 9/11 responders and survivors.

Rafael de la Hoz, MD, MPH, a professor of environmental medicine and public health at the Icahn School of Medicine at Mount Sinai in Manhattan, tells Verywell that the program "is funded by congressional mandate and the funding agency is the National Institute for Occupational Safety and Health, a branch of the CDC." Mount Sinai, where de la Hoz works, has the largest center in the program.

The researchers looked at the results of the participants' spirometry tests (which measure lung function by seeing how much air a person can force out in one breath), which were done between 2002 and 2018.

The researchers found that:

• 3.3% of the people in the study have been diagnosed with chronic obstructive pulmonary disease (COPD)
• Of those with COPD, 40% also experienced asthma (a condition called asthma COPD overlap) and many of the people who were diagnosed with COPD had been diagnosed with asthma before 9/11

The incidence of COPD is 30% higher in the people who had arrived at the World Trade Center within 48 hours of the attack compared to the people who got there after.

The researchers also noted that the findings were independent of other COPD risk factors that the participants might have had, such as smoking, age, or obesity.

Preparing for Future Disasters

“More than 90% of my work has been related to the World Trade Center since 2003,” de la Hoz says, who has been evaluating the health of the people in the study since 2012 and has been diagnosing and treating former World Trade Center workers and volunteers for many years. “Besides treatment options, we seek means to prevent any further lung function loss and improve their health.”

Studying the long-term health consequences of being a first responder at the World Trade Center might help us figure out the best treatments and preventive care for the emergency workers who will be first on the scene of a future disaster.

According to de la Hoz, the research is valuable because “few groups like these workers have had the benefit of a longitudinal program to examine the adverse health effects that may or may not be related to their exposures and suggest preventive measures and treatment protocols that can be used in the future."