A study published last month showed the average decline in lung function among
firefighters who were at Ground Zero one year after Sept. 11 was the equivalent of 12 years of aging.
Doctors who treat World Trade Center responders say they are surprised
almost five years later by the growing number seeking help for the
first time - 100 people a month in the biggest monitoring program - and
by the severity of illnesses among Sept. 11 workers already in
treatment.
"There's no question there's continuing demand and many in the
treatment program are quite ill," said Dr. Robin Herbert, codirector of
the World Trade Center Worker and Volunteer Medical Screening Program
at Mount Sinai Medical Center in Manhattan.
Herbert, whose
program has examined about 15,000 responders since 2002, said doctors
are finding "remarkable persistence" in breathing disorders such as
chronic sinusitis and asthma, stomach ailments such as gastrointestinal
reflux disease and psychological problems such as post-traumatic stress
disorder - a suite of maladies one survivor called "my 9/11 plague."
Some patients also have come in with severe lung scarring, which can be fatal.
And there have been cases of cancer, which worries experts, though they
are unwilling to directly attribute them to exposure to Ground Zero
toxins.
Doctors are also surprised by the numbers of new
patients. Mount Sinai's screening program sees 100 new people a month,
Herbert said.
Despite adding more health care providers,
Herbert said that for the last six months the waiting list for
treatment has grown to more than three months. "We honestly did not
expect such ongoing demand," she said.
Dr. Ben Luft, program
director for Long Island's World Trade Center monitoring program at
Stony Brook University Hospital, which is following about 1,800
workers, said about 250 new workers from Long Island have come to the
program in the past year.
"It's very surprising. Originally, we
felt these are people who had an acute exposure and acute reaction, and
we didn't think we were going to continue at this level for five years
after exposure," said Luft, whose program, like Mount Sinai's, follows
and treats Sept. 11 responders.
In some, he said, there
appears to be "a period of latency" before symptoms develop. In others,
symptoms have worsened over time, becoming bad enough to drive the
person to seek help for the first time. "There's a chronic, progressive
element to this," he said.
Herbert said she is also concerned
about a small number of cases of lung scarring similar to that which
killed Det. James Zadroga, 34, of Little Egg Harbor, N.J., in January.
The coroner there found swirls in Zadroga's lungs caused by foreign
material, which he linked to Ground Zero dust - the first death to be
officially tied to World Trade Center exposure.
"We're
concerned because now we have a very small number of World Trade Center
responders with much more serious lung-scarring diseases," Herbert said.
Luft said he has also seen a handful of such cases.
Dr. David Prezant, chief medical officer in the New York Fire
Department's Office of Medical Affairs at Montefiore Medical Center,
said he also has seen some cases of lung scarring among the 14,000
firefighters and emergency medical workers being monitored. He believes
larger numbers of scarring cases and other diseases may show up in
"another wave" decades from now.
Prezant coauthored a study
published last month that showed the average lung function decline
among firefighters who were at Ground Zero one year after Sept. 11 was
the equivalent of 12 years of aging.
World Trade Center
workers are exchanging stories of cancers in colleagues - especially of
the blood, kidneys and pancreas - they believe are the result of
inhaling and ingesting pulverized cement, glass fibers and other toxic
substances at Ground Zero.
"We have a rough estimate of 200 to
300 people who are between the ages of 30 and 50 [with cancer]," said
Jon Sferazo, 51, of Huntington Station, presiding officer of Unsung
Heroes Helping Heroes, an advocacy group for Sept. 11 responders.
"These cancers seem to be occurring in people far too young," he said.
Doctors are unwilling to link the cancer cases and exposure to Ground
Zero toxins because it generally takes years for cancers to develop -
but they are tracking them closely. "We don't know if these are just
normal, sporadic cases or if a pattern is developing. The methodology
[in monitoring patients] has to be vigilant," Luft said.
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