September 11, 2001 – Honoring the Past, Protecting the Present: The World Trade Center Health Program

September 11, 2001, is a day that remains etched in all our memories. The tragic events at the World Trade Center, the Pentagon, and in Shanksville, PA, changed our nation forever.  But beyond the immediate loss of life, another tragedy unfolded quietly in the months and years that followed - tens of thousands of responders, survivors, and community members began experiencing serious health problems directly related to their 9/11 exposure.

That’s why the World Trade Center (WTC) Health Program, managed by the National Institute for Occupational Safety and Health (NIOSH), is so critical. Established to provide medical monitoring and treatment, this program continues to serve those whose health was compromised by their bravery or simply by their presence in lower Manhattan during and after 9/11.  Today, more than 127,000 members are enrolled, including over 83,000 responders and 44,000 survivors.

Who is Eligible?

Eligibility is broader than many realize. You may qualify if you:

• Worked, lived, or went to school or daycare in the NYC disaster area between 9/11/01 and mid-2002.
• They were present in the dust cloud on 9/11.
• Performed rescue, recovery, cleanup, or related work at Ground Zero, the Staten Island Landfill, PATH tunnels, barge loading piers, the Pentagon, or Shanksville.

Even indirect roles—such as site security, administrative support, providing supplies, or working with the Medical Examiner’s Office—count toward eligibility.

Covered Health Conditions

The WTC Health Program recognizes and treats a wide range of certified WTC-related health conditions, including:

Top Health Conditions

• Respiratory diseases: asthma, chronic cough, sinusitis
• Digestive disorders: GERD, chronic acid reflux
• Mental health conditions: PTSD, anxiety, depression, trouble sleeping
• Cancers linked to toxic exposures
• Acute traumatic injuries sustained during response work

Many survivors and responders still don’t realize their health issues—persistent cough, runny nose, chronic heartburn, or ongoing anxiety—may be related to their 9/11 exposure.

Top Cancer Certifications

Where to Get Care

The program offers treatment through Clinical Centers of Excellence (CCE) in the New York metropolitan area, and for those outside NY, through the Nationwide Provider Network (NPN). Benefits include medical monitoring, prescription coverage, mental health care, and treatment tailored specifically to certified WTC-related conditions.

Why It Matters

The work of the WTC Health Program isn’t just about honoring those who served or survived—it’s about ensuring that no one is left behind in their fight for health. With over 400,000 people estimated to have been affected by 9/11, the program remains a lifeline for many and a reminder that the impact of that day continues.

On this September 11, we honor those we lost, but we also reaffirm our commitment to care for those still living with the health consequences of that day. The WTC Health Program, guided by NIOSH, ensures that the promise made in the aftermath—that we would not forget—continues to be fulfilled.

Call to Action: How to Apply

If you or someone you know may qualify for the World Trade Center Health Program, don’t wait:

• Visit the WTC Health Program website to learn more.

• Review the eligibility checklists for survivors and responders.

• Apply online or download an application to begin the process.

Getting connected to the program can provide access to the care, monitoring, and support needed to manage 9/11-related health conditions—and ensure no one faces these challenges alone.

Previous Posts Regarding 9/11

Re-Post of our 20 Year Anniversary of 9/11, 10-Year Anniversary of the World Trade Center Health Program. Lesson Learned?

Its Been 15 Years Since 9/11. 4 Things We Have Learned!

The Toxic Clouds of 9/11

Re-Post of our 20 Year Anniversary of 9/11, 10-Year Anniversary of the World Trade Center Health Program. Lesson Learned?

On September 11, 2001, Future Environment Designs (FEDTC) was teaching an asbestos supervisor refresher and an asbestos inspector initial course at the Underhill Blvd. Syosset office.  We were some of the fortunate individuals who were not in New York City when terrorists hijacked airplanes and proceeded to fly them into the World Trade Centers (WTC), the Pentagon, and crashed another in Pennsylvania.  On that day hundreds of thousands of people were exposed to a massive cloud of toxic gases and particulates from the terrorist attack on the WTC.  Significant failings by the Occupational Safety and Health Administration (OSHA) and the Environmental Protection Agency (EPA) led to tens of thousands of people who participated in the ensuing rescue, recovery, and clean-up efforts being exposed to the WTC toxic dust.  Nearly a half million people are estimated to be at increased risk of adverse health effects from exposures to physical, psychological, and emotional stressors in the days, weeks, and months following the terrorist attacks.  This year we honor their sacrifice on the 20th Anniversary of the attack on the World Trade Center.  On January 2, 2011, the James Zadroga 9/11 Health and Compensation Act of 2012 (the Zadroga Act) created the World Trade Center Health Program (WTCHP).  The WTCHP is administered by the director of the National Institute for Occupational Safety and Health (NIOSH).  So this year is also the 10th Anniversary of the WTCHP.  

We have no intention of changing our logo which depicts the NYC skyline with the WTC.

The WTCHP provides medical monitoring and treatment of covered health conditions for emergency responders, survivors, recovery and cleanup workers, and volunteers who helped at the WTC, the Pentagon, and the crash site near Shanksville, Pennsylvania, and maintains a research program aimed to improve the care and well-being of the affected population.  The WTCHP serves four groups of people affected by the 9/11 attacks:

• Fire Department of New York Responders,
• World Trade Center General Responders,
• World Trade Center Survivors (lived, worked, or went to school in NYC Disaster Area), and
• Pentagon/Shanksville Responders

From Express - 9/11 firefighters still Dying 20 years on - Devastating graph exposes the harrowing impact

As of December 31, 2020, 108,666 individuals have enrolled in WTCHP.  The ten most common certified conditions are:

• Chronic Rhinosinusitis
• Gastroesophageal Reflux Disease (GERD)
• Cancers
• Asthma
• Sleep Apnea
• Post-Traumatic Stress Disorder (PTSD)
• Chronic Respiratory Disorder - Fumes/Vapors
• WTC-Exacerbated Chronic Obstructive Pulmonary Disease (COPD)
• Anxiety Disorder (Not otherwise specified)
• Major Depressive Disorder

As the years go by, it will be interesting to see if this list changes.  In FEDTC's asbestos training courses, we discuss the latency period for asbestos-related diseases (asbestosis, lung cancer, and mesothelioma) are 10-50 years from the date of the first exposure.  In the next 5-10 years we will hit the beginning of the latency period for lung cancer and mesothelioma.  Currently, cancers only account for about 13% of WTCHP certified conditions with non-melanoma skin cancer (27%) and prostate cancer (21%) being the top two cancers.  Comparison studies indicate that prostate and thyroid cancer are elevated compared to other groups (without WTC toxic dust exposure). Other excess cancers at this time include bladder cancer, malignant melanoma, multiple myeloma, leukemia, and non-Hodgkin lymphoma.

It was published after the completion of the rescue, recovery, and clean-up efforts that there were no fatalities.  However, that isn't quite correct since we are seeing rescue, recovery, and clean-up workers dying from their exposure to the WTC toxic dust.  It is good to see that what occurred during the rescue, recovery, and clean-up at the WTC was not repeated at the recent rescue, recovery, and clean-up efforts at the Miami condo collapse.  As the picture below, from The Guardian, shows, rescue crews are wearing respirators to protect them from the potentially toxic dust from the collapse of that building.  If this is the lesson learned from the WTC tragedy, it was a hard lesson but one that will protect workers in other rescues, recoveries, and clean-ups in the future.  

 

The Guardian

Miami condo collapse: death toll rises to nine as crews search pile for survivors | Miami condo collapse | The Guardian

Its Been 15 Years Since 9/11. 4 Things We Have Learned!

On September 11, 2001, two planes were flown into the twin towers of the World Trade Center.  Those two planes caused the collapse of the buildings and the killing of 2,996 people and injuring over 6,000 others.  When they collapsed, a massive plume of dust was released into the air.  In addition, fires burned at Ground Zero for more than 90 days continuing to spew contaminants into the air.  Then-EPA chief Christine Whitman encouraged workers and residents to head back to Lower Manhattan saying the air was "safe to breathe.."  Former New York City Mayor Rudy Giuliani repeated her claim by saying "to go back to normal" and the air around Ground Zero was "safe as far as we can tell, with respect to chemical and biological agents."  Though some experts, like Mount Sinai's Dr. Philip Landrigan, warned that it was not.

New York City pre-9/11

Will 15 years later we now know that Whitman did not have sufficient information to make that claim and recently has admitted she was wrong.  Studies of the dust have shown significant quantities of carcinogens, irritants, and poisons.  Contaminants like polyaromatic hydrocarbons, dioxin, polychlorinated biphenyls (PCBs), fiberglass, lead, asbestos, volatile organic compounds, etc.  The pH of the dust was basic.  Records have shown the City knew of the hazards of the dust and air.  Expediency of the cleanup and the recovery was more important at Ground Zero, than protecting workers from the toxic dust at the site.  The Occupational Safety and Health Administration (OSHA) was only onsite acting in an advisory role and obviously had little impact on the health consequences of the workers.  As has been printed in numerous articles and pictures many did not wear the respirators they were provided or were provided the incorrect respirator.

Various Respirators Worn During Recovery & Cleanup

The result from this lack of concern regarding the dust?  Will 15 years later we know, that the Centers for Disease Control (CDC) estimates roughly 400,000 people - including rescue and recovery workers, residents, students and school staff, building occupants and passersby - were exposed.   As of July 2016, nearly 75,000 were enrolled in the World Trade Center Health Program (this program was established by the James L. Zadroga 9/11 Health and Compensation Act of 2011).  56,580 of the people enrolled are from the Fire Department of New York and other responders.  8,881 are civilians that were exposed to the toxic dust.  Based on the CDC estimate that means hundreds of thousands of people remain unaccounted for and maybe untreated.  The World Trade Center Health Program is monitoring over 30,000 people and is treating 23,000 people.  On December 18, 2015, President Obama signed a law that reauthorized the Zadroga Act that extended funding for the World Trade Center Health Program through 2090.

Photograph by Andrea Booher taken on 09-28-2001 in New York

The statistics from the program can be found on the CDC website for the program.  These responder statistics show 18,639 members suffer from rhinosinusitis; 16,418 members suffer from gastroesophageal reflux symptoms (GERD); 10,274 members suffer from asthma; 6,532 members suffer from respiratory disorders; 5,639 suffer from post traumatic stress disorder (PTSD), and 1,033 members suffer from prostate cancer.  The New York City Health Department's research found that for all cancer types more cancer cases were found among rescue/recovery workers and civilian survivors compared with the New York State general population between 2007-2011 (11% and 8% respectively).  A 2011 study found that 8 years after 9/11, the prevalence of several respiratory conditions among 10,999 World Trade Center exposed male firefighters remained high in comparison to men in the general population.

    

One World Trade Center

What have we learned?  First, we should heed the warnings of experts, not politicians.  Second, respirators are an essential and mandatory part of any emergency recovery/cleanup.  Third, safety is important but not if we sacrifice health.  Finally, dust generated by disasters, calamities, and emergencies cannot be underestimated in its potential health risk.  Yesterday, was a day to remember and mourn those who died at 9/11.  It was also a day to remember the mistakes made by those who disregarded the dust from the World Trade Center and make sure those mistakes don't happen again!

Related articles

• What We Know About How 9/11 Has Affected New Yorkers' Health, 15 Years Later(nymag.com)

  ---

• 15 Years Later: September 11 Is Not Just A Memory(forbes.com)

  ---

• Cuomo signs bill extending benefits for Ground Zero workers(newsday.com)

  ---

• Zadroga Act helped many 9/11 first responders; for others, it was too late(amny.com)

  ---

• Record Rates Of Cancer Seen In Survivors 15 Years After 9/11(nworeport.me)

  ---

• 9/11: 15 years later(cbsnews.com)

  ---

• Former EPA chief Whitman at center of 9/11 air safety controversy says 'I'm sorry'(yahoo.com)

  ---

• 9/11 rescue workers were not informed of the danger of the operation(irishcentral.com)

  ---

• Zadroga Act Needs An Extension(futureenv.blogspot.com)

  ---

• Protecting Yourself During Restoration or Renovation Projects(futureenv.blogspot.com)

  ---