Organochlorines in New York and the Hudson River: Sources, Environmental Distribution, and Health Risks

WTC Supplement

Pregnant Women and Their Infants: Stephanie Engel, Ph.D.

The destruction of the World Trade Center (WTC) on September 11, 2001, released a toxic atmospheric plume that contained soot, benzene, polycyclic aromatic hydrocarbon (PAHs), heavy metals, pulverized glass and cement, and alkaline particulates. The Mount Sinai SBRP has been centrally involved in a consortium of six NIEHS Centers who have mobilized under the leadership of Dr. Kenneth Olden, Director of NIEHS, to examine the environmental distribution and effects on health of the contaminants released from the WTC.

To assess the effects of WTC contaminants on pregnant women and their children, a cohort study was established under the direction of Dr. Gertrud Berkowitz of 187 women who were in or near the WTC on September 11 or shortly thereafter. As a comparison group, we tracked over 2300 pregnant women who delivered babies at The Mount Sinai Medical Center during the same time period and who were not known to have been in lower Manhattan on September 11. We found that women in the WTC group were twice as likely as the comparison group to give birth to babies who were small for gestation age (SGA); that is, they were small given the length of their pregnancy. This finding suggests that the WTC disaster had a detrimental impact on exposed pregnancies. Our findings were published as a Research Letter in JAMA on August 6, 2003, and were highlighted in the December 2003 issue of the Environmental Health Perspectives.

Air pollution has been linked in previous studies to decreased birth weight and premature delivery. It is also well established that cigarette smoking, which contains similar toxicants to air pollutants, can reduce infant size.

To follow up on our initial observations, we have in the past year characterized environmental exposures in this cohort of pregnant women using geographic information system (GIS)-based models, interview, and biologic markers. Women recorded their locations from 9/11 until October 8, 2001 (four weeks), using a time-activity log. Exposures were assessed by time spent in five zones around the WTC and by an exposure index (EI) based on plume reconstruction modeling of dust and smoke intensity multiplied by time spent per day at specific street addresses within these zones. Based on reported chemical contamination near the WTC, we measured selected chemicals in biological specimens collected starting in February 2002. Biomarkers included PAH-DNA adducts in maternal blood mononuclear cells, organochlorines (OC) in maternal plasma, and heavy metals in maternal urine and blood. We found an intense bystander exposure after the WTC collapse. A paper describing our findings is currently under review for publication in Environmental Health Perspectives.

Possible long-term effects on infant and childhood development are unclear and will require continuing follow-up. We are in the process of completing three year-old neurodevelopmental assessments on the children who were exposed in utero to the WTC disaster.

More information on The Effects of the World Trade Center Disaster on Pregnant Women and Their Infants (WTC Supplement Project 2)

Pediatric Outreach: Joel Forman, M.D.

The WTC Pediatric Outreach program continues a multi-faceted approach to training pediatricians about environmental threats to children’s health.

The Program collaborated with the WTC Worker and Volunteer Medical Screening Program at Mount Sinai to provide pediatric environmental consultation to adolescents who had worked at Ground Zero. The Program continues to answer calls and respond to media reports. After a lull in public focus on the environmental aftermath of 9/11, there is now a new wave of concern around the planned demolition of the Deutsch Bank Building and the reconstruction of lower Manhattan. The Program stands ready to respond to calls from members of the community.

To educate pediatricians about environmental threats to children's health, on November 15, 2004, the Program piloted an educational seminar titled "The World Trade Center Disaster: Effective Case Management of Environmentally Exposed Children" at the New York Academy of Medicine. The audience consisted of a select group of practitioners and government representatives. The Program utilized the WTC experience as a case study in pediatric environmental exposure to launch in to a training session focused on efficient evaluation of environmentally exposed children. Topics included a review of the exposures encountered after 9/11, internet and consulting resources available to the practitioner to evaluate environmentally exposed children, and risk communication techniques. The seminar was very well received and the feedback has led to a number of modifications and enhancements. We plan on holding a larger session open to more providers in lower Manhattan in March 2005.

More information on Outreach to Children and Families (WTC Supplement Project 4)

More information about the Superfund Basic Research Program World Trade Center Supplement