Health Issues Around the World Trade Center Disaster

Update: June 15, 2002
Health Issues and The World Trade Center Disaster

Mount Sinai - I.J. Selikoff Center for Occupational and Environmental Medicine has been actively involved in health and safety issues affecting workers and volunteers at or near the World Trade Center site since the disaster occurred. Initially, exposed individuals had irritation of the eyes, nose, throat or lungs. As the cleanup progressed, these symptoms lessened. After the fires went out, the symptoms have further improved, and in most cases, have gone away. Most of those whose nose, throat or lung problems have persisted worked at or near the site, but in some cases, nearby residents also reported symptoms that required treatment. Psychological effects, on the other hand, occurred in a wider area than just the immediate vicinity of the trade center.

Since our initial WTC health and safety Web site first appeared in September 2001, our Center for Occupational and Environmental Medicine has seen several hundred patients (mostly workers and volunteers at the site) exposed to the WTC dust, gases, and fumes, and our industrial hygienists have been actively involved with worksite health and safety issues at the WTC Emergency Project. The following question and answer update is based on our accumulated experience in WTC health and safety issues.

What health effects have been seen in individuals working in and around the site or in residents of the immediate vicinity?
What is meant by the "World Trade Center cough"?
What do I do if I have some of these symptoms?
What if I have other questions about the air quality or building cleanup?

What health effects have been seen in individuals working in and around the site or in residents of the immediate vicinity?

Mostly workers at or near the site have reported some or all of the following symptoms:

1. Respiratory Symptoms

• sore throat
• hoarse voice
• chest tightness
• shortness of breath
• persistent cough
• wheezing
• increased shortness of breath or chest tightness with exposure to any of the following: exercise or physical activity, cold air, cigarette smoke or other types of smoke, vehicle exhaust, household cleaners, or perfumes

Some of these symptoms may be associated with bronchitis, asthma or reactive airways disease. If these symptoms are new to you since the WTC disaster and still present or if you've had these problems before September 11th, but they are worse than they were previously, medical evaluation is recommended.

2. Nasal and Sinus Symptoms

• nasal or sinus congestion
• runny nose
• facial pain
• headache
• nasal discharge
• persistent throat clearing or cough
• postnasal drip

These symptoms may be associated with rhinitis or sinusitis. If these symptoms are new to you since the WTC disaster and are still present or if you've had these problems before September 11th, but they have significantly worsened, medical evaluation is recommended.

3. Gastrointestinal Symptoms

• inability to tolerate certain foods
• chronic indigestion
• persistent throat clearing or cough
• burning sensation in the chest

These symptoms may be associated with gastrointestinal reflux disease. If these symptoms are new to you since the WTC disaster and still present or if you've had these problems before September 11th but they are worse than they were previously, medical evaluation is recommended.

4. Psychological Symptoms

• depression
• anxiety
• panic attacks
• easily startled
• irritability and agitation
• excessive exhaustion
• feeling detached from family or friends
• lack of interest in usual activities
• difficulty concentrating
• nightmares
• flashbacks
• difficulty sleeping
• increased use of alcohol, drugs, and/or tobacco

If these symptoms are new to you since the WTC disaster and still present or if you've had these problems before September 11th, but they are worse than they were previously, medical evaluation is recommended.

5. Worsening of Prior Conditions

Following the September 11 attack on the WTC, exposed individuals have been seen by physicians who noted a worsening of their asthma, sinus problems, allergies, depression or anxiety, which had been diagnosed prior to September 11th. We recommend that those with worsening of the symptoms of these conditions follow up with their treating physician or counselor as it may be necessary to update or alter the current treatment plan.

What is meant by the "World Trade Center cough"?

Many people who had significant exposure to the dusts, gases, and fumes at the disaster site (in general, workers at or near the site) developed a cough. In our experience, we have found that the cough may be caused by some of the nasal, sinus, respiratory, and gastrointestinal symptoms that are mentioned above. In some cases, the cough was caused by irritation of the airways to large airborne contaminants. In others, it has been due to a post-nasal drip, which causes the person to clear his or her throat somewhat like a cough. Some people developed bronchitis and still others developed asthma which had a cough as one of its symptoms. In a few cases, the cough was caused by reflux (heartburn). It is important to have the cough properly evaluated so that the correct treatment is prescribed.

What do I do if I have some of these symptoms?

The World Trade Center Worker and Volunteer Medical Screening Program has been established. This is for individuals who have worked or volunteered at the WTC disaster site, especially in the following activities: rescue and recovery, debris removal, restoration of vital services (e.g. transit, communications), residential and commercial cleanup in the immediate vicinity, and WTC related activities that occurred at the Staten Island Landfill. The Program, with sites in Manhattan, Long Island, Queens, Yonkers, and Piscataway, New Jersey, will provide free medical screening examinations for these individuals. This health screening project is made possible through federal funding from the National Institute for Occupational Safety and Health (NIOSH). For more information or to enroll, call toll free at (888) 702-0630.

For any of the medical symptoms, you may also visit your regular physician. We have provided the following information for physician management of some of the sinus and breathing conditions at Irritative and Respiratory Problems in Relation to Environmental Exposures from the World Trade Center Disaster: A Guide for Clinicians.

You may also contact any of our Mount Sinai Occupational and Environmental Medicine clinical centers in Manhattan, Yonkers, or Queens for an appointment to be medically evaluated.

Mount Sinai - I. J. Selikoff Center for Occupational and Environmental Medicine
1391 Madison Avenue (at 97th Street)
New York, New York 10029
Tel: (212) 987-6043

Mount Sinai Center for Occupational and Medicine at St. John’s Riverside Hospital
967 North Broadway
Yonkers, New York 10701
Tel: (914) 964-4737

Mount Sinai Hospital of Queens
2525 30th Road, Second Floor
Astoria, New York 11102
Tel: (718) 278-2736

For psychological symptoms or help coping, please contact Project Liberty at (800) LIFENET (543-3638) whose Web site is at www.projectliberty.state.ny.us or you may contact NYCope at (212) 306-7597 .

What if I have other questions about the air quality or building cleanup?

Please go to the following Web site http://www.nyc.gov/html/doh/html/alerts/911.html .

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