Inside The Health Crisis Of 9/11 First Responders — And How The U.S. Government Made It Worse

Published September 5, 2021
Updated November 7, 2023

Ever since the terrorist attacks on September 11, 2001, thousands of 9/11 first responders have fallen victim to cancer and other terminal illnesses.

9/11 First Responders

BETH A. KEISER/AFP/Getty Images 9/11 first responders search through the rubble of the World Trade Center on September 13, 2001.

On September 11, 2001, American life changed forever. Nineteen al-Qaeda terrorists hijacked four U.S. passenger planes and launched attacks on New York City and Washington, D.C. As the disaster unfolded, thousands of 9/11 first responders rushed to help the survivors.

In New York City alone, over 100 EMS units and private ambulances raced to the scene of the Twin Towers of the World Trade Center, where two planes had crashed into the iconic buildings at over 466 miles per hour.

Meanwhile, the NYPD and Port Authority sent out over 2,000 officers to secure the area. And the FDNY dispatched at least 214 units, including 112 engines, 58 ladder trucks, five rescue companies, seven squad companies, and four marine units to help rescue as many people as possible.

As the dust settled, it soon became clear that some of the 9/11 first responders would be counted among the victims. Among the nearly 3,000 people who died on 9/11 in New York City, 343 were firefighters and paramedics, 23 were NYPD officers, and 37 were Port Authority officers.

However, those 9/11 first responders weren’t the only ones who lost their lives. In the 20 years since September 11, 2001, several 9/11 first responders who survived the terrorist attacks have suffered greatly. Many of them are now battling cancer and other horrific conditions. And to make matters worse, they’ve had to fight to get help from the U.S. government.

How 9/11 First Responders Have Suffered Since The Terrorist Attacks

First Responders On 9/11

Jose Jimenez/Primera Hora/Getty Images9/11 first responders run as a cloud of toxic smoke looms behind them.

The 9/11 first responders who survived the tragedy escaped with their lives. But the terrorist attacks left a deep mark upon them — and not just an emotional one. A number of recent studies have shown that many of these heroes suffer from high rates of cancer and cognitive impairment.

In 2020, Mount Sinai released a report that noted a high level of cancer among many 9/11 first responders. Short of calling the cancer rates an “epidemic,” doctors at Mount Sinai did acknowledge “evidence of increased risk for certain cancers among WTC-exposed responders.”

They also reported that police officers and other recovery workers suffered from cancer at a 9 percent higher rate than normal. In addition, they had a 25 percent higher risk of prostate cancer, a 41 percent higher risk of leukemia, and a whopping 219 percent higher risk of thyroid cancer.

First responders from 9/11 have also shown high rates of cognitive impairment. A study presented in July 2020 at the Alzheimer’s Association International Conference revealed that those responders with cognitive impairment often have a “brain age” that’s 10 years older than normal.

This may put the first responders at a high risk of Alzheimer’s and dementia, which they might also develop much earlier than usual.

FDNY Firefighter

Getty ImagesA firefighter shouts directions on 9/11, as toxic smoke billows behind him.

“The environmental exposures and psychological pressures experienced by responders during 9/11 and its aftermath has had an insidious effect on their health and well-being,” explained Dr. Benjamin Luft, the director of the Stony Brook WTC Health and Wellness Program.

What’s more, several 9/11 first responders also suffer from a horrifying respiratory condition known as the “World Trade Center Cough.”

“The symptoms these patients have are terrifying,” said Dr. Michael Crane, the director of the World Trade Center Health Program’s lead clinical center at Mount Sinai. “They will suddenly wake up and find they cannot breathe.”

Crane noted that this cough likely comes from the plumes of toxic smoke that the September 11th first responders breathed in.

“It was thick, terrible stuff. A witch’s brew,” Crane said, noting that it likely contained burning jet fuel, plastics, metal, fiberglass, and asbestos.

But despite the high rates of illnesses among 9/11 first responders, many of them were forced to spend years fighting for assistance.

Inside The Class-Action Lawsuit Launched By Thousands Of Plaintiffs

Ground Zero After 9/11

TED WARREN/AFP/Getty ImagesRescue workers search through the wreckage of the World Trade Center on September 24, 2001.

It didn’t take long for 9/11 first responders to start getting sick. And as more of them continued to fall ill, they began to file lawsuits.

One lawsuit, which began as a single case for a 9/11 first responder who developed leukemia after the attacks, escalated into a massive case with thousands of plaintiffs. Attorney David Worby, who took on the lawsuit in 2004, acknowledged that doing so was a huge risk on his part.

“I started this suit on behalf of one cop that got sick,” he explained. “Nobody would touch the case with a 10-foot pole because it was considered unpatriotic to say anything against the cleanup or the EPA.”

But the Environmental Protection Agency did indeed shoulder some blame. In fact, as early as September 12th, a high-ranking federal scientist had warned the EPA about asbestos, acid gases, volatile organic compounds, and heavy metals that were still in the air. But he was ultimately ignored.

On September 18th, Christine Todd Whitman, who was the head of the EPA at the time, publicly vouched for the safety of the air in New York City. She claimed that the air “did not pose a health hazard” and that “given the scope of the tragedy from last week, I am glad to reassure the people of New York… that their air is safe to breathe and the water is safe to drink.”

A report conducted by the EPA’s Inspector General later stated that the EPA lacked “sufficient data and analyses to make such a blanket statement.”

What’s more, the report found that The White House Council on Environmental Quality (CEQ) “convinced the EPA to add reassuring statements and delete cautionary ones.”

In the end, Worby filed suits against the City of New York, the Port Authority, and the EPA for exposing workers to carcinogenic particulate matter. It was an uphill battle, but he succeeded. Worby won $1 billion for his 8,000 clients.

“[My clients] are getting sick because of people like Christine Todd Whitman and [former New York City Mayor] Rudy Giuliani,” Worby said.

“[M]y people don’t want their names to be on the wall, because they are not victims of terrorists — they’re victims of bad government.”

The Long, Painful Fight To Get Help From The U.S. Government

Jon Stewart And Luis Alvarez

Zach Gibson/Getty ImagesComedian Jon Stewart applauds 9/11 first responder Luis Alvarez during a House Judiciary Committee hearing on reauthorization of the September 11th Victim Compensation Fund in 2019.

As many 9/11 first responders battled to get the medical care they needed, they got help from a surprising source: comedian Jon Stewart.

In 2010, Stewart — then the host of The Daily Show — spent an entire episode criticizing lawmakers for bickering over the James Zadroga 9/11 Health and Compensation Act. The act, named for a firefighter who’d inhaled toxic chemicals at Ground Zero and later died, granted $4.3 billion to 9/11 survivors for their medical treatment, benefits, and support.

However, some lawmakers believed that the act was too expensive. In response, Stewart accused them of “an outrageous abdication of our responsibility to those who were most heroic on 9/11.”

Though some Republicans tried to filibuster the bill, it ultimately passed in 2011. And after another round of political infighting, lawmakers voted to extend the Zadroga Act again in 2015 — this time for 75 years.

However, they did not extend one crucial part of the bill: the September 11th Victim Compensation Fund. So, in 2019, Jon Stewart went back into battle. This time, Stewart joined forces with Luis Alvarez — a 9/11 first responder with colorectal cancer — and traveled to Capitol Hill to fight for funding.

While Alvarez had received healthcare, he acknowledged that many of his fellow first responders could not say the same. To make matters worse, the September 11th Victim Compensation Fund was at risk of running out of money. Not willing to stand by and watch others suffer, Alvarez made an impassioned case before Congress — despite being near death.

“This fund isn’t a ticket to paradise, it’s to provide our families with care,” said Alvarez, a retired NYPD detective. “You all said you would never forget. Well, I’m here to make sure that you don’t.”

At his side, Stewart lambasted Congress for its failure to keep a close eye on the fund. But he was especially furious with congresspeople who refused to show up to the hearing and listen to the first responders speak.

At the hearing, Stewart said, “I can’t help but think what an incredible metaphor this room is for the entire process that getting health care and benefits for 9/11 first responders has come to. Behind me, a filled room of 9/11 first responders, and in front of me, a nearly empty Congress. Sick and dying, they brought themselves down here to speak — to no one. Shameful.”

But their testimony did seem to make a difference. The day after Stewart and Alvarez appeared before Congress, lawmakers passed the Never Forget the Heroes Act, which extended authorization for the fund through 2090. A little over a month later, the act was signed into law, finally ensuring that victims could seek the help that they needed for the rest of their lives.

However, the struggle of 9/11 first responders is far from over.

Illnesses Among September 11th First Responders 20 Years Later

Sadly, physicians suspect that 9/11 first responders suffering from diseases like cancer and cognitive impairment will face worsening health conditions.

“Cancers take 20 years to develop… we might see something different 20 years down the line,” said former NYC Health Commissioner Dr. Thomas Farley in 2012. Indeed, by 2020, 227 New York City firefighters had died of 9/11-related illnesses. The NYPD has lost more than 200 officers because of 9/11 diseases since 2011, and more than 500 are suffering from cancer.

“We lost 23 NYPD officers in the attack,” said Richard Dixon, who responded to the 9/11 attack in New York City as an NYPD officer. “But many more have died since then of these September 11-related illnesses.”

Even Luis Alvarez, who testified on behalf of other 9/11 survivors before Congress, succumbed to his illness in June 2019 — mere weeks before the act he tirelessly fought for was officially signed into law.

“I’m nobody special,” Alvarez said from his hospice bed shortly before he died. “I did what all the other guys did and now we’re paying the price for it. We did our job, now Congress has to do theirs.”

Fortunately, with the reauthorization of the September 11th Victim Compensation Fund and various successful class-action lawsuits, many 9/11 first responders have received the help they needed.

But in the coming years, many more may suffer from increased risks of cancer, cognitive impairment, and early death. And so as Americans move forward from September 11, 2001, they should keep one thing in mind.

When it comes to 9/11 first responders and the selfless sacrifices that these brave men and women made: “Never Forget.”


After learning about the health crisis of 9/11 first responders, take a look at these heartbreaking photos of 9/11 artifacts. Then, read up on some of the 9/11 conspiracy theories that some people actually think are true.

author
Kaleena Fraga
author
A staff writer for All That's Interesting, Kaleena Fraga has also had her work featured in The Washington Post and Gastro Obscura, and she published a book on the Seattle food scene for the Eat Like A Local series. She graduated from Oberlin College, where she earned a dual degree in American History and French.
editor
John Kuroski
editor
John Kuroski is the editorial director of All That's Interesting. He graduated from New York University with a degree in history, earning a place in the Phi Alpha Theta honor society for history students. An editor at All That's Interesting since 2015, his areas of interest include modern history and true crime.