It took fewer than 20 minutes for American life to irrevocably change. On the morning of September 11, 2001, 19 Al Qaeda terrorists hijacked four planes, with two of them hurtling into New York City’s Twin Towers at speeds of over 466 miles per hour. Hundreds died instantly. In total, 2,753 people in New York would perish then and there as a result of the attacks. Fires raged in the area 99 days after the fact.
As the world witnessed the largest terrorist attack on U.S. soil on live TV, an equally superlative event took place: the largest coordinated emergency service response in U.S. history.
On that day, over 100 EMS units and private ambulances raced to the site. The NYPD and Port Authority sent out more than 2,000 police officers to secure the area. The FDNY dispatched at least 214 units — constituting 112 engines, 58 ladder trucks, five rescue companies, seven squad companies, four marine units and dozens of chiefs. Other units dispatched themselves without command.
Many of these emergency workers would not return. In total, 343 firefighters and paramedics; 23 NYPD officers; and 37 Port Authority officers would die as a result.
Fifteen years have now elapsed since that fateful day, with the consequences of 9/11 making themselves known through multiple wars on terrorism, increased governmental surveillance, and threats to basic civil liberties, among others. For many 9/11 first responders who survived, the date’s significance lives on somewhere deeper: in their very bodies.
At the end of August 2016, researchers at Stony Brook University published a study that found what they called “disturbingly high” levels of cognitive impairment (CI) among 9/11 first responders. This impairment, researchers said, is considered a leading cause of Alzheimer’s and other forms of dementia.
In conducting the study, researchers screened over 800 World Trade Center responders, many of them in their early 50s, for signs of cognitive impairment and dementia. Of those screened, researchers found that 12.8 percent showed signs of cognitive impairment, with a further 1.2 percent demonstrating signs of possible dementia.
In a release, researchers called these numbers “staggering,” saying that the study affirmed the fact that the medical trauma of 9/11 has not, and will not, go away with time — and that the event has had more of an impact on first responders than initially thought.
“This study indicates that the effects of the exposure to the World Trade Center attacks on the responders may be more pervasive and insidious than originally thought,” Dr. Benjamin J. Luft, Director of the Stony Brook WTC Wellness Program and co-author of the paper, said in a release. “The results only support the wisdom of the passage of the Zadroga legislation, which provides continued monitoring and treatment of diseases caused by these exposures.”
Stony Brook’s findings build on a wealth of medical conditions that 9/11 first responders have developed since the towers fell. Indeed, doctors who work with the World Trade Center Health Program, which the federal government founded following the disaster, have identified and linked nearly 70 different kinds of cancer to Ground Zero.
“The diseases stemming from the World Trade Center attacks include almost all lung diseases, almost all cancers — such as issues of the upper airways, gastroesophageal acid reflux disease, post-traumatic stress, anxiety, panic and adjustment disorders,” Dr. David Prezant, co-director for the Fire Department of the City of New York’s World Trade Center Medical Monitoring Program, told Newsweek.
However, to some, it’s uncertainty that may prove to be the biggest threat to first responders’ health.
As NYPD cop Richard Dixon told Newsweek, “You don’t think that the cough you get today will be the cancer you get tomorrow.” Dixon worked in rescue and recovery for two months following 9/11. Since then, Dixon says he has had sleep apnea, sinusitis, and gastroesophageal reflex disease, which can develop into cancer.
Still, Dixon counts himself as lucky. “We lost 23 NYPD officers in the attacks,” he told Newsweek. “But many more have died since then of these September 11-related illnesses. We need to find out why, or that list of names on the 9/11 memorial is going to just keep growing.”
Physicians working with 9/11 first responders have also reported the incidence of what they call the “World Trade Center cough,” which they say likely stems from the debris they had inhaled while at Ground Zero.
“The symptoms these patients have are terrifying,” Dr. Michael Crane, director of the World Trade Center Health Program’s lead clinical center at Mount Sinai, told Newsweek. “They will suddenly wake up and find they cannot breathe.”
According to data obtained by Newsweek, in June of 2016 seven percent of individuals enrolled in the World Trade Center Health Program — 5,441 people out of the program’s 75,000 — have been diagnosed with at least one kind of 9/11-related cancer. Many have more than one kind of cancer, as the total number of cancers stands at 6,378 as of June.
Given the carcinogens and asbestos that response and recovery workers inhaled at the site, Crane does not find these figures, however devastating, wholly surprising. “We will never know the composition of that cloud, because the wind carried it away, but people were breathing and eating it,” Crane told Newsweek. “What we do know is that it had all kinds of god-awful things in it. Burning jet fuel. Plastics, metal, fiberglass, asbestos. It was thick, terrible stuff. A witch’s brew.”
It Didn’t Have To Be This Way
As terrible as stories like Dixon’s — and so many others like him — are, it’s even more terrible that his suffering could have been prevented, or at least lessened, had the right people listened and intervened.
On September 12, a day after the attacks, prominent scientist Dr. Edwin M. Kilbourne sent a memo to the Centers for Disease Control and Prevention, advising against the return to area buildings due to the presence of various toxic materials.
Kilbourne got the threats of Ground Zero right — and he was ignored.
On September 18, U.S. Environmental Protection Agency head Christine Todd Whitman said in a press release 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.”
Reality, of course, said otherwise. According to a 2003 report conducted by the EPA’s Inspector General, at the time Whitman made those remarks, the EPA lacked “sufficient data and analyses to make such a blanket statement.”
Furthermore, the report added that the Bush administration used its influence to effectively force the EPA to paint a rosier portrait of the Ground Zero situation to the public. As the report’s authors wrote, “the White House Council on Environmental Quality (CEQ) [under George W. Bush] influenced, through the collaboration process, the information that the EPA communicated to the public through its early press releases when it convinced the EPA to add reassuring statements and delete cautionary ones.”
For instance, in one early draft the EPA wrote that World Trade Center area residents should have their living spaces professionally cleaned. That recommendation did not make it into the actual release. When the Inspector General’s office later inquired as to why that recommendation did not make it to the public, an EPA associate administrator replied that “it was removed by…the CEQ contact.”
The associate administrator added that she had also considered including information about the health risks of being exposed to particulate matter, but that the “CEQ official discouraged her from doing so,” as “anything dealing with health effects should come from New York because they were on the ground and they were already dealing with it.”
The Inspector General’s Office created a table to illustrate the extent of the Bush administration’s influence on the EPA’s statements, which you can view below:
Ultimately, the report concluded that “competing considerations, such as national security concerns and the desire to reopen Wall Street” and the influence of the CEQ shaped “the final message in EPA’s air quality statements,” not the data.
The report then ended that section by stating, “given the current lack of health-based benchmarks, the lack of research data on synergistic effects, and the lack of reliable information on the extent of the public’s exposure to these pollutants, the answer to whether the outdoor air around WTC was ‘safe’ to breathe may not be settled for years to come.”
The Public Demands Action
Less than three years after the attacks, the consequences of breathing in Ground Zero carcinogens had already started to make themselves known, and victims began to file class-action lawsuits.
In March 2004, the firm Berger & Montague filed a class action lawsuit against Christine Todd Whitman and two of her assistant administrators, as well as the EPA writ large. A district judge ruled in 2006 that the lawsuit could proceed, but the case stopped in its tracks when it arrived at the 2nd U.S. Circuit Court of Appeals.
Without investigating air quality or ascertaining if the EPA had intentionally misled the public, a three-judge panel ruled that “the government’s interest in returning New York to normalcy following the attacks should protect it from lawsuits alleging that the government made false statements about air quality.”
Lawsuits forged on elsewhere. What began as a single case for an NYPD cop who contracted leukemia after spending time at Ground Zero escalated into a 10,000 plaintiff case, all of whom were represented by attorney David Worby. According to Worby, his taking on the case — in spite of the wealth of evidence plaintiffs had in their favor — was a risk.
As he told Discover magazine, “I started this suit on behalf of one cop that got sick…Nobody would touch the case with a 10-foot pole because it was considered unpatriotic to say anything against the cleanup or the EPA.”
He added that while exposure to particulate matter may have been the biological cause of his clients’ illnesses, bad government stood at the root of the problem. My clients “are getting sick because of people like Christine Todd Whitman and Rudy Giuliani,” he told Discover.
“[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. Giuliani should be banned from public office for what he did.”
Worby filed suits against the City of New York, the Port Authority, and the EPA for exposing workers to carcinogenic particulate matter, and sought billions for medical screening, treatment and damages.
In court, the city claimed that federal and state statutes immunized it from suits related to its handling of rescue and recovery operations. A federal judge disagreed, saying that while those statutes provides some immunity, it is not universal and as such, as The New York Times reported, “protection varies by time and place, making it necessary to hear the details of individual cases.”
In 2010 — after seven years of legal battles between the city and workers — attorneys representing the 10,000-plus victims reached a settlement, in which the city would pay a total of $625 million to the plaintiffs.
Those who collected this money would still be eligible to receive benefits from the James Zadroga 9/11 Health and Compensation Act, which President Obama signed into law in early 2011 and offered $7.4 billion in aid and medical coverage to those who were exposed to toxins following the attacks.
That, too, came with its own hurdles. In 2015, when the act was up for permanent reauthorization in the Highway Bill, act proponents were shocked to discover that funding for the program had been excluded in House and Senate negotiations. Zadroga proponents were quick to pass blame to Senate Majority Leader Mitch McConnell, who they said was playing politics at the expense of sick, national heroes.
“There was a clear path to getting this done but Senator McConnell blocked it,” Senate Minority Leader Harry Reid (D-Nev.) told the Daily News.
“This is a sad state of affairs for the Republican Congress. They have the time to take away health care from 17 million Americans. They have the time to restrict access to health care for women. But they don’t have time to give health care to our first responders who risked their lives on September 11th and the recovery efforts.”
Eventually, the bill passed and was reauthorized for 75 years. Good thing, too, as the effects of a 17-minute attack will last a lifetime.