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Twenty-two years ago, in NYC, as people were running from the terrifying scene, first responders were running towards it. And that day’s consequences have been affecting their health ever since. In fact, a 2021 study found that rescue and recovery workers at Ground Zero are starting to develop chronic obstructive pulmonary disease (COPD) decades after these horrific events.

In a review of nearly 18,000 workers and volunteers who dug through the rubble of the Twin Towers in the hours and days following the attacks, researchers from the Icahn School of Medicine at Mount Sinai discovered many had started to develop COPD after a previous asthma diagnosis.

The disease primarily impacts smokers, but doctors say people who work in environmentally hazardous conditions are also at risk. Prior studies have shown that the toxic dust cloud produced by the destruction of the Twin Towers contained a myriad of chemicals that have led to long-term illnesses, diseases, and cancer in the workers breathing in those particles.

In a media release, Professor Rafael E. de la Hoz from the Icahn School of Medicine at Mount Sinai, New York, said, 

“We know that emergency workers who arrived in the aftermath of the World Trade Center disaster face higher risks of airway diseases, such as asthma, chronic non-specific bronchitis, and bronchiolitis, probably caused by the smoke and toxic dust that persisted in the air days and weeks after the attacks. It’s important that we continue to monitor these workers to understand the long-term impacts of their exposure while working on the site because some conditions can take many years to develop.”

For the study, researchers looked at 17,996 people who worked at Ground Zero after the September 11 terror attacks. Each person took part in a spirometry test to measure lung health in 2002 and then again in 2018. Those tests helped doctors see how much air a person can exhale in one powerful breath. The exams also helped doctors diagnose cases of COPD and asthma. The researchers compared those results to each person’s age, weight, and smoking habits.

The results revealed that first responders who arrived at Ground Zero within the first two days were at the highest risk for poor lung function. Smoke and dust levels were at their highest during that time, the study authors noted. 

As of 2021, they found that 586 workers (3.3%) had developed COPD — with those arriving earlier at the site at greater risk. Particularly, those working at Ground Zero immediately had a 30% higher risk of developing COPD than those working there later. The results remained the same even after taking into account those who smoke tobacco and who are obese.

What’s more is that 1 in 4 patients diagnosed with COPD are lifetime non-smokers. About 40% of rescue workers with COPD also had symptoms of asthma, a condition known as asthma-COPD overlap or ACO.

“Many of these workers were non-smokers and in their early 40s in 2001, and COPD is rare in that age group. Twenty years on from their work at the World Trade Center site, and despite decreasing rates of smoking, we are starting to see cases of COPD emerge. Our study shows that those facing the greatest risk are those who worked on the site in the first day or two after the towers collapsed and in those who had previously been diagnosed with asthma,” Prof. de la Hoz ascertained.

Researchers say their findings may help ensure World Trade Center rescue workers get proactive care and treatment for the growing number of people beginning to deal with lung diseases in the years following the tragedy.

“Besides my research work, I have been diagnosing and treating these workers’ airway disorders since 2002 through smoking cessation, encouraging weight reduction and improved diet and lifestyle, curtailment of ongoing occupational exposures, appropriate vaccination, treatment of disease worsening comorbidities, and pulmonary rehabilitation when appropriate. We would like to think that this work may have prevented worse COPD morbidity,” Prof. de la Hoz explained.

“COPD is a serious disease that can have a major impact on people’s day-to-day lives, but importantly it is preventable. Treatments and rehabilitation can help to relieve COPD symptoms, but it is so important to raise awareness of how to prevent the disease or diagnose it at the earliest possible stage,” remarked Arzu Yorgancıoğlu, Chair of the European Respiratory Society Advocacy Council and Professor in Pulmonology at Celal Bayar University in Turkey.

She also added, “Around the world, we rely on our emergency workers to help when disasters occur. This study shows how important it is to keep monitoring the health of workers, like those who attended the World Trade Center site 20 years ago, as occupational exposure to pollutants can lead to COPD. What we can learn from research like this is not only how best to care for emergency workers who operate in dangerous conditions, but also how we can protect them in their work in the future.”

Yorgancıoğlu did not take part in the study. Researchers presented their findings at the ERS International Congress.

These findings have significant implications for all first-responders. The heroes that make a career out of charging into the worst situations are putting themselves at greater risks now… and decades into the future. Knowing what to look for helps everyone to remain healthy as long as possible.

Mr. Rogers has famously been quoted as saying, “When I was a boy and I would see scary things in the news, my mother would say to me, “Look for the helpers. You will always find people who are helping.”

22 years later and we’re still finding new and horrible ways that day has efected us.

For the workers, first responders, and volunteers who ran toward the unthinkable:

Thank You. Thank you for being a helper. Thank you for being our heroes. You didn’t abandon us in our time of need. We aren’t going to abandon you in yours.