On this 11th anniversary of the awful attacks on the World Trade Center, Federal health authorities announce that mesothelioma will be added to the World Trade Center (WTC) Health Progarm created by the Zadroga 9/11 Health and Compensation Act of 2010 to cover First Responders who were exposed to asbestos.  The Zadroga Act originally only covered a short list of illnesses, but now has added 58 new cancers to the list, one of which is mesothelioma.

On September 11, 2001, almost 3,000 people were killed and the World Trade Center destroyed as hijackers crashed passenger jets into the Twin Towers.  The dust and the debris from the fallen towers was immense, and full of toxins such as asbestos, lead, glass, gypsum, etc.  Unfortunately, due to exposure to such toxins by those who were on the scene or first responded to the scene, the number of deaths caused by this attack still continues.

Many of those who helped with rescue and clean up have developed serious illness and cancers, one of which is mesothelioma.  Mesothelioma is caused by inhaling microscopic asbestos fibers.  Almost every building constructed before 1980 contains asbestos materials, and the buildings that sustained damage or were destroyed created tons of contaminated dust that was inhaled by rescue workers and those in the nearby area.

With the expansion of this Act, First Responders who develop mesothelioma are now entitled to receive free medical care as well as compensation for lost wages and any financial loss.

A study published today in The New England Journal of Medicine reveals that Fire Department of New York (FDNY) firefighters and emergency medical services (EMS) workers who responded to the 9/11 attacks at the World Trade Center have suffered significant, persistent declines in lung functions. According to the report, exposure to World Trade Center dust created when the towers collapsed led to “large declines” in lung functions for FDNY rescue workers during the first year, and that “the declines were persistent, without recovery over the next 6 years, leaving a substantial proportion of workers with abnormal lung function.”

The study included 12,781 workers who were present at the WTC site between Sept. 11, 2001 and Sept. 24, 2001, which is 91.6 percent of the workers that were present. The report notes that the event exposed the workers – as well as those living and working in the surrounding area – to a dense cloud of pulverized building materials and chemical byproducts, including pulverized glass and cement, insulation fibers including asbestos, and toxic chemicals.

According to a report in The New York Times that summarizes the study findings, this is the first study to document long-term harm in a large group of firefighters and emergency medical workers who worked at Ground Zero. All of the subjects of the study had had previous lung function tests, providing a baseline for the study.

The study was authored by Dr. David J. Prezant, chief medical officer in the Office of Medical Affairs at the New York City Fire Department. The study was approved by the institutional review board at Montefiore Medical Center.

Results of the study revealed that firefighters, who had heavier exposure to dust by the nature of their work had greater first-year declines than EMS personnel, especially for firefighters who were present in the morning on 9/11, when the dust cloud was most intense after the buildings fell. However, researchers noted they were surprised to see “little or no recovery of average lung function during the 6-year follow-up period.” In fact, they noted continued decline in lung function among the study groups.

Normally, the study notes, “smoke inhalation during firefighting causes relatively mild and reversible respiratory impairment.” Additionally, according to the report, long-term effects of firefighting on pulmonary function also are normally mild.

The average loss of lung function for 9/11 rescue workers is about 10 percent. Most of the loss occurred within the first year after 9/11 exposure, with little or no subsequent recovery.

Thousands of workers injured at Ground Zero have been fighting for compensation from the City of New York. Last month about 10,000 plaintiffs reached a settlement agreement totaling $657.5 million, but a judge rejected the settlement shortly afterward, saying it did not provide enough compensation for the plaintiffs. The matter is now back in negotiations, and a new hearing is set for Monday, according to the Times.

Research conducted by the Fire Department of the City of New York (FDNY), and published by The Lancet, provides evidence of an increased risk for cancers of all types among firefighters who were first responders on 9/11. The findings were released on Sept. 3, as American began to reflect on the 10th anniversary of the terrorist attacks. This particular study focused on rescue workers who responded to the attack on the World Trade Center in New York City.

According to The Lancet, “Respiratory illnesses and post-traumatic stress disorder are known to be increased in those who survived the World Trade Center disaster, but data reported in this issue show that 9 years after the attacks, rescue and recovery workers continue to have substantial physical and mental health problems.”

While it is too early yet to find evidence of increased mortality among these workers, the research indicates that “An excess of cancer cases is reported in firefighters who survived the disaster..” according to The Lancet.

The study, titled “Early assessment of cancer outcomes in New York City firefighters after the 9/11 attacks: an observational cohort study” was published in Volume 378, Issue 9794 of The Lancet. Researchers studied cancer incidence and its potential association to exposure of New York City firefighters to known and suspected carcinogens at Ground Zero. The study examined the effect of these possible carcinogens on FDNY first responders in the first 7 years after 9/11/01.

According to the report, the study included 9,853 men who were employed as firefighters on Jan. 1, 1996. Researchers determined that “on and after 9/11, person-time for 8,927 firefighters was classified as WTC-exposed; all person-time before 9/11, and person-time after 9/11 for 926 non-WTC-exposed firefighters, was classifed as non-WTC exposed.” Explaining their methods, researchers state in the report, “We estimated the ratio of incidence rates in WTC-exposed firefighters to non-exposed firefighters, adjusted for age, race and ethnic origin, and secular trends, with the US National Cancer Institute Surveillance Epidemiology and End Results (SEER) reference population.”

In its Findings summary, the report concluded that cancer incidence in firefighters exposed to toxins at the World Trade Center was about 1 in 10, while cancer incidence in the general male population in the U.S. was about 1 in 19. This incidence among the non-WTC-exposed firefighters also was about 1 in 19. This leads researchers to believe there is a “modest excess of cancer cases in the WTC-exposed” group.

However, researchers also caution that there has been a relatively short time period since the events of 9/11 and the exposures, while many cancers, such as mesothelioma, may have long developmental periods. They recommend continued follow-up including cancer screenings and prevention strategies.

Read the full FDNY post-9/11 cancer assessment.

The Lancet has a full report on the events of 9/11 in this special section.