Firefighters still suffer from 9/11 cough

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September 10, 2002

Firefighters still suffer from 9/11 cough.

WASHINGTON, Sep 09, 2002 (United Press International via COMTEX) -- Hundreds

of New York City firefighters developed severe coughs and respiratory

problems from breathing in the vast amount of dust at the site of the World

Trade Center attacks and the effects still persisted in nearly half of them

six months later, health officials reported Monday.

During the six months after the attacks, 332 firefighters and one emergency

worker developed what has been termed the World Trade Center-related

cough -- a cough severe enough to require at least four weeks of medical

leave, Prezant, deputy chief medical officer of the NYC Fire

Department, said in a teleconference from Atlanta.

Prezant noted more than half of these firefighters have recovered. Yet 48

percent, or 173, still are suffering severe complications related to the

cough such as asthma, shortness of breath and wheezing.

The cough is most likely due to exposure to airborne particulate matter

created by the collapse and burning of the World Trade Center towers,

Prezant said. He said 90 percent of the exposed rescue workers developed a

cough but it did not persist or require medical leave in most.

The WTC-related cough is a combined irritation of both the air passages and

the digestive tract, Prezant said. The sinuses, throat, lower airways and

also the esophagus have been irritated by the dust particulates the rescue

workers breathed. Treatment requires a multi-system approach involving

relieving esophageal irritation, sinus drip and asthma-like breathing

difficulties.

Scientists do not know exactly what the rescue workers were exposed to, but

whatever was in the dust cloud was likely to be " incredibly toxic at that

level of exposure, " Prezant said. It could induce asthma, emphysema and

heart attacks, although no rescue worker suffered a heart attack, he said.

The dust likely included a lot of reactive oxygen species, volatile organic

chemicals and plastics -- all of which are known to have the potential to

create respiratory problems, said Scanlon, a professor of medicine and

a consult in pulmonary and critical care medicine at the Mayo Clinic in

Rochester, Minn.

Scanlon, who wrote an editorial on the WTC-related cough that appears in the

Sept. 12 issue of the New England Journal of Medicine, told United Press

International it is " unusual to have that many people affected by it. "

Prezant added it is surprising that only 48 percent have recovered. " We

wouldn've expected a higher number to recover ... closer to 90 percent "

based on previous experience with firefighters who have suffered smoke

inhalation.

The volume of airborne matter and the fact they were exposed to it for many

weeks likely played a role in the severe complications seen in some of the

rescue workers, Prezant said.

One of the contributing factors is many of the workers did not wear

respirators. They are uncomfortable, inconvenient and cumbersome, Scanlon

said.

Prezant noted the workers had some of the best respirators available but

they required wearing a heavy oxygen tank on the back, which only lasted for

a few minutes and interfered with recovery efforts, so many workers opted

not to wear them.

Scanlon said whether the workers who have not yet recovered fully will

suffer long-term disability or other respiratory problems remains uncertain.

Only time will tell, he said, adding the main risk is of asthma-type

problems -- there does not appear to be much risk of developing cancer.

Prezant noted more than " 500 firefighters will ultimately file and qualify

for retirement or disability based on this. " No workers have yet retired but

several are in the pipeline, he said.

" This is a lesson in the appropriate response to major disasters and

highlights the need to be prepared for the risk that rescue workers will

rush in and not take appropriate precautions, " said Scanlon.

Prezant said the findings illustrate how " first responders respond and they

respond no matter what the danger to themselves is ... and because they were

there, 25,000 civilians were successfully evacuated from the World Trade

Center. "

In addition to the Sept. 12 issue of the New England Journal of Medicine,

Prezant's findings appear in a special Sept. 11 issue of the Morbidity and

Mortality Weekly Report, a journal published by the Centers for Disease

Control and Prevention.

By STEVE MITCHELL, UPI Medical Correspondent

Copyright 2002 by United Press International

©The Clinton Courier 2002