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For Ground Zero responders, illness in the dust

Copyright 2006 Newsday, Inc.

By DELTHIA RICKS
Newsday (New York)

Debris that rose like a thunderhead over lower Manhattan with the World Trade Center’s collapse nearly five years ago continues to cause respiratory problems in hundreds who responded to Ground Zero, pulmonary experts said yesterday.

Doctors are still treating first responders and others who worked at the site and expect patients will be monitored over the next 15 to 20 years in a federally funded screening program.

“The estimate is that 1.2 million pounds of concrete were destroyed along with other damaging materials,” said Dr. Kenneth Steier, co-director of World Trade Center Medical Screening Program at Nassau University Medical Center in East Meadow. “People who were at the site inhaled those materials in large quantities. We’ve seen about 800 responders and diagnosed a number of problems related to particles.”

In all, 24,000 firefighters, police officers, construction workers and those who cleared Ground Zero debris have been screened in the wider program, which in addition to Nassau University Medical Center, includes Stony Brook University Hospital on Long Island and Mount Sinai Hospital, NYU Medical Center and Bellevue Hospital Center in Manhattan.

Steier underscored that exposure differed among first responders and not all inhaled the same amount of debris nor suffered the same ill effects. However, World Trade Center cough, a disorder new to medicine, developed in the wake of the attacks because of the unique nature of the debris. The dry, hacking cough still plagues many first responders, he said.

Reactive airways dysfunction syndrome — RADS — is another chronic respiratory condition that lingers. It is an asthma-like condition first described in 1985 and generally is caused by occupational irritants. But doctors also continue to diagnose asthma and even pulmonary fibrosis, a devastating lung condition typified by inflammation and scarring in the lungs’ airways.

Dr. William Rom, a specialist in environmental medicine at NYU School of Medicine, said immediately after the disaster he and his team performed a bronchoalveolar lavage - a wash - on both lungs of a firefighter in respiratory failure and found ash particles, degraded chromium and long amosite fibers, which are associated with asbestos.

The firefighter was treated aggressively with steroids to reduce inflammation and now is healthy, said Rom, who added that the worst respiratory problems were experienced by only a minority of responders. “There are lingering effects from the exposure, which are best described as inflammatory or destructive processes.”

Dr. Phillip Landrigan, who has led numerous studies on exposure to World Trade dust, said the primary component in the plume was pulverized concrete. “The striking thing about concrete is that it can be very toxic when inhaled. It’s alkaline, but basically it does the same thing as a very strong acid. It burns and cauterizes tissue,” said Landrigan, chairman of community and preventive medicine at Mount Sinai.