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The medical response to an environmental disaster: lessons from the World Trade Center attacks



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  • Personal Author:
  • Description:
    The September 11, 2001, terrorist attacks on the World Trade Center (WTC) in New York City resulted in collapse of the towers, generated a thick plume of dust and fumes that wafted across Lower Manhattan and Brooklyn, ignited fires that smoldered for months, and deposited more than one million tons of debris in one of the most densely populated and vitally important commercial districts in the world. In addition to the event's devastating personal, emotional, political, and economic consequences for New York City and the nation, the tragedy was an unprecedented and unanticipated environmental disaster. The scale of the environmental impact-both in terms of quantity and complexity of pollutants released and the size and diversity of populations at risk for adverse health effects-made the emergency response in the immediate aftermath of the attack exceedingly difficult. Balancing the need for search and rescue operations, a criminal investigation of the cause of the disaster, restoring function to the financial district, and ensuring the safety of the residents and workers in the area was a complex task that fell upon multiple local and federal agencies. Criticism of the actions of the Environmental Protection Agency (EPA), National Institute for Occupational Safety and Health (NIOSH), Occupational Safety and Health Administration (OSHA), the New York State Department of Environmental Conservation (DEC), and the many other government agencies present during the aftermath has been intense. It has become common knowledge that personal protective equipment was underutilized by rescue and recovery and cleanup workers. Many people focus on the air quality assessment by the EPA and the famous statement made by its director at the time, Christie Todd Whitman: "The air is safe to breathe, and the water is safe to drink." Reassured by the words of a well-known public figure, many area workers and residents returned to their homes and businesses with a sense that the danger had passed. Subsequently, the shortcomings of the agencies responsible for advising residents and workers on how to clean the debris may have needlessly increased the exposure and health risks of these individuals. Certainly, the magnitude of the situation could never have been anticipated by any of these agencies, and, in fact, it could be suggested that each individual agency was able to achieve its particular mission with some success given the circumstances. Unfortunately, the actions of each agency were ovcrlaid by political concerns and were never synthcsized into a global assessment of the situation at Ground Zero (GZ) to guide health regulations and protect responders, workers, and the public. Furthermore, onc might imagine that public health departments might have stepped in early on; however, the reality is that health departments have expertise in the domains of preventive medicine and infectious diseases, but little to no experience in acute environmental exposures. The lack of a single authority, coupled with an enormous amount of political pressure to allow life in Lower Manhattan to resume, is likely the real reason that many warning signals of potential health threats were ignored. This chapter focuses on the role of the medical and scientific community in the days, months, and years after 9/ I I in elucidating the characteristics and toxicity of WTC dust and in caring for individuals with adverse health effects related to 9/11 exposures. We describe the accumulated knowledge on the characteristics and toxicity of WTC dust. We then follow a loose chronology to tell the story of how our understanding of WTC health effects emerged from single centers and grew through partnerships among medical, government, philanthropic, and community organizations. Finally, we discuss lessons learned from the WTC experience for future disasters and for environmental health in general. This chapter was completed before the signing of H.R. 847, the 'James Zadroga 9/11 Health and Compensation Act of 20 10" on January 6,2011, by President Barack H. Obama. This law, a result or continued efforts by rescue and recovery workers, community members, medical personnel, organized labor, and persistent congressional and senate members, puts into place a screening, monitoring and treatment program for adverse medical and mental health effects for rescue and recovery workers as well as community members. The hopes for this compromise bill are that funding will now be in place for continued health monitoring and treatment of populations at risk for adverse health outcomes. The fears are that onerous reporting requirements, rigid restrictions, and interesting additions (the government requires the name of each patient to ensure that they are not on the terrorist watch list), will provide barriers to care. Regardless, the signing of this bill, nearly ten years after the event, represents the culmination of combined cfforts from diverse groups to move the federal govcrnment to provide an appropriate health response to an environmental disaster with wide ramifications. [Description provided by NIOSH]
  • Subjects:
  • Keywords:
  • ISBN:
    9780470593431
  • Publisher:
    John Wiley & Sons
  • Document Type:
    Text
  • Funding:
    Grant
  • Genre:
    Book
  • Place as Subject:
  • CIO:
    National Institute for Occupational Safety and Health (NIOSH)
  • Topic:
    Workplace Safety & Health
  • Location:
    North America
  • Pages in Document:
    137-157
  • NIOSHTIC Number:
    nn:20046263
  • Citation:
    Environmental policy and public health: air pollution, global climate change, and wilderness. Rom WN, ed. San Francisco, CA: John Wiley & Sons, 2011 Nov; :137-157
  • Editor(s):
    Rom WN
  • Federal Fiscal Year:
    2012
  • Performing Organization:
    New York City Health and Hospitals Corporation
  • Peer Reviewed:
    True
  • Start Date:
    20080929
  • Source Full Name:
    Environmental policy and public health: air pollution, global climate change, and wilderness
  • End Date:
    20110928
  • Collection(s):
  • Main Document Checksum:
    urn:sha-512:11d65e03160f6cafd073b3ed923c4eb4d8688fe2dcc11a3cbc6f6ceb5adc8a3acd20ab3816d3771b60781ba6ed4bb8e254a911e8c046e7e6e65af0873f8440fc
  • Download URL:
  • File Type:
    Filetype[PDF - 6.63 MB ]
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