This article is part of Discover's package on the health effects of 9/11 air pollution on the people in New York City.
Click here to read about the city and federal governments' failure to protect ordinary citizens.
At an age when many of his peers are practicing their golf swings, 65-year-old Philip Landrigan is smack dab in the middle of a crucially important health project: He is the lead doctor researching the sometimes deadly health effects of living and working in lower Manhattan in the aftermath of the 9/11 terrorist attacks on the World Trade Center.
What's more, he's just getting started on an even bigger undertaking: the National Children's Study, a landmark field investigation that will follow 100,000 American children from conception to age 21.
Landrigan's office is at the Mount Sinai School of Medicine in New York, where he heads the Department of Community and Preventive Medicine.
Q: Your department is monitoring the health effects from the collapse of the World Trade Center. When the towers collapsed, two million tons of dust containing cement, asbestos, glass, lead,and carcinogens rained down on lower Manhattan. Yet less than a week later, the EPA said it was safe to go there and breathe the air. Now we know that erroneous assessment may have put thousands of people at risk for serious chronic health problems, and even death.
A: [EPADirector] Christine Todd Whitman's statement that the air in Manhattan was safe to breathe was stupid and ill-considered because she was making a very strong assertion with almost no data. I wondered how she could say this—it's like a doctor telling a patient that the patient is healthy before he's done any tests.
At that point, only minimal air sampling had been done because all the air monitors had been destroyed. And most of the early sampling was focused on asbestos because we thought that asbestos was the big hazard. It took a few weeks before we realized that it was the complex mix of chemicals and dust that was the hazard—asbestos was just part of the puzzle—especially the pulverized concrete, which was extremely alkaline.
Like breathing Drano.
Unfortunately, that's true. And the concentrations of dust in the air were so high that they overwhelmed all the normal defenses of the human respiratory tract, and people inhaled ounces of dust into their trachea or their bronchi.
Did you have any inkling about what was going to happen?
Not immediately because it took time for that recognition to evolve. It was about one to two months later that we began to see a few people with a persistent cough in our occupational medicine center here at Mt. Sinai, which is the biggest in the region. And another symptom that didn't get as much attention was extraordinary inflammation of their upper airways, and nasal sinuses, which was very painful. These observations started accumulating through the fall and winter, and by the spring of 2002, we realized we had a lot of people with respiratory problems.
We got some money from the National Institute of Environmental Health Science, and did a quick survey of members of the Iron Workers Union, the guys that operate the heavy cranes and who got down there within hours of the attacks. We compared 110 ironworkers who had been down at Ground Zero versus a couple hundred who were elsewhere in New York City. And there was a very striking difference in the rate of respiratory symptoms.
That was when we went to the National Institute for Occupational Safety and Health, and said there is a need for a structured medical monitoring program for the people who worked down there. They set up two big programs here in New York City. One was at the Fire Department, which focuses on the active duty firefighters and that program has seen about 15,000 people. The other is based here at Mt. Sinai, which anchors a consortium of five institutions around the city: Bellevue, Stony Brook Medical Center on Long Island, the University of Medicine and Dentistry of New Jersey, and Queens College. We're the hub of this consortium, which has now seen about 20,000 people, and we're continuing to follow up.
But it's hard to capture everyone who worked at the site. Many of them live outside of Manhattan, and some are immigrants who don't speak much English.
Efforts have been made because we all recognize the problem. The fire department has the best records of all because they are a paramilitary organization—they knew exactly who was where when and they can command people to come in for physical examination. We've got all the other workers, and we've done a pretty good job, but not as good as the firefighters. One of the problems is that nobody kept a very good record of who was working on the site, and there are estimates that go from 40,000 to 100,000 people were down there.
The truth will never be known because there's no way to completely recapture them. My own guess is that between the two groups, we've probably seen two-thirds to three-quarters of everyone who was down there. But even now, six years after the events, we're still getting 500 new people every month who are finally coming in for medical assistance; they have just now gotten sufficiently worried or pushed by their spouse or their partner.
Now some experts are saying there's a third wave of Ground Zero illnesses—cancers and in particular, myelomas.
That's still in the very early stages. We have seen some cases of cancer in people who were down at Ground Zero, and we're trying right now to verify precisely which kind of cancers those are because that obviously makes a difference. What we don't know is whether these cases are related to Ground Zero, and if this is the beginning of a trend or just background noise. Frankly, only time will tell. Mesothelioma as a result of asbestos, for example, typically takes two or three decades to makes its appearance.
So the ultimate death toll from the World Trade Center could be in the tens of thousands.
Who knows? But it's almost certainly going to be greater than what we know today.