Health problems persist among in WTC workers

Friday, August 29, 2003

NEW YORK -- Nearly two years after the World Trade Center attack, a medical screening program continues to reveal a surprisingly high rate of physical and mental problems among cleanup and rescue workers.

About 48 percent of workers screened had ear, nose and throat problems such as nasal congestion, hoarseness, headaches and throat irritation, according to the latest figures. Thirty percent had pulmonary problems, including shortness of breath, persistent cough and wheezing.

The data reflect patients screened between July 2002 and April 2003. But the director of the program's medical component said patients have continued to report symptoms at about the same rate since then.

"It is surprising that it's lasted this long," said Dr. Jacqueline Moline of Mount Sinai Medical Center, which is conducting the screening in with the National Institute for Occupational Safety and Health.

The researchers, who issued preliminary findings in January, described the ongoing examination of the data in interviews this week with The Associated Press. A formal updated analysis is expected within the next several weeks. The researchers' comments come a week after the inspector general of the Environmental Protection Agency criticized that agency for downplaying air quality risks in public statements after the attack.

"It was such a massive irritant exposure," Moline said. "Some people will be left with permanent respiratory symptoms."

Soot from the collapse of the towers contained asbestos, lead, glass fibers and concrete.

On the mental health side of the study, about 19 percent of patients have been diagnosed with post traumatic stress disorder -- at least double the rate seen in the general population, said Dr. Craig Katz, supervisor of the program's psychological component.

Consistent percentage

He said the percentage has remained surprisingly constant throughout the program. Typically, people with PTSD have an immediate peak in symptoms, followed by a decline and then a second peak one to two years later.

"You'd expect that it would wane with time," he said. "But it's been the same kind of problems, the same kind of reporting from the beginning of the program to now."

In addition, 56 percent of those screened have reported psychological problems that warrant additional counseling, including insomnia, trouble focusing and irritability.

Those symptoms are all potential signs of depression. But major depression has been diagnosed in only 5 percent to 8 percent of patients -- about the same as in the general population, Katz said.

The Mount Sinai figures are for site workers who have visited the hospital and regional centers nationwide between July 2002 -- when the program began -- and April 2003. To date, about 7,500 workers have been examined, Moline said, with the results of about 1,100 quantified.

"What they're doing is so important, because it's the only way we're going to find out what will happen to people who were down there," said Dr. Robin Gershon, a professor of sociomedical sciences at Columbia University who is not affiliated with the program. "It's like following the canary in the coal mine."

Medical screening is scheduled to run through next March; psychological screening will continue until June. By that time, about 12,000 of the estimated 30,000 people who worked at the site will have been screened, at a total cost of $12 million, Moline said. Most of the funding has come from the federal Centers for Disease Control and Prevention.

The program evaluates each subject only once. Those who need further medical or psychological treatment are referred to specialists.

A joint study by Mount Sinai and Columbia, preliminary results of which were released earlier this month, found that air pollution from the attacks may have resulted in smaller babies among pregnant mothers who were in or near the towers.

There are no plans for a long-term study to gauge health problems such as cancer and chronic mental illness that may not surface until later in workers' lives. Such a study would be crucial to understanding the full health impact of the attacks, doctors said.

"You won't see all the effects of asbestos, for example, for 20 or 30 years," Moline said. "There were some other carcinogenic agents there, too. It's so hard to predict what will happen."

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