The WTC ‘Cough’?
by Howard Fienberg
When the World Trade Centers came crashing down, the
casualties and the impact were obvious. But you may have heard of a threat to
According to MSNBC’s Francesca Lyman (Mar. 11), “Just as people once traded tragic stories about lives lost in the terror attacks ... New Yorkers now circulate stories about people whose health has been injured in the line of duty.” Estimates of the number of people suffering from the WTC cough vary dramatically, because they are based on anecdotal evidence. Some sources gauge only a few hundred cases, but the Uniformed Firefighters Association thinks about 3,000 of its members suffer from it and the National Resources Defense Council believes there are at least 10,000 cases.
The implications are pretty big. A new bill in the New
York State legislature proposes to extend workers compensation benefits to
rescue and recovery personnel at the trade center for “exposure-related
illnesses” (AP, Apr. 7). Those illnesses will presumably encompass the
WTC cough. Meanwhile, 1300 people gave notice in early February that they may
Politicians, activists and lawyers have identified a WTC cough. It envelopes a vague collection of symptoms and ailments, including colds, asthma, nosebleed, headache, sinus infection, pneumonia, bronchitis, nasal congestion, diminished lung capacity, hoarseness of voice, chest tightness, flu and, of course, coughing.
Are all these ailments connected? If so, what could have caused them?
Many environmental health researchers have fingered the
release of toxic pollutants on September 11 as the cause of the WTC cough.
The mix of dust, melting steel, jet fuel, asbestos and dozens of other
chemicals spread around
But independent tests, and there are lots of them, have found elevated levels of all kinds of substances in and around lower Manhattan, ranging from fiberglass to PCBs. Dozens of private firms have run tests for pollutants, but the results are usually controversial. There are many methods of testing for each pollutant and getting folks to agree on one can be difficult, if not impossible. Many of the testing methods used are either not acknowledged or not understood by federal scientists.
Indeed, tests with wickedly high levels of sensitivity can detect such ultra-fine particles (.001 inches in diameter, according to the AP), but the higher the sensitivity, the higher the chances for false positives (the Mar. 18 column “Mexican Jumping Genes" illustrates the perils in false positives). That may be the reason that the EPA chose not to run those kind of tests.
Regardless, scientists are not even certain that a lot of these substances, even in large doses, can have a negative health impact. The presumed minimal exposure over a short period of time makes it unlikely there will be any noticeable health effects that can be tied to the substances themselves.
The USA Today (Feb. 7) quotes Manhattan resident Dennis Gault, who worries that, for a 3-year-old, there are no safe levels of toxins. Most scientists, who deliberately set safety limits for toxic exposure levels lower than doses at which any health effects could be detected, do not share Gaults opinion. While the many different tests that found elevated levels of some substances may be cause for concern, they should not necessarily scare the bejeebers out of Manhattanites, even their children.
Still, some scientists believe that the scientific understanding of safe levels for individual toxins may overlook the possibility that, taken together, they may combine synergistically, creating unsafe effects far in excess of their simple addition. This precise argument was invoked in some media coverage, raising fears that although the toxic exposure at ground zero may have been minute, the combination of substances might cause adverse health effects.
However, the best known example of synergistic effects, involving endocrine disrupting chemicals, turned out to be based on a study so pathetic that it could not be replicated. The study’s authors eventually retracted it.
Environmental Health Studies
There is no obvious shortage of people researching the possible health impacts at ground zero. The Mount Sinai School of Medicine is monitoring pregnant women for possible exposure outcomes. The fire department is monitoring all of its potentially exposed emergency personnel.
Unfortunately, this should have come as no surprise to the
doctor. Workers on the low end of the socioeconomic pole are unlikely to have
medical insurance or receive regular health examinations and are prone to
poor diet and exercise. Day laborers are strong candidates for health
problems anywhere, not just in
The New York Academy of Medicine is trying to build a registry of everyone who worked for even a moment at ground zero. That would make the environmental health studies significantly more accurate.
Even so, all the studies will be confounded by the city’s demographics, which mix residents, tourists and commuting office workers. Many of them no longer live or work there. Because we lack reasonable data about the number of people exposed, epidemiological estimates based on these studies will be weak at best. There will be no way to accurately derive a sample of the 9-11 population.
Could Something Else Be Causing the WTC Cough?
Experienced emergency workers have pointed out that the
WTC, despite its frightening scale, did not differ all that much from other
disaster scenes, like
Kerry Kelly, chief medical officer of the NYCFD, told the Washington Post (Feb. 12) that the number of firefighters who have taken medical leave because of stress and respiratory problems had doubled since 9-11. But perhaps this should not have surprised the Post. Menlo Park Deputy Fire Chief Ed Greene, whose force sent many volunteers to ground zero, told the San Francisco Chronicle (Dec. 25), “Its not unusual for firefighters to come back from an operation with colds or other ailments, especially after a lengthy, exhausting deployment that batters the immune system.”
Presuming that we can even lump together all those disparate symptoms and illnesses under one simple rubric, what could have brought on the WTC cough? Stress, fatigue, seasonal allergies and seasonal illnesses are all likely candidates. Exposure to any kind of dust, toxic or not, is bound to aggravate any of the above ailments, but not necessarily to cause them.
Science Trumps Politics
Media coverage of the WTC cough has mostly focused on
political stories: an alleged EPA cover-up; officials so eager to reopen
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