Lung ailments linked to 9/1123rd May 2006
As they pursue their investigation into the health risks to workers in the recovery and cleanup operations at ground zero, doctors, scientists and forensic pathologists are focusing on a group of lung diseases that can lead to long-term disabilities and, in some cases, death.
The death of Detective James Zadroga, in January, was the first to be officially linked by an autopsy report to exposure to the ground zero dust. After nearly five years, it is still too early for medical professionals to say with certainty whether any long-term cancer threat came with exposure to the toxic cloud arising from the trade center collapse. There are already clear signs, however, that the dust, smoke and ash that responders breathed in have led to an increase in diseases that scar the lungs and reduce their capacity.
The Fire Department reported an increase in cases of a particular lung scarring disease, known as sarcoidosis, among firefighters, which rose to five times the expected rate in the two years after Sept. 11. Though that rate has declined, experts who regularly see workers who were at ground zero in the 48 hours after the towers' collapse expect monitoring to show many more cases of lung- scarring disorders among that group.
New evidence also suggests that workers who arrived later or worked on the periphery may also be susceptible to debilitating lung ailments. Some of the people working in the cleanup and recovery effort after Sept. 11 wore masks, but the most effective ones were effective for no more than 20 minutes.
The ailments now seen are far more serious than the general hacking and congestion known as "World Trade Center cough" that initially hit most responders. Rather, these are a set of diseases and disorders that typically take a few years to develop, and in some cases get progressively worse.
Some of the most worrying of these are granulomatous pulmonary diseases, which show a particular type of swirling marks left on the lungs by foreign matter like dust; these diseases include pulmonary fibrosis and sarcoidosis; the severity of the disease is often dictated by a patient's genetic makeup.
Detective Zadroga's death was the first to be officially linked by an autopsy report to exposure to the ground zero dust, although the electronmicroscope comparisons that could have proved the match beyond a reasonable doubt were not done by the coroner's office.
The reported cases of lung disease affect a tiny portion of the 40,000 people who responded to the trade center collapse, but have already caused widespread concern among the survivors, lending urgency to medical efforts to understand illnesses and risks involved.
Dr. Levin, a professor at Mount Sinai School of Medicine, whose screening programme offers a detailed picture of the health consequences, said that of 12,000 workers who were examined, more than 60 percent developed respiratory problems like sinusitis. He said continued monitoring was beginning to suggest that more serious lung problems might follow.
Even in diseases closely related to dust, making an absolute connection to ground zero exposure is hard. The Fire Department has linked sarcoidosis to working at the trade center site, while the Police Department has not. Firefighters who have developed sarcoidosis since Sept. 11 are thought to have contracted the disease because of their work at ground zero. Yet the Police Pension Board has ruled that working at ground zero did not cause the death of a police officer who developed the disease after working multiple shifts at ground zero; the Police Pension Board said that sarcoidosis is "not known to be related to employment in the police force."
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