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Ground Zero responders face multitude of illnesses
By Barbara Williams
NEW YORK — More than 30,000 police officers, firefighters and emergency medical technicians who toiled in the smoldering wreckage at Ground Zero suffer physical or mental health problems today, health officials say.
Ten years ago, they were healthy, active and focused on the massive recovery effort. Today, these emergency workers have illnesses ranging from persistent sinusitis and other minor sicknesses to diseases that have left them weak and disabled.
"I have 17 diagnoses, nodules in my lungs, polyps in my colon," said Charles Giles, 43. I had black fluid in my lungs that had crushed glass and bricks in it."
Giles, who moved from Garfield to Barnegat since getting sick, spent 497 hours in lower Manhattan following the terrorist attacks as the director of a private EMT company. He has congestive heart failure, coronary artery disease, asthma and chronic sinusitis, among other maladies.
He is one of the nearly 16,000 Ground Zero patients being monitored at the Center for Excellence at the University of Medicine and Dentistry of New Jersey Robert Wood Johnson Medical School. Another 34,000 first responders and lower Manhattan residents go to similar centers in New York, all overseen by the World Trade Center Health Program and funded through the James Zadroga 9/11 Health and Compensation Act.
More than 70 percent of these patients have some physical or mental health problem that still requires treatment, researchers said.
Studies are being conducted to tally the number of people who have died from these ongoing illnesses. Results are due by the end of the year.
While working at Ground Zero, these patients inhaled jet fuel, soot, glass fibers, asbestos, crushed metals, cement dust, pesticides, dioxins and other contaminants. Individually, these pollutants cause serious damage, but mixed together and absorbed into the human body, the toxic brew is harming patients in ways experts never predicted.
"I believe there was permanent damage to the sinuses from what they inhaled," said Dr. Iris Udasin, principal investigator and director of the center at UMDNJ. "There is long-standing inflammation and what would have been minor and livable illnesses are now more serious conditions."
Now they have asthma rates at least twice the nation's general population. More than 70 percent have respiratory problems. They have gastro- esophageal reflux, upper and lower respiratory problems, sinusitis, sleep apnea and post nasal drip, researchers said.
In healthy individuals, these medical conditions are annoying, but don't stop patients from their daily activities. But the airborne pollutants have caused so much damage to nasal cavities, lungs and digestive systems that the illnesses are now chronic and debilitating.
First responders said they toiled without masks or protective gear based on comments by Christie Whitman, the former New Jersey governor who headed the federal Environmental Protection Agency at the time. A week after the World Trade Center towers fell, Whitman stated that the air was safe.
"That stuff was absorbed into the nose, mouth and skin," said John Feal, a former supervisor in a demolition company who now suffers from acid reflux. "If you took any of those toxins and put them in a bottle, there would be skull and crossbones on the label."
Feal started the FealGood Foundation, an organization that helps survivors and families of 9/11 victims. He helped spearhead the effort to pass the federal Zadroga Act, which provides $4.3 billion over the next five years to monitor, treat and compensate people exposed to the cloud of toxins.
James Zadroga was a New York City police detective and North Arlington resident who worked on the rescue and recovery efforts at Ground Zero for about three weeks after 9/11. Soon after, his family said, he began experiencing flu-like symptoms and difficulty breathing -- common symptoms in first responders that doctors called the "World Trade Center cough." His respiratory illness quickly worsened.
He died in January 2006 at his parents' home in Ocean County. He was 34.
Zadroga was recognized as the first police officer to die as a direct result of inhaling the toxic dust.
Funding from the act covers treatment for respiratory diseases, skin rashes and chronic acid reflux, but specifically excludes cancer. A July report by the National Institute for Occupational Safety and Health said there isn't enough scientific evidence to link the disease to the dust.
"Drawing casual inferences about exposures resulting from the Sept. 11, 2001, terrorist attacks and the observation of cancer cases in responders and survivors is especially challenging since cancer is not a rare disease," the report said.
But Dr. John Howard, director of NIOSH, said cancer may be included in the future and another review of data on the disease will be conducted in early to mid-2012.
Dr. Michael Crane, medical director of the center at Mount Sinai Medical Center that monitors patients who worked at Ground Zero, said although he doesn't want to draw any conclusions about the pollutants causing cancer, he is "extremely concerned."
"There was tremendous exposure to highly toxic chemicals and the potential for these exposures to accelerate or initiate a cancer," Crane said.
UMDNJ's Udasin said cancer cases must be thoroughly reviewed before experts will report that the pollutants are causing the illnesses.
Cancer cases need to be confirmed by state health departments, a detailed process that typically takes about two years. Further, the 2009 report from the centers on which the NOISH decision was based had covered cases only through 2007, so any diseases that developed since then would not be included, Udasin said.
"But there are 60 different cancers we're watching and we have seen a substantial number of blood and esophageal cancers," she said.
Physicians at the centers monitoring the patients said they also have at least 10 confirmed cases of multiple myeloma, a cancer in the bone marrow that typically develops in people over 65.
Convinced by cancer cases
"I believe cancer will be put on the list by the end of 2011 -- there are too many people who have cancer from 9/11," Feal said. "I've been to 54 funerals of people who worked at Ground Zero and 52 of the deaths were from cancer. And I know 12 more workers right now who have brain cancer."
David Howley of Edison, a retired New York City police officer, said he has "no question" his cancer is a direct result of working at Ground Zero. Now 50, he's been battling squamous-cell carcinoma, a common form of skin cancer, since 2006.
In Howley, however, the disease formed a quarter-size lump on his neck that doctors knew had metastasized -- moved from another location. Yet it still took two years of testing before doctors found the original cancer under his tongue.
"I was told this type of cancer is very unusual in people my age unless you are a heavy smoker or drinker or chew tobacco over a long period of time, and I didn't do any of those," Howley said.
Currently cancer-free, Howley said he deals with other lingering problems. He has trouble breathing when he laughs and his sinuses are constantly draining.
Patty Cortazzo is convinced the cancer that killed her husband, John Cortazzo, developed from his recovery work at the World Trade Center site.
Cortazzo, a Port Authority K-9 officer and a Montvale resident, died in March 2009 of myelodysplastic syndrome, a disease that develops in the bone marrow and is typically found in the elderly.
He was 48. His canine partner, Sienna, died eight months later.
Last month, the Port Authority of New York and New Jersey recognized Cortazzo as the 38th agency officer to die as a result of the terrorist attacks, and the first to lose his life from an illness caused by working at the site.
Despite the devastating health effects, many of the survivors said they don't know how they could have reacted any differently 10 years ago.
"After I outran the second tower falling, I went back to try and help and the first tower collapsed and I was trapped," Giles said. "My eye was injured and I had second-degree burns and I went back again. That's what you do -- people need help. You don't even think about it."
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