Ridgely Ochs / Newsday – 2006-06-03 09:08:30
NEW YORK (June 1, 2006) — A study published last month showed the average decline in lung function among firefighters who were at Ground Zero one year after Sept. 11 was the equivalent of 12 years of aging.
Doctors who treat World Trade Center responders say they are surprised almost five years later by the growing number seeking help for the first time — 100 people a month in the biggest monitoring program — and by the severity of illnesses among Sept. 11 workers already in treatment.
“There’s no question there’s continuing demand and many in the treatment program are quite ill,” said Dr. Robin Herbert, codirector of the World Trade Center Worker and Volunteer Medical Screening Program at Mount Sinai Medical Center in Manhattan.
Herbert, whose program has examined about 15,000 responders since 2002, said doctors are finding “remarkable persistence” in breathing disorders such as chronic sinusitis and asthma, stomach ailments such as gastrointestinal reflux disease and psychological problems such as post-traumatic stress disorder – a suite of maladies one survivor called “my 9/11 plague.”
Some patients also have come in with severe lung scarring, which can be fatal. And there have been cases of cancer, which worries experts, though they are unwilling to directly attribute them to exposure to Ground Zero toxins. Doctors are also surprised by the numbers of new patients. Mount Sinai’s screening program sees 100 new people a month, Herbert said. Despite adding more health care providers, Herbert said that for the last six months the waiting list for treatment has grown to more than three months.
“We honestly did not expect such ongoing demand,” she said. Dr. Ben Luft, program director for Long Island’s World Trade Center monitoring program at Stony Brook University Hospital, which is following about 1,800 workers, said about 250 new workers from Long Island have come to the program in the past year.
“It’s very surprising. Originally, we felt these are people who had an acute exposure and acute reaction, and we didn’t think we were going to continue at this level for five years after exposure,” said Luft, whose program, like Mount Sinai’s, follows and treats Sept. 11 responders. In some, he said, there appears to be “a period of latency” before symptoms develop. In others, symptoms have worsened over time, becoming bad enough to drive the person to seek help for the first time.
“There’s a chronic, progressive element to this,” he said. Herbert said she is also concerned about a small number of cases of lung scarring similar to that which killed Det. James Zadroga, 34, of Little Egg Harbor, N.J., in January. The coroner there found swirls in Zadroga’s lungs caused by foreign material, which he linked to Ground Zero dust — the first death to be officially tied to World Trade Center exposure.
“We’re concerned because now we have a very small number of World Trade Center responders with much more serious lung-scarring diseases,” Herbert said. Luft said he has also seen a handful of such cases.
Dr. David Prezant, chief medical officer in the New York Fire Department’s Office of Medical Affairs at Montefiore Medical Center, said he also has seen some cases of lung scarring among the 14,000 firefighters and emergency medical workers being monitored. He believes larger numbers of scarring cases and other diseases may show up in “another wave” decades from now.
Prezant coauthored a study published last month that showed the average lung function decline among firefighters who were at Ground Zero one year after Sept. 11 was the equivalent of 12 years of aging. World Trade Center workers are exchanging stories of cancers in colleagues — especially of the blood, kidneys and pancreas — they believe are the result of inhaling and ingesting pulverized cement, glass fibers and other toxic substances at Ground Zero.
“We have a rough estimate of 200 to 300 people who are between the ages of 30 and 50 [with cancer],” said Jon Sferazo, 51, of Huntington Station, presiding officer of Unsung Heroes Helping Heroes, an advocacy group for Sept. 11 responders. “These cancers seem to be occurring in people far too young,” he said.
Doctors are unwilling to link the cancer cases and exposure to Ground Zero toxins because it generally takes years for cancers to develop — but they are tracking them closely. “We don’t know if these are just normal, sporadic cases or if a pattern is developing. The methodology [in monitoring patients] has to be vigilant,” Luft said.
Mental health problems, including depression and post-traumatic stress disorder, are also not going away, experts said. As with new cases of physical ailments, health professionals are seeing new cases of psychological difficulties among people who previously hadn’t sought help. “What we’re seeing is people coming forward for the first time,” said Michael Arcari, the head of Faithful Response, a free mental health program for World Trade Center responders in North Bellmore.
Arcari, a former New York City Police Department lieutenant, said it is not unusual to see more people seeking help four to six years after a major trauma when their “coping mechanisms” start to falter.
Since it began last year, his program has seen 130 people, the majority of whom are from Long Island. “You start to see it in their personal lives and in their work performance,” he said. “… A marriage is breaking up or something else is going on and their backs are up against a wall.” Still hurting Experiences of three Ground Zerro workers
JON SFERAZO, 51 Huntington Station
ROLE — Structural ironworker with New York State Wilderness Search and Rescue who worked for four weeks at Ground Zero.
SUFFERS FROM — Reduced breathing capacity, chronic sinusitis, reactive and restrictive airway diseases, gastrointestinal reflux, sleep apnea and post-traumatic stress disorder.
IN HIS WORDS — “We don’t have an administration that cares about us and a medical community that can’t or won’t be forthright enough to make the link .”
MARVIN BETHEA, 46 Kew Gardens Hills
ROLE — Paramedic, St. Vincent’s Catholic Medical Center-St. John’s Hospital in Queens, who survived collapse of both towers.
SUFFERS FROM — Asthma, chronic sinusitis, depression and post-traumatic stress disorder. Had stroke five weeks after Sept. 11.
IN HIS WORDS— “Don’t let survivors and heroes become victimized twice.”
BONNIE GIEBFRIED, 41 Oceanside
ROLE — Emergency medical technician, Flushing Hospital Medical Center, who was buried twice when the towers fell.
SUFFERS FROM — Asthma, gastrointestinal reflux disease, hiatal hernia, damaged vocal cords, nerve damage from neck to knee, sciatica, neck and back problems and post- traumatic stress disorder. Injuries to left thumb, wrist and elbow required surgery.
IN HER WORDS — “Here we are in a country that proclaims justice for all. But where is the justice? I have my 9/11 plague and my friends are dying, but how can you not link anything and not give us treatment?” They suffer.
The World Trade Center Worker and Volunteer Medical Screening Program at Mount Sinai Medical Center evaluated 1,138 people who had worked in rescue or recovery from July 2002 to August 2004. A breakdown of their main illnesses:
• 51% Mental health problems
• 50% Upper respiratory symptoms (Head or sinus congestion, stuffy nose, post-nasal discharge, ear pain, sore throat).
• 40% Lower respiratory symptoms (Wheezing, dry cough, shortness of breath, chest tightness)
• 20% Post-traumatic stress disorder
• 15% Persistent heartburn
— Centers for disease control and prevention’s morbidity and mortality weekly report, Sept. 4, 2004
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