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This month was the 13th anniversary of the haunting September 11 event that has changed us, our Nation, and the world we thought we knew. It seems like yesterday that these events happened.

Three years ago, I posted my frustration of my inability to get First Responders, and/or their health practitioners, to consider addressing the issue of immune homeostasis, immune balance, to enhance the quality of life of individuals that had put themselves at risk to save others.

 Exposure to Air-Borne Particles

The World Trade Center Health Registry estimates about 410,000 people were exposed to air-borne particles and toxins attempting to rescue survivors and recover the dead, clearing the site, or cleaning the surrounding buildings.

 Despite the fact that early in the World Trade Center (WTC)’ construction, builders abandoned asbestos as a fireproofing material, over 400 tons of asbestos were used in the building of the World Trade Center (WTC). Additionally ”mineral wool”, minerals that were melted and spun into fibers and bound together by cement like components was used in construction.

 Massive amounts of hazardous fiber, asbestos, glass, gypsum, and cement were pulverized into ultra-fine particles when the Towers imploded and collapsed on September 11. Virtually every surface was covered with a fine, white particulate dust, and downwind from the complex, the fine particulate matter settled to a depth of 3 inches or more.

Affected groups of Responders include firefighters, police, health professionals, clean-up crews, construction workers, truck drivers, transit workers, lower Manhattan residents, and office workers.

 Increase Risk of Cancer

Responders were exposed to hundreds, if not thousands, of toxic particulates, dust, and gases at Ground Zero. As many of these are known to be potential carcinogens, it is not surprising that two years ago, 58 different types of cancers were added to a list of diseases with which many World Trade Center responders suffer.

 Overall, First Responders at Ground Zero have a 15% increased cancer risk with a 239% higher risk for thyroid cancers. However, unfortunately, asbestos-related lung cancers such as malignant mesothelioma may not appear for 20-40 more years.

 Signature Illness: PSTD and Respiratory Illness

If having a significant increase in cancer risk was not enough, according to the findings of the Stony Brook [NY] Medicine’s World Trade Center Health Program, as many as 60% of 9/11 World Trade Center responders continue to experience “clinically significant symptoms of post-traumatic stress disorder (PTSD) and … respiratory illness”.

Coughing and breathing problems have been a major issue, even in Responders that were only “moderately” exposed. Additionally individuals with the most exposure were more likely to find that their asthma symptoms became worse.

Benjamin Luft, MD, Medical Director of the Stony Brook Program is of the opinion that “a signature illness” of a WTC Responder is having both PTSD and respiratory problems at the same time.

 Respiratory Difficulties and Inflammation

Inflammatory biomarkers have been monitored in those exposed to WTC dust and smoke. Elevated levels soon after exposure were associated with increased risk of difficulty breathing in the years that followed.

 PTSD and Inflammatory Responses

A few months ago I stated “Clinical studies suggest that individuals with post-traumatic stress disorders suffer from chronic low-level inflammation. This is reflected in their greater propensity to have inflammation-associated diseases such as autoimmune, cardiovascular, gastrointestinal, musculoskeletal, and respiratory diseases.”

 “…individuals with PTSD are more likely to have significantly higher amounts of circulating CRP [an inflammatory marker] than those not diagnosed with PTSD.”

 The Combination of PTSD and Respiratory Issues

To repeat from my previous post,“The immune system mounts an immune, inflammatory response when the body is exposed to pathogens, pollutants, or toxins. The inflammatory cells release immune factors, such as cytokines, cellular messages, that are involved in cell-to-cell communication with the “purpose” of recruiting more inflammatory cells into an area to help eliminate a perceived threat.”

 “Pollutants and chemicals … trigger airway inflammation and increase mucous production. Other immune molecules cause narrowing of airways resulting in the contraction of the muscles lining the airways. The combination of inflammation and increased mucous makes it difficult for air to enter or leave the lungs and can result in breathing issues.”

“Additionally, lungs that do not function properly, are ideal for the multiplication of molds, bacteria, and viruses. The lungs continue their struggle to eliminate pollutants and pathogens, resulting in a chronic, persistent, dry cough and worsened lung function.”

 A Plea to Readers

I am convinced that immune inflammatory imbalances contribute in large portion to the reason that that First Responders experience so many health challenges.

 It is my heart-felt hope and expectation that helping individuals return to immune homeostasis, immune balance, may be the key to changing their quality of life. Despite numerous attempts and avenues, I have been unable to make reliable contact with decision makers or Responders.   I hope that you will forward my note to individuals that are still suffering the consequences of serving others.

 I can be reached at: DrHellen@DrHellenGreenblatt.info or at 302.265.3870. Thank you.

www.asbestos.com/world-trade-center/
sb.cc.stonybrook.edu/news/general/140910wtc.php
911research.wtc7.net/wtc/evidence/dust.html
www.sciencedaily.com/releases/2014/09/140910185910.htm
www.health.ny.gov/environmental/investigations/wtc/health_studies/responders.htm
www.cnn.com/2013/09/11/health/911-cancer-treatment/
www.thelancet.com/themed-911
www.mesothelioma.com/blog/authors/barbara/help-running-out-for-911-first-responders.htm
www.ncbi.nlm.nih.gov/pubmed/21998260

This is the second part of a two day posting. Please see yesterday’s posting for the introduction to this posting. Thank you.

Cancer Risks

Responders are 19% more likely to develop cancer than their non-exposed colleagues, with skin, prostate, thyroid, and non-Hodgkin’s lymphoma, being the most common of the cancers. Many of the airborne toxins to which individuals were exposed, benzene, volatile organics, metals, polycyclic aromatic hydrocarbons, pulverized building materials, glass fibers, asbestos, lead, hydrochloric acid, polychlorinated biphenyls, organochlorine pesticides, and polychlorinated dioxins and furans are linked to causing cancer.

Cancer is an illness that may take years to develop and detect. Dr. Ware Kuschner, Stanford School of Medicine, CA says, “Carcinogenic effects, if any, will not be observed for a very long period of time.” [As an aside, according to the University of Pennsylvania School of Veterinary Medicine, eight search and rescue dogs have died from cancer since their exposure to rubble from the Sept. 11 terrorist attack.]

 

Pulmonary Function Declines

We do not have sufficient data from the general population residing and working in lower Manhattan, nor detailed health information of individuals that returned to their home states or countries after their contributions to rescue efforts. However, of the rescue, recovery, and clean-up personnel that were monitored, 42% have respiratory problems.

Steep declines in pulmonary function were first detected after 9/11 and they have largely persisted. Over the last nine years, 28% of those monitored have had asthma and 42% sinusitis (inflammation of sinuses). They also suffer from upper airway cough syndrome (UACS) and sarcoidosis. Sarcoidosis is an inflammatory autoimmune disorder in which the body’s own immune system attacks and destroys the tissues of the body. There has been a 36-fold increase in the number of individuals with this disease that can affect the lungs, lymph nodes, eyes, skin, heart, liver, and brain. The hallmarks of the disease are clusters of inflammatory cells throughout the body and often, significant, life-altering declines in breathing and other bodily functions.

 Inflamamtion: The Body’s Defense Against Perceived Threats

The immune system mounts an immune, inflammatory response when the body is exposed to pathogens, pollutants, or toxins. The inflammatory cells release immune factors, such as cytokines, cellular messages, that are involved in cell-to-cell communication with the “purpose” of recruiting more inflammatory cells into an area to help eliminate a perceived threat.

Pollutants and chemicals can trigger airway inflammation and increase mucous production. Other immune molecules cause narrowing of airways resulting in the contraction of the muscles lining the airways. The combination of inflammation and increased mucous makes it difficult for air to enter or leave the lungs and can result in breathing issues.

Additionally, lungs that do not function properly, areideal for the multiplication of molds, bacteria, and viruses. The lungs continue their struggle to eliminate pollutants and pathogens, resulting in a chronic, persistent, dry cough and worsened lung function.

 Immune Homeostasis, Immune Balance

A healthy person produces the right amount of inflammation in response to environmental and biological challenges. If WTC responders and others involved in rescue and clean-up of the 9/11 destruction, were able to control the amount of inflammation in their bodies , the body could finally start its healing process. Returning the body to inflammatory homeostasis, to inflammatory balance, would result in significant differences in the quality of their lives.

 

A Personal Note

It has been my conviction for years that a compromised immune system is at the root of the majority of health issues of World Trade Center responders, recovery and clean-up workers.

As a former New Yorker, I, as most Americans and overseas friends, took the attacks on America’s premier city personally and we still feel-grief and compassion, especially around this time of the year.

But what has really gnawed at me all these years is that surviving workers,–individuals who thought only of others and risked their lives to help despite terrible odds, are still suffering emotionally and physically.

I have been frustrated by my inability to reach the right people to share my decades long experience suggesting a different approach to helping individuals regain their health.

Based on decades of working with individuals having immune issues, I am confident that World Trade Centers workers would experience major quality of life changes if they were able to help their body regain its delicate balance—return to its optimum immune homeostasis.

These brave souls have visited physician after physician, clinic after clinic without a solution to what ails them. Ten years of searching for answers is long enough. It is now time for these individuals to take control of their own health by helping their bodies return to inflammatory homeostasis, balance.

I am not a health practitioner, but I am a scientist who can provide the facts to you. You will know within a short period of time whether or not my suggestions work for you.

I encourage you to contact me so we can start on the journey.

Resources:

www.guardian.co.uk/world/2011/sep/02/world-trade-centre-rescuers-health-risk

www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60989-6/abstract

www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61180-X/abstract

www.thelancet.com/journals/lanonc/article/PIIS1470-2045(01)00543-5/fulltext

www.home2.nyc.gov/html/doh/wtc/html/know/mental.shtml

 

It is ten years since the horrific 9/11/01 attacks on the World Trade Center in New York City, The Pentagon in Washington, DC, and Flight 93 in Pennsylvania. On that day at the World Trade Center alone, there were approximately 3,000 murders.

These events have not only left the families, friends, and citizen survivors distraught and at great emotional and financial risk, but the heroic responders, the rescuers, recovery, and clean-up personnel, and civilians that lived and worked in the area, continue to pay a significant price in terms of their health.

There will never be a true accounting of how many individuals were exposed to smoke, thick-coatings of dust, combustion materials, asbestos, polychlorinated biphenyls (PCBs), dioxin, asbestos, and metals. Fire fighters, police, military members, paramedics, construction and iron workers, municipal employees, security workers, residents and workers in the area, and those that came from afar to help, were exposed to these toxic chemicals for days, weeks, and months. Fires burned for 69 days and even eight months after the destruction, workers were still searching for body fragments (1).

For some, the years may be receding from memory, but there are many individuals, and rescue and recovery dogs, that have, or are, still, paying a significant price for their heroic sacrifices. If they are still alive, their emotional and physical health has declined significantly, and no one seems to be able to help them.

Only limited funding has been available to study and monitor individuals that were at Ground Zeroand its surrounding environs. When researching information for this article I was surprised at the relatively few, peer-reviewed publications on this topic, and there is even less information on the effects of this trauma on children and adolescents.

Multiple Health Issues

A primary investigation now led by Dr Juan Wisnivesky, Mount Sinai School of Medicine in New York, has said, “Our findings show a substantial burden of persistent physical and mental disorders in rescue and recovery workers who rushed to the site of the WTC and labored there for weeks and months. Many of these individuals now suffer from multiple health problems (2), since World Trade Center-related mental and physical health conditions often co-exist (3).

Mental Health Issues Persist

One year after 9/11, it was estimated that more than 420,000 people New Yorkers were suffering from post traumatic stress disorders (PTSD) as a result of the attacks (1). This month, the prestigious British journal, Lancet, reports that 32% of tested personnel experienced post traumatic stress disorders and 28% per cent experienced depression at some time after 9/11. The incidence of most of the disorders was highest in workers with greatest World Trade Center exposure (3,4). Other emotional problems such as recurring nightmares, flashbacks, self-medication with alcohol, etc. have also been persistent issues.

Tomorrow: 9/11 Responders: Cancer Risks, Pulmonary Function, Immune Homeostasis, Balance.

1) www.guardian.co.uk/world/2002/aug/18/usa.terrorism

2) www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61180-X/abstract

3) www.guardian.co.uk/world/2011/sep/02/world-trade-centre-rescuers-health-risk

4) www.thelancet.com/journals/lanonc/article/PIIS1470-2045(01)00543-5/fulltext

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