Health and Environmental Consequences of the World Trade Center Disaster

• Published in: Environmental health perspectives Vol. 112; no. 6; pp. 731 - 739
• Main Authors: Landrigan, Philip J., Lioy, Paul J., Thurston, George, Berkowitz, Gertrud, Chen, L. C., Chillrud, Steven N., Gavett, Stephen H., Georgopoulos, Panos G., Geyh, Alison S., Levin, Stephen, Perera, Frederica, Rappaport, Stephen M., Small, Christopher, The NIEHS World Trade Center Working Group
• Format: Journal Article
• Language: English
• Published: United States National Institute of Environmental Health Sciences. National Institutes of Health. Department of Health, Education and Welfare 01.05.2004; National Institute of Environmental Health Sciences
• Subjects: Adult; Air pollution; Air sampling; Aircraft; Animals; Asbestos; Construction Materials; Cough; Environmental agencies; Environmental Exposure; Environmental health; Female; Fire fighting; Humans; Hydrogen-Ion Concentration; Incidence; Infant, Newborn; Infant, Small for Gestational Age; Infants; Lung - immunology; Lung - pathology; Male; Mice; Middle Aged; New York City; Occupational Exposure; Particulate matter; Plumes; Polycyclic Aromatic Hydrocarbons - analysis; Polycyclic Aromatic Hydrocarbons - poisoning; Pregnancy; Prevalence; Respiratory Tract Diseases - epidemiology; Respiratory Tract Diseases - etiology; Risk Assessment; Terrorism; Workgroup Report; USA, New York; USA, New York, New York
• ISSN: 0091-6765; 1552-9924
• DOI: 10.1289/ehp.6702

The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyses of outdoor and indoor settled dust; high-altitude imaging and modeling of the atmospheric plume; inhalation studies of WTC dust in mice; and clinical examinations, community surveys, and prospective epidemiologic studies of exposed populations. WTC dust was found to consist predominantly (95%) of coarse particles and contained pulverized cement, glass fibers, asbestos, lead, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polychlorinated furans and dioxins. Airborne particulate levels were highest immediately after the attack and declined thereafter. Particulate levels decreased sharply with distance from the WTC. Dust pH was highly alkaline (pH 9.0-11.0). Mice exposed to WTC dust showed only moderate pulmonary inflammation but marked bronchial hyperreactivity. Evaluation of 10,116 firefighters showed exposure-related increases in cough and bronchial hyperreactivity. Evaluation of 183 cleanup workers showed new-onset cough (33%), wheeze (18%), and phlegm production (24%). Increased frequency of new-onset cough, wheeze, and shortness of breath were also observed in community residents. Follow-up of 182 pregnant women who were either inside or near the WTC on 11 September showed a 2-fold increase in small-for-gestational-age (SGA) infants. In summary, environmental exposures after the WTC disaster were associated with significant adverse effects on health. The high alkalinity of WTC dust produced bronchial hyperreactivity, persistent cough, and increased risk of asthma. Plausible causes of the observed increase in SGA infants include maternal exposures to PAH and particulates. Future risk of mesothelioma may be increased, particularly among workers and volunteers exposed occupationally to asbestos. Continuing follow-up of all exposed populations is required to document the long-term consequences of the disaster.