Helping Responders and Those Affected
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Overview
During and after the attacks on the World Trade Center (WTC) on September 11, 2001, many people involved in the response, rescue, and recovery efforts were exposed to environmental contaminants. Those involved in rescue, recovery, clean-up and restoration include:
- New York City Fire Department employees
- New York City Police Department employees
- Emergency medical service personnel, including paramedics
- New York State employees
- Other New York City employees
- Federal employees and those who became federal employees for the period in which they worked in response to the WTC disaster
- Responders from surrounding communities and states
- Construction workers and heavy equipment operators
- Volunteer workers
In keeping with good practice, medical protocols to help identify and treat conditions related to exposure to environmental contaminants at the WTC have been developed. The full impact of exposure to these potential contaminants is not yet known. Continued monitoring of responders and volunteers will provide data that is useful in treatment and in preparation for future emergency responses.
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Reported Physical and Mental Health Effects
Analysis of individual case reports and data from monitoring programs and the WTC Health Registry shows that certain symptoms are cited consistently. These are:
- Respiratory problems: sinus problems, persistent cough, wheezing, shortness of breath, reactive airways, hoarseness, scarring of the lung
- Psychological problems: anxiety, depression or post-traumatic stress disorder (PTSD)
- Stomach problems: acid reflux or heartburn
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Resources for Responders
CDC's National Institute for Occupational Safety and Health (NIOSH) works to oversee programs that have been established to monitor, screen, treat and support responders and volunteers who responded to the disaster site at the World Trade Center in New York City and who may have been affected by their service.
If you are not yet enrolled in the program, you may find out whether you are eligible by doing the following:
If you were or are working for the Fire Department of New York (FDNY), you should call the FDNY Bureau of Health Services (718-999-1858) or visit the following website for information about the program: http://www.nyc.gov/html/fdny/insider/bhs/wtcmm/index.shtml
If you were not or are not working for the FDNY, you should call 888-702-0630 or click on http://www.wtcexams.org/contactus.html to obtain the fax number and mailing address for sending in a completed eligibility form, which can be accessed by clicking on http://www.wtcexams.org/forms.html. When you call the toll-free number, an operator will ask you questions about when and where you worked at ground zero and what kind of work you did. After you are determined to be eligible, you will be provided information about the network of clinics from which you would choose one to make an appointment for an examination. Currently there are three programs funded to assist individuals who meet the eligibility requirements. For links to these programs, please see below.
FDNY Program
If you were or are working for the Fire Department of New York (FDNY), you should call the FDNY Bureau of Health Services (718-999-1858) or visit the following website for information about the program: http://www.nyc.gov/html/fdny/insider/bhs/wtcmm/index.shtml
Mt. Sinai Coordinated Consortium Program
If you were not or are not working for the FDNY and live in the New York City (NYC) vicinity, you should call 888-702-0630 or click on http://www.wtcexams.org/index.html.
National Program
If you were not or are not working for the FDNY and live outside the NYC vicinity, you should call Logistics Health Incorporated (LHI) at 877-498-2911.
WTC Monitoring and Treatment
HHS-supported monitoring and treatment are available to:
- Workers and volunteers who participated in rescue, recovery, cleanup, and related activities in the wake of the attacks on the WTC.
- Individuals who participated in the WTC Worker & Volunteer Medical Screening Program.
Program participants can receive examinations at six clinic locations in and around the New York City metropolitan area and at other participating clinics around the country. Participants may choose to be seen at any one of these locations, regardless of where their initial exams were done.
For more information:
WTC Federal Responder Screening Program
The Office of Public Health Emergency Preparedness, a division of the Department of Health and Human Services, established the WTC Federal Responder Screening Program to address the needs and screen the health of Federal employees who worked at the WTC site as part of their assigned duty.
Federal Occupational Health clinics in or near Federal offices will provide medical screening for current or former employees of the Federal government who meet the following criteria:
- Worked at least one shift in response operations any time between September 11, 2001 and September 10, 2002.
- Were involved in rescue, recovery, or cleanup operations at the WTC site or at debris-handling operations on Staten Island.
For more information about medical screening for eligible current or former Federal employees, please visit https://wtcophep.rti.org/.
Patrolmen’s Benevolent Association World Trade Center Health Registry
In July 2006, the Patrolmen’s Benevolent Association (PBA) of New York City established a health registry. PBA members can make self-reports to the registry. This is not a federally funded registry.
To learn more about the PBA World Trade Center Health Registry, please go to: http://nycpba.org/wtc/index.html.
New York City Department of Public Health and Mental Hygiene 9/11 Health Website
The New York City Department of Public Health and Mental Hygiene (NYC-DOHMH) established the 9/11 Health Info website to provide the latest scientific information to the public about 9/11-related health problems and to serve as a resource for people who have health problems related to the September 11, 2001 terrorist attack on the World Trade Center.
To learn more and to view the NYC-DOHMH site, please visit: www.nyc.gov/9-11healthinfo
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Resources for Residents, Students and Community Members
In the Consolidated Appropriations Act, 2008, Congress appropriated funding "to provide screening and treatment for first response emergency services personnel, residents, students, and others related to the September 11, 2001, terrorist attacks on the World Trade Center."
In response, on July 24, 2008, CDC published a funding opportunity announcement (FOA) to provide access to screening, diagnosis and treatment services for residents, students, and others in the community (the non-responder population). Applications for this FOA were received through August 25, 2008, and CDC anticipates making award decisions September 29, 2008.
The NIOSH-administered competitive grants would provide up to $10 million per year for three years for health screenings and assessments, health monitoring and tracking and improved access to health care services. The grant money would be used to help cover gaps when individuals' public or private insurance is insufficient to fully cover the costs associated with care or treatment.
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Other Treatment Programs
Medical monitoring and treatment are available to residents of Lower Manhattan and Chinatown at the Bellevue Hospital/New York University School of Medicine. This is primarily for individuals with respiratory symptoms.
More information about eligibility is available from:
Bellevue Asthma and WTC Health Impacts Clinic
462 First Avenue
New York, NY 10016
212-562-3849
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Clinical Guidelines
In August 2006, the New York City Department of Health and Mental Hygiene released Clinical Guidelines for Adults Exposed to the World Trade Center Disaster (PDF). The guidelines recommend screening approaches to improve detection of illness possibly associated with WTC exposures. These guidelines have been written in collaboration with medical experts who have been working with responders.
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Additional Resources for Health Care Professionals
Health care professionals may review scientific reports on health effects in certain exposed populations by visiting: Scientific Reports.
World Trade Center Health Registry
In 2003, the New York City Department of Health and Mental Hygiene created the WTC Health Registry, with funding from the Centers for Disease Control and Prevention’s Agency for Toxic Substances and Disease Registry, a division of HHS.
The WTC Health Registry gathers information about the physical and mental health status of a large group of people exposed to environmental contaminants for up to 20 years through regular health surveys and detailed studies. The Registry published its first report in April 2006 based on its first survey. The second survey began in 2006.
Enrollees answered an initial 30-minute telephone survey about where they were on Sept. 11, 2001, and they were asked to report the status of their health. This information allows health professionals to compare the health of enrollees with the health of the general population. Approximately 71,000 people enrolled in the Registry.
Enrollment criteria for the Registry included:
- People who were in a building, on the street, or on the subway south of Chambers Street on Sept. 11, 2001.
- People involved in rescue, recovery, cleanup, or other activities at the WTC site and/or WTC Recovery Operations on Staten Island any time between Sept. 11, 2001, and June 30, 2002.
- Students and staff enrolled in schools (pre K-12) or day care centers south of Canal Street on Sept. 11, 2001.
- People who were living south of Canal Street on Sept. 11, 2001.
The Registry was open for enrollment from September 5, 2003, through November 20, 2004. Although enrollment in the WTC Health Registry is closed, other health registries and treatment programs are still tracking health effects for those not enrolled.
For more information about the WTC Health Registry, please go to http://www.wtcregistry.org.
Fatalities Investigation
In an initiative funded by NIOSH, the New York State Department of Health is collecting information on deaths among World Trade Center responders, recovery workers and volunteers. This data collection system will be used to identify and track all fatalities that occur among WTC responders so that science-based investigations of root causes can begin to be explored. Further information is available at http://www.nyhealth.gov/environmental/investigations/wtc/health_studies/fatality_investigation.htm
To report a fatality, please contact:
NYS Department of Health
Center for Environmental Health
Bureau of Occupational Health
547 River Street, Room 230
Troy, New York 12180
Telephone: 518-402-7900
E-mail: wtcfatality@health.state.ny.us
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Other Resources for Those Affected by Environmental Exposure
Where can I find results of exposure monitoring from the WTC site?
The initial damage to and eventual collapse of the WTC towers impacted the environmental air quality around the site.
Exposure monitoring data for the components of dust and smoke during the period immediately after September 11, 2001, are available from these agencies:
Where can I learn more about building cleanup efforts?
EPA is the lead agency coordinating the efforts of federal, state, and city agencies to ensure that the impacted buildings are demolished or deconstructed in a manner that protects the health of people who live and work in the area.
- Indoor Residential Dust Cleanup Program: The Residential Dust Cleanup Program was administered by the EPA and ended in 2003. The program included among other things distribution of health and cleanup information, testing of asbestos in indoor air, and professional cleanup of remaining uncleaned, unoccupied buildings. For more information about the program and reports related to this activity, please visit: Residential Dust Cleanup Program.
- Demolition / Deconstruction: A number of Lower Manhattan residential and commercial buildings in the immediate vicinity of the World Trade Center were damaged on September 11. The majority have been repaired, cleaned, and re-occupied. A few of the buildings are slated to come down. For more information about these activities, please visit: Lower Manhattan Demolition and Deconstruction Activities.
Where can I learn more about workplace safety?
The New York State Department of Labor's Public Employee Safety and Health (PESH) Program oversees the workplace protection of public employees at the state and local levels. OSHA sets protection standards for all sectors in New York; however, it also enforces these standards in the private sector through its regional and local offices. While similar hazards can occur in public and private sector jobs, the PESH Program also addresses safety and health areas that are of specific concern to public employees. Public sector work sites range from subway tunnels and public landfills to hospitals and office buildings.
New York also has an On-site Consultation Program that provides free occupational safety and health assistance to private sector businesses. Priority for on-site assistance is given to employers with 250 or fewer employees at the work site and with fewer than 500 nationwide.
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