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APHA Scientific Session and Event Listing

Recorded presentation

Philip J. Landrigan, MD, MSc, Department of Community and Preventive Medicine, Center for Children's Health and the Environment, Mount Sinai School of Medicine, One Gustave L. Levy Place Box 1057, New York, NY 10029-6574, 212-241-4804, phil.landrigan@mssm.edu

The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. We assessed the environmental exposures resulting from destruction of the WTC and their effects on health. 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; 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 rescue and recovery 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. 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 exposed populations is required to document the long-term consequences of the disaster.

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