18 Years after the 9/11 Terrorist Attacks: The Health Fallout Continues

Above: Some of the FDNY members who fell on 9/11/01.

This year that marks the 18th anniversary of the attacks on the World Trade Center (WTC) and the Pentagon. This segment focuses on health and wellness. This issue was dominating from several aspects: We lost many first responders to 9/11-related illnesses, the Victims Compensation Fund had to be refunded for an extensive period, and there is evidence that there likely will be no “expiration” date for the adverse health effects of the WTC “dust.” They will continue to stalk this generation and likely generations to come.

The dust that boiled up from the ruins of the World Trade Center was, in fact, a witches’ brew of deadly pollutants, made up of ‘the jetliners, their tanks of benzene jet fuel, and the entire contents of the buildings: the outside structure, the windows, the interior walls, the ceilings, the insulation, each painted surface, every piece of treated carpet, all the air-conditioning and heating equipment, and all of the office equipment, including monitors, computers and copy machines,’ 1 million tons of debris that was ‘fused by the extreme heat into … toxic combinations never seen before.’—Jonathan Kirsch, book editor, Jewish Journal, Book Review of 9/12: The Epic Battle of the Ground Zero Responders.


Voices of 9/11

343: A Tribute to the Fallen Firefighters of 9/11

Fire Engineering‘s Report on the WTC Disaster Part 1 | Part 2

In his review, Kirsch cites passages from 9/12: The Epic Battle of the Ground Zero Responders, written byWilliam H. Groner and Tom Teicholz, which he describes as “a work about a long course of investigation and litigation …[and] also a tale told at human scale.”1

Groner, a participant in the litigation to get first responders financial assistance from the U.S. Government to cover medical expenses associated with fighting WTC-associated illnesses, and Teicholz, a longtime contributor to the Jewish Journal and a widely published journalist and author, “tell the memorable tales of heroism [of the responders] and, at the same time, “reveal the disgraceful way that the first responders were treated when they began to fall ill from their exposure to ‘the Godzilla-like cloud [that] engulfed all in its path.’ ”

In the WTC exposure problem are embedded some “lessons learned” in the areas of preparation and protection from hazardous health exposures. “The 9/12 authors point out that little or nothing was done to protect most of the first responders aside from paper masks of the kind that housepainters use or respirators that quickly ran out of cartridges,” explains Kirsch. He relates the authors’ account of a conversation between a police officer and his partner at the WTC. The officer asks, ‘What’s wrong with this picture? We’re out here, we’re standing in the street wearing paper masks, and there’s a Humvee going by and the Army guys are sitting with their chemical suits on.’” (1)

Kirsh identifies “the heart of 9/12” as “an account of the long and heartbreaking struggle of the first responders to make their case in the courthouse and in the halls of government.” He identifies “another set of heroes — the attorneys who represented the first responders in the bundle of cases that came to be called the World Trade Center Disaster Site Litigation.” Groner, he adds, was one of the leading lawyers in the ‘mass tort’ case. (1)


The full impact of the reassurances that the air was safe from the Environmental Protection Agency’s then Administrator Christine Todd Whitman, former governor of New Jersey, probably will never be known. Neither is it clear whether under the prevailing circumstances anything would have been changed, but there was a lesson learned, according to a reader of the Georgia newspaper MDJ (Marietta Daily Journal). In August, he wrote in a letter to the editor:

I lived well out on Long Island, on Long Island Sound in the wetlands. Walking out the next morning, there was a super strong odor of ash. I drove into New York City a few days later and everything had a coating of ash. I recall Francis [Fraunces]Tavern, where Gen.Washington had his farewell dinner, the golden bricks were grayish. I went over to the pile and spoke to a state trooper on the security detail, and he told me that they were told the air is safe. I was down in the PIT the following November, and the air was still not clean.

New York learned a very good lesson on letting the United States EPA do our thinking for us.2

9/11 Victims Compensation Fund

This year, legislators, first responders, and advocates including comedian Jon Stewart lobbied Congress to extend the expiration date of the 9/11 Victims Compensation Fund. The end of July, President Donald J. Trump signed a bill that extends funding until October 1, 2090.

Also, at the suggestion of some legislators, the bill’s name was changed to “The Never Forget the Heroes: James Zadroga, Ray Pfeifer and Luis Alvarez Permanent Authorization of the September 11th Victim Compensation Fund.3” All three of these first responders succumbed to 9/11-related illnesses. Alvarez, a retired member of the New York Police Department, lobbied for the funding extension and traveled to Washington, DC, despite his being severely ill. He passed away on June 29, 2019, at the age of 53. (Mayor Bill de Blasio is to award Alvarez posthumously the Key to the City). 4-5

Notification of Non-Responders

This year also saw accelerated efforts to make residents, workers, students, and others who were exposed to WTC toxins aware of their coverage under the Victims Compensation Fund if they should get a WTC-associated illness.

The New York City Council has drafted legislation that states: ‘the DOE [Department of Education] in collaboration with the Department of Health….shall submit to the Council a report on outreach to all individuals who were enrolled as students or employed as teachers or staff members at schools within one-and-a half miles from the World Trade Center in 2011-2002 school year.’ The notice is to include information on how to participate in the World Trade Center Health Registry, the World Trade Center Health Program, and the 9/11 Victims Compensation Fund. The DOE would also be required to inform the Council of any ‘difficulties’ or ‘gaps….in such outreach efforts.’”6

Local lawyers and advocates are also making efforts to advise people in Lower Manhattan that they can qualify for benefits if they become ill as a result of exposure to the 9/11-related toxins. An information seminar has been scheduled for September 16, from 6 p.m.-8 pm., at the Borough of Manhattan Community College. Attorney Michael Barasch will be among those at the seminar to answer questions. He emphasizes that people who were in Lower Manhattan during the post-9/11 period need to start collecting proof that they were there because they will need this proof to be eligible for health benefits. Advocates from Students of 9/11; the FealGood Foundation, which helps emergency personnel; and doctors from the WTC Health Program will also be on hand to provide information. The seminar will be at 199 Chambers St., Theater 1. Tickets, which are free, are available on a first-come, first-served basis. To reserve tickets, call 212-220-1460 or visit http://tickets.tribecapac.org/FREE-911-informational-seminar.7

Deaths from Related Illnesses

WTC toxinscontinued toclaim the lives of WTC responders this year, among them Firefighter Richard Driscoll, who retired from Engine 91 in East Harlem in 2002, passed away from a WTC-related illness this year. He is the 200th member the Fire Department of New York lost to WTC-related illness.8

Father Michael A. Carrano, 74, pastor of Our Lady of Hope in Middle Village, New York, since 2009 passed away from cancer this past summer. In the months following the WTC attacks, Father Carrano was a major support and spiritual advisor to FDNY Engine 205/Ladder 118, which lost eight firefighters on 9/11.9

Effects on Future Generations

It appears that future generations will experience the adverse medical effects of the WTC-related toxins. Studies have shown that some former students (now in their mid-30s) of Stuyvesant High School, just a few short blocks from Ground Zero, are experiencing severe asthma, digestive issues, breast cancer, thyroid cancer, and rare bone cancers, and a student reportedly died from gastric cancer. Research has shown that children who breathed in the toxins from the WTC cloud had elevated levels of artery-hardening fats in their blood compared to other children, and others had early signs of heart disease risk.10

Psychiatric, Physical Fallout for Children of 9/11

Children who were directly exposed to the 9/11 terrorist attack that occurred in New York City in 2001 have significantly more long-term psychiatric and physical disorders than those who were not directly exposed to this trauma, new research has shown. The largest and longest longitudinal face-to-face study of individuals subjected to the 9/11 attack as children showed that 14 years later, these individuals continued to suffer the consequences of the trauma, including separation anxiety, panic attacks, and drug abuse.11

‘… All kids exposed to 9/11 should be followed for their lifetime so we can learn what is the long-term effect of such a trauma. And we can help them by making sure they get all the help they need,’ Lawrence Amsel, MD, assistant professor of clinical psychiatry, College of Physicians and Surgeons at Columbia University, who practices at New York–Presbyterian Hospital, New York City. Amsel, the study investigator, stated: ‘The results should remind clinicians that young patients who are exposed to a one-time trauma can have long-lasting physical and/or psychiatric complaints.” The findings of the study were presented at the 2019 American Psychiatric Association annual meeting. (11)

The study did not show elevated rates of posttraumatic stress disorder (PTSD) among exposed persons. According to Amsel, ‘We think PTSD symptoms may have morphed into panic disorder, social anxiety disorder, and kids being scared to be alone.’ Amsel suggests ‘universal resiliency programs that teach kids resilience as part of their growing up–kind of a user’s manual for the human mind.’ The study was funded by the National Institute for Occupational Safety and Health and was conducted by the Global Psychiatric Epidemiology Group of Columbia University. (11)


“For generations to come, the 9/11 Memorial Glade will stand as a testament to the tremendous capacity of the human spirit in the face of unimaginable tragedy,” Alice M. Greenwald, chief executive of the 9/11 Memorial & Museum, said at the dedication. “The Glade honors all who continue to suffer from and succumb to illnesses in this ongoing health crisis stemming from 9/11.”12 https://ny.curbed.com/2019/5/31/18647100/world-trade-center-9-11-memorial-glade-opening

The 9/11 Memorial Glade

The opening of the9/11 Memorial Glade as part of the 9/11 Memorial (https://www.911memorial.org/memorial-glade) on May 30, 2019, solidified that realization that 9/11 is still claiming victims. The Glade is an open-air pathway dedicated to those who are sick or who have died from 9/11-related illnesses. Weekly bagpipe performances on the Glade help to raise awareness of the 9/11 health issue, and a commemoration ceremony is held each year on May 30, the date in 2002 that the rescue and recovery efforts at the WTC site formally ended.12

The memorial was designed by Michael Arad, who with Peter Walker also designed Reflecting Absence, the pools of the 9/11 memorial. The six monoliths of granite that flank the glade weigh between 13 and 18 tons, and are placed on either side of a pathway that’s accompanied by an inscription on either end. The monoliths are meant to “symbolize strength and determination through adversity.”13

Additional Benefits

Even thoughit has been 18 years since the WTC attacks, first responders in local fire departments are still dealing with circumstances that are hindering them from claiming medical disability retirement benefits. In New Jersey, for example, employees who volunteered to work at Ground Zero and have become medically disabled to the WTC-related toxins cannot qualify for their accidental disability retirement benefits. The State Assembly this year passed a bill (A4882) that would allow adjustment of the retirement rules for public employees so the disabled employees can collect the pension. The bill must pass the Senate. According to the present laws, employees who volunteered at Ground Zero do not qualify for an accidental disability pension.1,4

The WTC attacks also have brought into the open and removed the stigma from firefighters seeking help for conditions related to mental health/post-traumatic stress disorder (PTSD). The Forsyth County (GA) Commissioners, for example, have added counseling services to its existing employee assistance program (EAP). Forsyth County Chief Barry Head explains that counseling services and weight-loss, smoking-cessation, and financial-advice programs were included in the EAP, but the added program would more closely focus on the issues facing first responders. He added that before 9/11, PTSD was often spoken about in the fire service and that since 9/11, it became a mainstream topic of conversation.15

Author’s note: Annalise Knudson (aknudson@siadvane.com) advises that a guide to resources, services, assistance programs, and academic scholarships continues to be available to 9/11 victims and their families. These services and resources are available through federal programs, non-profit organizations that began in the aftermath of the terrorist attacks, and organizations that created scholarships for victims’ family members. It is available at: https://www.silive.com/news/2019/09/18-years-later-a-guide-to-resources-available-for-sept-11-victims-families.html/


I share with you during this most solemn week a song written by a mother of a firefighter who had no connection to New York, the World Trade Center, or the first responders and other New Yorkers who fell on 9/11, other than compassion and horror. She is a former bagpiper with the San Diego Cameron Highlanders Pipe Band and wrote the song to say “thank you” to all responders.

We Will Remember You

(The Best Part of Us All)

You answered the call without thinking of yourself at all

You were brave and true and strong

You fought through the smoke and dust

And brought out the best in us

You carried our hope along

And We Will Remember You

That Day in September You

Showed the world the best part of us all

You left behind a trail of tears and memories of all those years

With the ones who loved you most

And those of us who never knew you

Now embrace the thought of you

you’re forever etched in our souls

And We Will Remember You

That Day in September You

Showed the world the best part of us all.

Bridge: Auld Lang Syne on the pipes

And We Will Remember You

That Day in September You

Showed the world the best part of us all

Now we must go on and we will be strong

Together and forever we’ll stand

We’ll rise above adversity

We’ll get through this hand in hand

And We Will Remember You

That Day in September You

Showed the world the best part of us all

©2001 Robyn Adams and Arno Kimsey

Words: Robyn Adams Music: Robyn Adams and Arno Kimsey

Engineered by Arno Kimsey-By The Sea Productions

Vocals and Bagpipes: Robyn Adams

You Tube link:https://www.youtube.com/watch?v=O2Xo34g_SqQ


1. Kirsch, Jonathan. Aug. 28, 2019. Jewish Journal9/12: The Epic Battle of the Ground Zero Responders, William H. Groner and Tom Teicholz (Potomac Books/University of Nebraska Press); https://jewishjournal.com/culture/books/303722/saga-of-first-responders-never-ending-battle-told-in-9-12/.

2. Steve Reilly, “9/11 was a lesson on trusting the EPA,” Aug. 28, 2019, Letter to the Editor, MDJ (Marietta Daily Journal); https://www.mdjonline.com/opinion/letters_to_editor/was-a-lesson-on-trusting-the-epa/article_3d9bc660-c54a-11e9-92d2-5bbef947f740.html

3. “First responders exhale as 9/11 Victims Fund extended.” Aug. 1, 2019 | Posted by: Gabe Herman https://www.thevillager.com/2019/08/first-responders-exhale-as-9-11-victims-fund-extended/

4. “Wake Held for 9/11 First Responder Lou Alvarez,” July 2, 2019. By Michael McAuliff, New York Daily News, Jun 29, 2019;https://www.nydailynews.com/new-york/ny-retired-detective-lou-alvarez-dies-911-cancer-20190629-2liactybizhovkws24phhfho6a-story.html …

5. DBSNNewYork; (https://newyork.cbslocal.com/2019/07/02/lou-alvarez-911-first-responder-wake-today/w).

6. “Council WTC Bill Would Notify DOE Staff, Pupils.” June 3, 2019. Ellie Engler, https://thechiefleader.com/news/news_of_the_week/council-wtc-bill-would-notify-doe-staff-pupils/article_2c77ce6e-83ba-11e9-96c0-9bbf3205bf50.html/.

7. “Seminar to spread word on 9/11 Fund benefits,Sept. 4, 2019, Gabe Herman; https://www.thevillager.com/2019/09/seminar-to-spread-word-on-9-11-fund-benefits/.

8. “200th FDNY member dies of WTC-related illness,” WABC; https://abc7ny.com/200th-fdny-member-dies-of–wtc-related-illness/5403860/.

9. “Middle Village pastor, spiritual aid to firefighters after 9/11, dies at 74,” June 26, 2019, Jacob Kaye; https://qns.com/story/2019/06/26/middle-village-pastor-spiritual-aid-to-firefighters-after-9-11-dies-at-74/

10. “Millennials impacted by Ground Zero toxins confront 9/11 illnesses,”Aug. 20, 2019; Tribune Media Wire https://fox43.com/2019/08/20/millennials-impacted-by-ground-zero-toxins-confront-911-illnesses/.

11. “Long-term Data Reveal Psychiatric, Physical Fallout for Children of 9/11,” May 20, 2019, Pauline Anderson, American Psychiatric Association (APA) 2019: Abstract 124 (session 8). Presented May 19, 2019; https://www.medscape.com/viewarticle/913254/.

12. “Sept. 11 Memorial honors those sick from ground zero toxins.”May 30, 2019, James Ford, May 30, 2019, https://pix11.com/2019/05/30/sept-11-memorial-honors-those-sick-from-ground-zero-toxins/.

13.9/11 Memorial Glade Opens, Honoring Victims in Tragedy’s Wake,May. 31, 2019. Carl Glassman; http://tribecatrib.com/content/911-memorial-glade-opens-honoring-victims-tragedys-wake

14. N.J. first responders who volunteered at Ground Zero could get accidental disability pensions, June 7, 2019, Samantha Marcus, NJ Advance Media for NJ.com; https://www.nj.com/politics/2019/06/nj-first-responders-who-volunteered-at-ground-zero-could-get-accidental-disability-pensions.html/.

15. Fire chief: New counseling program tailored to post-traumatic stress for public safety employees, June 28, 2019, Kelly Whitmire, https://www.forsythnews.com/local/local-government/fire-chief-new-counseling-program-tailored-post-traumatic-stress-public-safety-employees/.

MARY JANE DITTMAR is senior associate editor of Fire Engineering and conference manager of FDIC. Before joining the magazine in January 1991, she served as editor of a trade magazine in the health/nutrition market and held various positions in the educational and medical advertising fields. She has a bachelor’s degree in English/journalism and a master’s degree in communication arts.

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