(Trends Wide Español) — Almost 20 years have passed since the attack on September 11, 2001, which killed a total of 2,977 people in New York City, Washington and outside of Shanksville, Pennsylvania.
In addition to the loss of life directly caused by the September 11 attacks, hundreds of thousands of people have suffered short- and long-term health consequences from exposure to the immense cloud of dust, debris, fumes from the fires. , in addition to the mental trauma from having witnessed one of the most traumatic events in the history of the United States.
A study published in 2020 by the World Trade Center Health Program (WTCHP) – created to provide medical care to those affected after the attacks – indicates that tens of thousands of people participated in rescue, recovery and clean-up efforts, while nearly half a million people were at increased risk of adverse health effects from physical and psychological stressors in the days, weeks and months after the terrorist attacks.
“The most common health outcomes associated with 9/11 are post-traumatic stress disorder, depression, respiratory-type conditions including asthma, and gastroesophageal reflux disease,” said Mark Farfel, director of the World’s Health Registry. Trade Center. Other potential conditions include heart disease in adults, the inflammatory disease sarcoidosis and increased smoking and alcohol use, Farfel added.
The debris of the attack
The World Trade Center (WTC) complex in New York it was made up of two 110-story towers and five other buildings mainly constructed of reinforced concrete, steel and glass, according to a study that analyzed the environmental and health consequences of 9/11.
The study indicated that the dusts that settled in the area after the attack were complex mixtures of inorganic and organic materials, including toxins and carcinogens.
“The intense fire and collapse of buildings resulted in a massive environmental exposure from a dense cloud of suspended pulverized debris and combustion by-products that covered much of lower Manhattan,” the study reads, which highlights that even three months after the attacks, intermittent fires were occurring in the area.
It should be taken into account that the cleaning work at Ground Zero continued for nine months, ending on May 30, 2002. To clean approximately between 1.6 and 1.8 million tons of debris, as taken into account a report from the U.S. Government Accountability Office (GAO) or a study of data from the World Trade Center Health Registry and the New York City Department of Health . That task required 3.1 million hours of work, according to the GAO.
According to a report published by the scientific journal The Lancet in 2011, people who were exposed to the WTC for longer periods of time and intensely “generally experienced more severe and persistent respiratory illnesses.”
10 years after 9/11
The report of The Lancet on the short- and medium-term consequences of 9/11 indicates that there is strong evidence on the associations between having experienced or witnessed the events of 9/11 and post-traumatic stress disorder (PTSD, in Spanish, or PTSD, in English) and medical conditions respiratory.
The medical journal indicates that although many people who reported respiratory problems after being exposed to the WTC attacks improved over time, thousands “continue to have long-term symptomatic and functional problems.”
That same year, New York City published a report through WTCHP stating that PTSD “identified by a positive screening test using a standardized psychological assessment tool” is the most common health effect among adults exposed to it. events of September 11 and often coexisting with respiratory illnesses.
In addition, it was more common among those who were trapped in the dust cloud released after the collapse of buildings, as well as people who were injured during the attacks and who were directly exposed to the events of 9/11, including their proximity to the site.
By 2011, more than 150 studies had documented the mental health effects of September 11, including stress, PTSD, substance abuse, suicide, and depression.
The impact on mental health
Massive trauma can create a prolonged state of “chronic threat response,” the continuous state of being in a hyperactive survival mode. More than 21% of people tracked by the World Trade Center Health Registry reported new symptoms of PTSD five to six years after 9/11.
PTSD is a mental health disorder in which a person experiences thoughts, flashbacks and nightmares that strike unpredictably and return the person to the moment of trauma. Re-experiencing the memories causes panic attacks and trouble sleeping.
However, the impact of trauma can persist for many years, even decades. For example, a sample carried out 15 years after 9S in which 36,897 people exposed to the events of that day participated indicated that the prevalence of PTSD was 14.2% and of depression 15.3%.
Jonathan Morris, 62, a U.S. Army personnel, who was the NCO in charge of the emergency department at Walter Reed National Military Medical Center in Bethesda, Maryland on Sept. 11, lost two Army colleagues in the attacks on the Pentagon: Lt. Gen. Timothy Maude and Lt. Col. Karen Wagner, who died on their first day on the job at the Pentagon.
“Almost 20 years have passed and I still think about the friends and colleagues that I have lost every day,” Morris told Trends Wide in September 2020.
The impact of trauma often diminishes and flows over time, and help is not always there when it is needed. More than a quarter of people with PTSD or depression reported unmet needs for mental health care in the past year.
Morris is taking a proactive approach. “Since this time of year is especially difficult for all of us, I have been reaching out and doing ‘buddy checks’ on others who were affected like me by 9/11. I don’t want to lose any more friends to suicide.”
Links between 9/11 and heart problems
A study published in the medical journal JAMA Network Open In 2019, it found that immediate and repeated exposures to dust during the cleanup months after the attack were associated with an elevated risk of cardiovascular disease that lasted up to 16 years.
Among the firefighters in the study, “those with the highest exposure, those present on the morning of 9/11, had a higher risk than those who showed up later in the week,” said Dr. David Prezant, lead author of the study. , chief medical officer for the New York City Fire Department and a professor at the Albert Einstein College of Medicine, lead author of the new study.
For his part, Dr. Leonardo Trasande, professor and director of the Division of Environmental Pediatrics at the New York University School of Medicine, who did not participate in the new study, indicated that there are some explanations for why exposure to September 11 events could be associated with an increased risk of long-term cardiovascular disease.
“One is that air pollution is known to be a major cardiovascular risk factor. After all, it is a major contributor to the global burden of disease, not just in highly exposed firefighters,” Trasande said.
“Second, the disaster produced a cloud of toxic chemicals, which are not in routine air pollution,” he said. “Then there is the stress that is well known among people who were exposed to the World Trade Center disaster, especially those who responded, such as firefighters, who frequently put themselves in danger to save lives. So there are three ways down which the findings described here were unfortunately plausible. “
Exposure to the column of dust and toxins from the 9/11 attack may also be linked to abnormal cholesterol levels in children who lived or went to school near the World Trade Center at the time, according to a separate study led by Trasande and published in the magazine Environment International in 2017. High cholesterol is a risk factor for heart disease.
During 9/11, approximately 25,000 under 18s they lived or went to school near the WTC.
Previous studies have shown a link between exposure to carcinogens and other toxins in the dust from the World Trade Center remains and an increased risk of some cancers among people who worked at the site, including firefighters.
Another study published in 2017 in the journal Injury Epidemiology found that being acutely exposed to the dust cloud or being injured on September 11 was associated with heart and respiratory disease later in life.
“We found that, in this particular group of people who had an acute exposure, an injury was associated with a heart attack and also with angina (a type of chest pain) and that the dust cloud was associated with respiratory problems, such as asthma and other respiratory diseases, ”explained Dr. Robert Brackbill, director of research for the World Trade Center Health Registry.
“In fact, we also published two previous articles on the heart and … we found that, for example, post-traumatic stress disorder was associated with reported heart disease,” Brackbill said.
“Injuries are trauma and people who are injured in a disaster situation can have post-traumatic stress disorder, and PTSD is an established risk factor for heart disease, so it could be one of the ways that it’s happening, “he added.
Jacqueline Howard and Shauna Springer contributed to this report.