title: The response to September 11: a disaster case study.
abstract: BACKGROUND
  The response to 9/11 continues into its 14th year. The World Trade Center Health Program (WTCHP), a long-term monitoring and treatment program now funded by the Zadroga Act of 2010, includes >60,000 World Trade Center (WTC) disaster responders and community members ("survivors"). The aim of this review is to identify several elements that have had a critical impact on the evolution of the WTC response and, directly or indirectly, the health of the WTC-exposed population. It further explores post-disaster monitoring efforts, recent scientific findings from the WTCHP, and some implications of this experience for ongoing and future environmental disaster response.
  
  
  RESULTS
  Transparency and responsiveness, site safety and worker training, assessment of acute and chronic exposure, and development of clinical expertise are interconnected elements determining efficacy of disaster response.
  
  
  CONCLUSIONS
  Even in a relatively well-resourced environment, challenges regarding allocation of appropriate attention to vulnerable populations and integration of treatment response to significant medical and mental health comorbidities remain areas of ongoing programmatic development.
authors.affiliation: Mount Sinai School of Medicine, World Trade Center Health Program, New York, NY. Electronic address: michael.crane@mssm.edu.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Crane
authors.affiliation: New York University School of Medicine, Department of Psychiatry, New York, NY.
authors.forename: Nomi C
authors.initials: NC
authors.lastname: Levy-Carrick
authors.affiliation: Mount Sinai School of Medicine, World Trade Center Health Program, New York, NY.
authors.forename: Laura
authors.initials: L
authors.lastname: Crowley
authors.affiliation: Mount Sinai School of Medicine, World Trade Center Health Program, New York, NY.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Barnhart
authors.affiliation: Mount Sinai School of Medicine, World Trade Center Health Program, New York, NY.
authors.forename: Melissa
authors.initials: M
authors.lastname: Dudas
authors.affiliation: Mount Sinai School of Medicine, World Trade Center Health Program, New York, NY.
authors.forename: Uchechukwu
authors.initials: U
authors.lastname: Onuoha
authors.affiliation: Mount Sinai School of Medicine, World Trade Center Health Program, New York, NY.
authors.forename: Yelena
authors.initials: Y
authors.lastname: Globina
authors.affiliation: Mount Sinai School of Medicine, World Trade Center Health Program, New York, NY.
authors.forename: Winta
authors.initials: W
authors.lastname: Haile
authors.affiliation: Mount Sinai School of Medicine, World Trade Center Health Program, New York, NY.
authors.forename: Gauri
authors.initials: G
authors.lastname: Shukla
authors.affiliation: Mount Sinai School of Medicine, World Trade Center Health Program, New York, NY.
authors.forename: Fatih
authors.initials: F
authors.lastname: Ozbay
mesh_terms: D004190:Disasters; D061388:Firefighters / Q000523:psychology; D006078:Government Programs / Q000331:legislation & jurisprudence; D062489:Health Impact Assessment; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects* / Q000032:analysis; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D016272:Occupational Health; D016495:Police; D011159:Population Surveillance; D012042:Registries; D018635:Rescue Work; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000209:etiology; D012449:Safety; D047851:September 11 Terrorist Attacks / Q000523:psychology; D017741:Survivors / Q000523:psychology
keywords: 9/11; World Trade Center; disaster response; environmental disaster; post-disaster health surveillance