title: Destruction of the World Trade Center Towers. Lessons Learned from an Environmental Health Disaster.
abstract: The assault and subsequent collapse of the World Trade Center towers in New York City on September 11, 2001 (9/11), released more than a million tons of debris and dust into the surrounding area, engulfing rescue workers as they rushed to aid those who worked in the towers, and the thousands of nearby civilians and children who were forced to flee. In December 2015, almost 15 years after the attack, and 5 years after first enactment, Congress reauthorized the James Zadroga 9/11 Health and Compensation Act, a law designed to respond to the adverse health effects of the disaster. This reauthorization affords an opportunity to review human inhalation exposure science in relation to the World Trade Center collapse. In this Special Article, we compile observations regarding the collective medical response to the environmental health disaster with a focus on efforts to address the adverse health effects experienced by nearby community members including local residents and workers. We also analyze approaches to understanding the potential for health risk, characterization of hazardous materials, identification of populations at risk, and shortfalls in the medical response on behalf of the local community. Our overarching goal is to communicate lessons learned from the World Trade Center experience that may be applicable to communities affected by future environmental health disasters. The World Trade Center story demonstrates that communities lacking advocacy and preexisting health infrastructures are uniquely vulnerable to health disasters. Medical and public health personnel need to compensate for these vulnerabilities to mitigate long-term illness and suffering.
authors.affiliation: 1 Department of Medicine.|2 Department of Environmental Medicine, and.
authors.forename: Joan
authors.initials: J
authors.lastname: Reibman
authors.affiliation: 3 Department of Psychiatry, New York University School of Medicine, New York, New York.|4 Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Cambridge, Massachusetts.
authors.forename: Nomi
authors.initials: N
authors.lastname: Levy-Carrick
authors.affiliation: 5 NYC Health and Hospitals System, New York, New York.
authors.forename: Terry
authors.initials: T
authors.lastname: Miles
authors.affiliation: 6 World Trade Center Health Program Survivors Steering Committee, New York, New York.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Flynn
authors.affiliation: 6 World Trade Center Health Program Survivors Steering Committee, New York, New York.
authors.forename: Catherine
authors.initials: C
authors.lastname: Hughes
authors.affiliation: 7 Icahn School of Medicine at Mount Sinai, New York, New York; and.
authors.forename: Michael
authors.initials: M
authors.lastname: Crane
authors.affiliation: 7 Icahn School of Medicine at Mount Sinai, New York, New York; and.|8 University of Brescia, Brescia, Italy.
authors.forename: Roberto G
authors.initials: RG
authors.lastname: Lucchini
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects; D054597:Disaster Medicine / Q000639:trends; D004190:Disasters; D004782:Environmental Health / Q000592:standards*; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D009519:New York City; D011634:Public Health / Q000331:legislation & jurisprudence*; D047851:September 11 Terrorist Attacks; D014947:Wounds and Injuries / Q000628:therapy
chemical_list: D000393:Air Pollutants
keywords: World Trade Center; disaster medicine; environmental health; inhalation exposure