September 11th, Asbestos Exposure, and The World Trade Center

Photo of World Trade Center Memorial on 9/11 anniversary

While the whole world watched the collapse of the World Trade Center on September 11th, 2001, about 2,000 tons of asbestos dust was released into the air around Manhattan. After two decades since the event, first responders, survivors, and residents are still developing health effects.

The World Trade Center Terrorist Attacks

The World Trade Center began construction in the late-1960s and was completed in the early-1970s. The large complex of seven buildings occupied several city blocks and contained over 13 million square feet of office space. Two of the world’s tallest buildings at the time were constructed with thousands of tons of asbestos-containing products. The towers contained a variety of common building materials, including fireproofing spray along steel beams on the first 40 floors of the north tower.

Chrysotile, or “white asbestos,” is the most common form of asbestos found in building materials located in the United States. Amphibole asbestos makes up the remaining five types of asbestos, including actinolite, amosite, anthophyllite, crocidolite, and tremolite. Amphibole asbestos can be found in mineral deposits all over the world. The tragic attack cost the lives of nearly 3,000 civilians. Sadly, hundreds of thousands of people were exposed to toxic asbestos dust for weeks following the event. 20 years later, doctors estimate an increase in mesothelioma cases and other asbestos-related conditions. 

Asbestos Exposure at Ground Zero

A looming cloud of dust permeated lower Manhattan, local businesses, and residences for weeks, exposing an estimated 400,000 to 500,000 thousand people to contaminants. The dust mostly contained non-fibrous construction materials, glass, and other fibers. Burnt paper made up a significant amount of the dust, and a small percentage contained asbestos. The nearly 2 million tons of debris at ground zero consisted of asbestos levels well above the legal limit.

Mesothelioma isn’t the only risk associated with the dust at the World Trade Center following 9/11. According to a study from the Centers for Disease Control and Prevention (CDC), nearly 50 percent of residents near the World Trade Center reported nose, throat, or eye irritation one month after 9/11.

Within a week after the attack, respiratory, cardiovascular, and cerebrovascular hospitalizations increased among residents in the area. The study also found that those admitted to the hospital were mostly women and people over 65 years old.

Following the attack, many victims and first responders developed the “World Trade Center cough.” The health effect causes intense cough, respiratory pain, restricted breathing, and coughing up blood or ash. Some of the victims and first responders experienced nerve damage, causing pain in their hands and feet. About 1,560 firefighters reported experiencing the health effect. Researchers say there is a strong association between WTC cough and PTSD.

World Trade Center Health Registry

The World Trade Center (WTC) Health Registry, in collaboration with the WTC Environmental Health Center, was established to examine the long-term health effects of a large-scale disaster. In a study published in the National Library of Medicine, about 8 percent of adults enrolled in the registry reported a new diagnosis of asthma 5 to 6 years after 9/11. 

The intense dust cloud was also a risk factor for mental health issues. 5 to 6 years after 9/11, the WTC Health Registry recorded new PTSD symptoms in 21 percent of residents enrolled. The dust exposure, combined with witnessing horror, returning to a home with a heavy layer of dust, job loss, and lack of social support, caused difficulties with social and family lives among patients.

Types of Mesothelioma

Malignant mesothelioma is a rare form of cancer affecting the lining of organs located in the chest, abdomen, and thoracic cavity. In rare cases, mesothelioma can develop in the testicles. The cancer is often diagnosed in later stages and is primarily caused by exposure to asbestos. Mesothelioma is categorized based on where the onset of it occurs.

Pleural, Peritoneal, and Pericardial Mesothelioma

Pleural mesothelioma first occurs in the tissues surrounding the lungs and chest cavity. Accounting for about 80 percent of all cases, pleural mesothelioma is the most common type. There are roughly 2,500 to 3,00 pleural mesothelioma cases each year. Peritoneal mesothelioma begins in the tissues surrounding the organs in the abdomen. As the second-most common type of mesothelioma, it accounts for 15 and 20 percent of all diagnoses each year. Pericardial mesothelioma occurs in the pericardium, which is the tissue sac covering the heart. This form of mesothelioma is rare, accounting for one percent of all cases.

Testicular Mesothelioma

Even more rare, only a few hundred cases on record of testicular mesothelioma were ever diagnosed. The most common symptoms of testicular mesothelioma are lumps on the scrotum that don’t cause pain.

Signs and Symptoms of Mesothelioma

Once mesothelioma tumors develop, noticeable health complications and early signs start to occur. Early signs of pleural mesothelioma begin with persistent chest pain or cough. Fluid buildup, shortness of breath, fatigue, and weight loss may also occur. Patients in late stages may notice lumps beneath the skin on the chest.

Symptoms of peritoneal mesothelioma include swelling and pain in the stomach. In advanced cases, other symptoms include lumps in the abdomen and unexplained weight loss. Pericardial mesothelioma patients may experience frequent chest pain, shortness of breath, a persistent cough, and heart palpitations.

After the first exposure to asbestos, it can take decades for mesothelioma to diagnose. The time between prolonged exposure and the development of mesothelioma, called the latency period, can take between 20 and 60 years. The average age of people diagnosed in the U.S. is 72 years old.

After prolonged exposure, inhaled or ingested asbestos fibers become trapped inside areas of the chest, abdomen, or thoracic cavity. The affected tissue eventually becomes irritated, inflamed, and scarred. The body’s natural response is to provide lubrication in the form of liquid to inflamed areas. Over time, the fluid builds up, causing cell mutation and the development of mesothelioma cells.

Occupations at Risk

Anyone within a 1.5-mile radius of ground zero risked exposure to highly toxic and carcinogenic substances, such as asbestos, lead, mercury, benzene, and dioxins. Those who risked the most exposure were first responders and search and rescue workers, followed by cleanup workers and survivors and residents. Those with significant exposure live with an increased risk of developing cancer.

What To Do If You Were Exposed During 9/11

First responders, survivors, and anyone else exposed to 9/11 should monitor for symptoms early so that the best treatment options are available. Anyone exposed should get regular medical evaluations and checkups, especially of the respiratory system and digestive system. First responders and survivors should also receive regular mental health evaluations.

With an expected increase in 9/11-related health conditions, the September 11th Victim Compensation Fund (VCF) was established to provide compensation to individuals or representatives of deceased individuals who are affected. To be eligible, victims and first responders must have been present at the World Trade Center, surrounding exposure zone, the Pentagon crash site, and the Shanksville, Pennsylvania crash site between 9/11 and May 30, 2002.

Funding for the VCF has been extended until 2092 and has an estimated 7.375 billion dollars available. The VCF provides most of the compensation to construction workers, volunteers, clean-up and debris removal crews, victims, first responders, and residents who lived, worked, or went to school in the exposure zone.

Exposed individuals who were later diagnosed with mesothelioma can seek additional reimbursements of medical bills and lost wages through legal compensation. If a loved one passes away from an asbestos-related illness resulting from exposure at ground zero, compensation for wrongful death is also available. The VA offers compensation for service members and veterans who developed or physical or mental health conditions from exposure at the World Trade Center.