Persistent Lower Respiratory Symptoms in the World Trade Center (WTC) Survivor Program, a Treatment Program for Community Members

Abstract

Hundreds of thousands of community members (local residents, local workers, cleanup workers, students, and passersby) were exposed to the massive dust cloud released by the collapse of the World Trade Center towers on September 11, 2001. Many also had chronic exposures to settled and resuspended dust in indoor and outdoor spaces and to fumes from fires that burned for months. Although funding for treatment and monitoring of this population lagged behind that of rescue and recovery workers, local communities and physicians were concerned early on about the potential adverse health effects of this group’s complex and varied WTC exposures, and the Bellevue Hospital Asthma Clinic began treating community members with respiratory symptoms soon after the disaster. Over the years, the program has evolved and grown and, with the passing of the Zadroga Act in 2010, earned ongoing federal funding as part of the World Trade Center Health Program (WTCHP), which provides comprehensive treatment and monitoring to both “responders” and “survivors” (community members). The World Trade Center Environmental Health Center (WTC EHC) at Bellevue Hospital, the flagship Center of Excellence for the Survivor Program, provides multidisciplinary medical and mental health treatment to symptomatic WTC-exposed community members. Mirroring findings in rescue and recovery populations, studies from the WTC EHC, World Trade Center Health Registry, and others have documented persistent lower respiratory symptoms, mental health symptoms, and abnormalities of distal airway function in community members exposed to WTC dust, gas, and fumes. Ongoing monitoring, treatment, and research are essential to detect emerging health effects, improve treatment, and prevent adverse outcomes to communities affected by environmental disasters.