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The Air Down There:
Ground Zero Crews Question EPA
By Tree McElhinney

Hudson Valley resident George Smith, a New York City Department of Sanitation worker who spent nine months trucking rubble and smoking debris from Ground Zero to Fresh Kills landfill, has been on disability for over a year. Diagnosed with asthma in October 2002, the once active 57-year-old who used to spend his free time dancing and playing ball now struggles to catch his breath.

“I can’t breathe normal any longer. I just wish I could. My lung capacity has been diminished so much,” says Smith. “I’ve been going to a pulmonary specialist, and with the medication and steroids that I am on it helps somewhat, but I can’t even slow-dance to the completion of a song. I can’t even play with my grandkids. I can’t walk a block without having to stop and rest.”

During the initial months of the World Trade Center cleanup, Smith says he worked 12-hour shifts seven days a week, sleeping in Red Cross stations and returning to his Middletown home maybe once a week. Periodically, he was asked to wet down the perimeter of the site to assist in the removal of the dust that settled after the collapse of the towers, blanketing lower Manhattan with a range of environmental toxins, including pulverized cement and glass fibers, asbestos, highly alkaline particulate matter as well as heavy metals, PCBs, dibenzofurans, volatile organic compounds, and other products of combustion. “A lot of dust was on the window ledges.” Smith explains. “If you had a little bit of wind it would fly around. So if we kept the streets wet it would stick and then mechanical brooms could sweep it up.”

Smith says the visible particulates in the air prompted him at the time to cover his nose and mouth with a handkerchief, but he was not made aware of possible health hazards or fitted for a respirator until over two months after the attacks. And in light of reports in August that the Environmental Protection Agency downplayed potential health risks in the wake of the attacks and failed to provide both workers and residents with adequate warnings, Smith now holds the government accountable for his disability. “Either their testing was inadequate or they just plain lied to us,” he says, despite a strong patriotic sensibility that would lead him “without doubt or question” to participate in the cleanup all over again. “If they were honest, they would have protected us, and a lot of us would not be in the condition we are in now.”

More than two years after former EPA administrator Christie Whitman reassured New Yorkers that their air was “safe to breathe,” thousands of people who worked and volunteered at Ground Zero are now sick, even disabled, from asthma, chronic infections, and other respiratory illnesses. Of the approximate 9,000 who have been screened so far through a federally funded program run by the Mount Sinai Center for Occupational and Environmental Medicine, for example, nearly 80 percent have reported at least one pulmonary symptom that first developed or worsened in the aftermath of September 11. And more than half continue to show persistent symptoms of upper or lower respiratory disease.

“We are finding that these problems are not going away,” says Marie Divan Stelluti, a spokesperson for the program, which recently received additional federal aid to screen 3,000 more patients by March. “People who are walking in for the first time now are still showing the same rate of ailments and respiratory distress as those who were screened last year. It’s disturbing.”

It is disturbing indeed because the debilitating ailments of people like Smith and Orange County resident William Cummings—a former emergency services worker who says he’s been suffering from respiratory problems since helping people escape the collapse of the second tower—appear to corroborate the charges leveled against the EPA by its top watchdog in a written evaluation of the agency’s overall response to the attack on the World Trade Center. According to a report issued by the EPA’s inspector general in August, the agency “did not have sufficient data and analyses” to make a “blanket statement” when it announced on September 18 that the air around Ground Zero was safe to breathe. “Competing considerations, such as national security concerns and the desire to open Wall Street,” the report said, “also played a role in EPA’s air quality statements.”

In addition, the report said that White House officials instructed the agency to be less alarming and more reassuring to the public in the first few days of the attack, citing as an example a comparison of two news releases with their draft versions. The title for the original version of one news release dated September 13 was “EPA Initiating Emergency Response Activities, Testing Terrorized Sites for Environmental Hazards.” The White House changed the second clause to “Reassures Public About Environmental Hazards.” The EPA draft of the other release dated September 16 said: “Recent samples of dust on Water Street show higher levels of asbestos.” The White House version: “New samples confirm…ambient air quality meets OSHA [Occupational Safety and Health Administration] standards”…and “is not a cause for public concern.”

For Dr. Robin Herbert, who serves as the medical co-director of the Mount Sinai Center, the government’s downplay of its findings have directly interfered with the health and well-being of those who were working at or residing near Ground Zero. “Accurate and timely information from government is a cornerstone of good public health,” she was reported to have said. “By deleting good information to the public—people in their apartments, people on the pile—we lost opportunities for disease prevention.”

In an interview following the release of the inspector general’s report, Whitman, who left the agency in June, said that when she made the announcement about the air quality, the statement was correct. Pollutants that the EPA was measuring outside the smoldering pile, she said, had dropped to near-normal levels. But she also said that New Yorkers, anxious and frightened at the time, would not have stood for a vaguely worded scientific response.

“They’re now saying we didn’t have enough information,” she said. “But when people are really upset, you can’t win. You’ve got to say something, and what we communicated was what we knew. There may be long-term health implications we never could have conceived of, but we couldn’t stop and say, ‘We can’t tell you for 10 years.’ That absolutely wouldn’t work.”

Many doctors, however, currently involved in the treatment of patients suffering from 9/11-
related illnesses believe the government grossly underestimated the health risks posed by the collapse of the World Trade Center towers and did not begin taking air samples early enough.

“They arrived there late—the largest exposure occurred in the first 48 hours—they took very little samples—which they recently said they still haven’t finished analyzing—and they had the nerve to then say that it was safe for people to be there,” says Dr. Rafael de la Hoz, an occupational pulmonary specialist who oversees a privately funded treatment program for Ground Zero workers and volunteers at the Mount Sinai Center.

Although he admits that hindsight may not be a fair way to assess what transpired, de la Hoz says a “reductionist view” derived from extensive clinical experience is.

“Occupational pulmonary specialists know that exposure to alkaline and caustic substances and products of combustion like PAHs (polycyclic aromatic hydrocarbons) can cause bronchial inflammation and asthma. Seeing that cloud hovering over the area for weeks and months did not make me think that it was a safe place for people to work or for tourists to visit. The EPA should have [conducted] a very serious analysis of the conditions and then given that information back to the workers.”

Since January 2003 de la Hoz has treated nearly 600 patients, some 30 percent of whom live in and around the Hudson Valley area. About three-quarters are suffering from chronic upper-airway illnesses, he says, while almost half have asthma and other aggravated bronchial conditions, back and musculo-skeletal pain, and psychological problems such as post-traumatic stress disorder, anxiety, and depression.

A large number of these patients, de la Hoz says, were the building cleaners, who, unlike the police officers and firefighters whose heroism and subsequent illnesses have gotten huge amounts of attention, are largely unknown for their efforts. These workers, many of them Latinos from the laborers union, were hired to do things like remove the powdery dust that had settled in office heating and air-conditioning ducts and dispose of dust-covered office furniture, rugs, and computers. Some, de la Hoz says, worked upwards of 64 to 84 hours per week.

“Their conditions are very chronic. On average we are able to improve symptoms and a person’s level of functioning with anti-inflammatory medications and nasal inhalers, but we have to keep treating and treating,” says de la Hoz, whose program has recently received funding from the Bear Stearns Charitable Foundation that will keep it up and running through June 2005.

But other diseases such as lung cancer, fibrosis of the lung, and pleural cancer, de la Hoz says, take longer to manifest. “The patients feel reassured when I tell them that their cough now is not an asbestos-related condition, but it has been very well established in medical literature that there is a long latency period, anywhere from 10 to 20 years, between exposure to asbestos and the development of conditions.” In addition, he says, because the World Trade Center related illnesses do not appear to be subsiding—his next available appointment is over two months from now—and doctors do not know what other implications may arise in the future, the need for long-term medical monitoring is important.

Under heavy pressure from Senator Hillary Rodham Clinton, the federal government last February allotted $90 million, $25 million of which is designated specifically for New York City firefighters, for the long-term health monitoring of Ground Zero workers and volunteers. According to Stelluti, the Mount Sinai Center has submitted a proposal to the National Institute for Occupational Safety and Health, the federal agency administering the funding, to expand its current screening program to follow a total of 12,000 people over a period of 5 years as part of an “ideally developed” 20-year plan. “We would monitor these folks throughout the years, one examination every 18 months, to reevaluate their status and to diagnose as early as possible any illness that may arise in the future.”

But the program covers only screening, not treatment. Over two years have passed since the attacks and there has been no comprehensive effort by the federal government to treat people who have had their health compromised and have put their futures at risk as a result of participating in the recovery of the World Trade Center site.

“People need to be treated now,” says Stelluti, who describes the patchwork of resources available, such as de la Hoz’s privately funded program, as limited. “We’ve tried to outreach to private sources, but there are still hundreds of people out there who are ill, in need of treatment, and have no access to care.” They include, she says, volunteers with no insurance, people whose workers' compensation claims are in dispute, and others who had to stop working because of their illnesses and, subsequently, have lost their health benefits. Forty percent of the people enrolled in the Mount Sinai Center’s screening program, Stelluti says, are without insurance, while one-third are unemployed. “All we can do is attest to the fact that people are ill and that there is a need for resources.”