9/11: Ten Years Later
“9/11: Ten Years Later," is the title of an award-winning documentary by brothers Gideon and Jules Naudet, with James Hanlon. First filmed in 2001, the film was updated and aired on the tenth anniversary of Sept. 11, 2001 (CBS). Narrated by actor Robert De Niro, the film follows the firefighters of Engine 7 Ladder 1 located in the TriBeCa area of lower Manhattan as they respond to the attack at the World Trade Center. Ten years later, the documentarians revisit the firehouse and find that some of the firefighters may have either retired or died because of WTC-related illnesses. These heroes personify the bravery and selflessness of the estimated 100,000 persons including first responders, those who searched for the remains of victims, and those who helped to clean up the WTC site known as the "pile." Unfortunately, they also share the illnesses and disabilities that plague other 'first responders,' many of whom are currently subjects of ongoing studies, two of which are briefly described below:
1) While the WTC disaster has been linked to a variety of adverse chronic health sequelae, it has not been determined whether excess mortality has occurred. As such, Jordan HT, et al, undertook a study {Mortality among survivors of the Sept 11, 2001, World Trade Center disaster, Lancet [2011 Sep 3;378(9794):879-87]} to determine whether excess mortality had indeed occurred by employing results gleaned from the World Trade Center Health Registry cohort data from the New York City Department of Health and Mental Hygiene (NYC DOHMH). Study participants were categorized as either rescue and recovery workers (including volunteers), or non-rescue and non-recovery participants. Standardized mortality ratios (SMR) were calculated with New York City rates from 2000-09 as the reference. Within the cohort, proportional hazards were used to examine the relation between a three-tiered WTC-related exposure level (high, intermediate, or low) and total mortality;" 156 deaths were found to have occurred in 13,337 recovery and rescue workers, while there were 634 deaths recorded in 28,593 non-rescue and non-recovery workers. "All-cause SMRs were significantly lower than that expected for rescue and recovery participants as well as non-rescue and non-recovery participants." However, SMRs for respiratory system, or heart pathology, or hematological malignancies were significantly increased. In non-rescue and non-recovery subjects, both "intermediate and high levels of WTC-related exposure were significantly associated with increased SMRs" v. low exposure. In contrast, with rescue and recovery study participants, "...the degree of WTC-related exposure was not significantly associated with all-cause mortality." Jordan HT, et al, concluded their"...study of mortality in a well defined cohort of 9/11 survivors provides a baseline for continued surveillance. Additional follow-up is needed to establish whether these associations persist and whether a similar association over time will occur in rescue and recovery participants."
2) "The New York State Department of Health (NYS DOH) is the data collection center for information on deaths of WTC responders, recovery workers and volunteers, regardless of how or why the death occurred." As of June 2010, 836 persons who worked at the WTC site and have subsequently died have been identified; the World Trade Center Responder Fatality Investigation Program has collected data for each relevant death comprised of medical records, death certificates, autopsy results, employment records, and WTC exposure information Confirmed causes of death have been identified in the same manner. At present, the program researchers are analyzing data from the 836 deaths, and comparing these mortality rates to local and national death rates in order to ascertain whether WTC responders are at greater risk for any specific causes of death. Conclusions re mortality rates, however, are considered to be "premature" until the study is completed; methodological issues remain regarding the study cohorts.