Health and environmental consequences of the World Trade Center disaster

Philip J. Landrigan; Paul J. Lioy; George Thurston; Gertrud Berkowitz; L. C. Chen; Steven N. Chillrud; Stephen H. Gavett; Panos G. Georgopoulos; Alison S. Geyh; Stephen Levin; Frederica Perera; Stephen M. Rappaport; Christopher Small; Mark Becker; Patrick N. Breysse; Beverly Cohen; Max Costa; Christos Efstathiou; Steven Eisenreich; Gary Foley; Robert Frank; John K. McGee; John D. Groopman; Robin Herbert; Julie Herbstman; Eric Jayjock; Michaela Kendall; Sally A. Lederman; H. J. Lim; Morton Lippman; Polina Maciejczyk; J. Millette; Ady Miretzky; Sheung P. Ng; John H. Offenberg; Haluk A. Özkaynak; Joachim D. Pleil; Francesca Pozzi; Chunli Quan; Joan Reibman; J. Ross; Jonathan M. Samet; Regina M. Santella; Margo Schwab; Pamela Shade; Mary Sobo; G. Stenchikov; Qing Sun; J. Morel Symons; Barbara Turpin; Vikram Vyas; Sheng Wei Wang; Clifford P. Weisel; D'Ann L. Williams; Mary S. Wolff; Lih Ming Yiin; Mianhua Zhong; Michael A. Gallo

doi:10.1289/ehp.6702

Health and environmental consequences of the World Trade Center disaster

Philip J. Landrigan, Paul J. Lioy, George Thurston, Gertrud Berkowitz, L. C. Chen, Steven N. Chillrud, Stephen H. Gavett, Panos G. Georgopoulos, Alison S. Geyh, Stephen Levin, Frederica Perera, Stephen M. Rappaport, Christopher Small, Mark Becker, Patrick N. Breysse, Beverly Cohen, Max Costa, Christos Efstathiou, Steven Eisenreich, Gary FoleyRobert Frank, John K. McGee, John D. Groopman, Robin Herbert, Julie Herbstman, Eric Jayjock, Michaela Kendall, Sally A. Lederman, H. J. Lim, Morton Lippman, Polina Maciejczyk, J. Millette, Ady Miretzky, Sheung P. Ng, John H. Offenberg, Haluk A. Özkaynak, Joachim D. Pleil, Francesca Pozzi, Chunli Quan, Joan Reibman, J. Ross, Jonathan M. Samet, Regina M. Santella, Margo Schwab, Pamela Shade, Mary Sobo, G. Stenchikov, Qing Sun, J. Morel Symons, Barbara Turpin, Vikram Vyas, Sheng Wei Wang, Clifford P. Weisel, D'Ann L. Williams, Mary S. Wolff, Lih Ming Yiin, Mianhua Zhong, Michael A. Gallo

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

261 Scopus citations

Abstract

The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyses of outdoor and indoor settled dust; high-altitude imaging and modeling of the atmospheric plume; inhalation studies of WTC dust in mice; and clinical examinations, community surveys, and prospective epidemiologic studies of exposed populations. WTC dust was found to consist predominantly (95%) of coarse particles and contained pulverized cement, glass fibers, asbestos, lead, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polychlorinated furans and dioxins. Airborne particulate levels were highest immediately after the attack and declined thereafter. Particulate levels decreased sharply with distance from the WTC. Dust pH was highly alkaline (pH 9.0-11.0). Mice exposed to WTC dust showed only moderate pulmonary inflammation but marked bronchial hyperreactivity. Evaluation of 10,116 firefighters showed exposure-related increases in cough and bronchial hyperreactivity. Evaluation of 183 cleanup workers showed new-onset cough (33%), wheeze (18%), and phlegm production (24%). Increased frequency of new-onset cough, wheeze, and shortness of breath were also observed in community residents. Follow-up of 182 pregnant women who were either inside or near the WTC on 11 September showed a 2-fold increase in small-for-gestational-age (SGA) infants. In summary, environmental exposures after the WTC disaster were associated with significant adverse effects on health. The high alkalinity of WTC dust produced bronchial hyperreactivity, persistent cough, and increased risk of asthma. Plausible causes of the observed increase in SGA infants include maternal exposures, to PAH and particulates. Future risk of mesothelioma may be increased, particularly among workers and volunteers exposed occupationally to asbestos. Continuing follow-up of all exposed populations is required to document the long-term consequences of the disaster.

Original language	English (US)
Pages (from-to)	731-739
Number of pages	9
Journal	Environmental health perspectives
Volume	112
Issue number	6
DOIs	https://doi.org/10.1289/ehp.6702
State	Published - May 2004

Keywords

Air pollution
Airway hyperresponsiveness
Asbestos
Occupational lung disease
PM
PM
Small for gestational age (SGA)

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health
Health, Toxicology and Mutagenesis

Access to Document

10.1289/ehp.6702

Cite this

Landrigan, P. J., Lioy, P. J., Thurston, G., Berkowitz, G., Chen, L. C., Chillrud, S. N., Gavett, S. H., Georgopoulos, P. G., Geyh, A. S., Levin, S., Perera, F., Rappaport, S. M., Small, C., Becker, M., Breysse, P. N., Cohen, B., Costa, M., Efstathiou, C., Eisenreich, S., ... Gallo, M. A. (2004). Health and environmental consequences of the World Trade Center disaster. Environmental health perspectives, 112(6), 731-739. https://doi.org/10.1289/ehp.6702

Landrigan, PJ, Lioy, PJ, Thurston, G, Berkowitz, G, Chen, LC, Chillrud, SN, Gavett, SH, Georgopoulos, PG, Geyh, AS, Levin, S, Perera, F, Rappaport, SM, Small, C, Becker, M, Breysse, PN, Cohen, B, Costa, M, Efstathiou, C, Eisenreich, S, Foley, G, Frank, R, McGee, JK, Groopman, JD, Herbert, R, Herbstman, J, Jayjock, E, Kendall, M, Lederman, SA, Lim, HJ, Lippman, M, Maciejczyk, P, Millette, J, Miretzky, A, Ng, SP, Offenberg, JH, Özkaynak, HA, Pleil, JD, Pozzi, F, Quan, C, Reibman, J, Ross, J, Samet, JM, Santella, RM, Schwab, M, Shade, P, Sobo, M, Stenchikov, G, Sun, Q, Symons, JM, Turpin, B, Vyas, V, Wang, SW, Weisel, CP, Williams, DAL, Wolff, MS, Yiin, LM, Zhong, M & Gallo, MA 2004, 'Health and environmental consequences of the World Trade Center disaster', Environmental health perspectives, vol. 112, no. 6, pp. 731-739. https://doi.org/10.1289/ehp.6702

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title = "Health and environmental consequences of the World Trade Center disaster",

abstract = "The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyses of outdoor and indoor settled dust; high-altitude imaging and modeling of the atmospheric plume; inhalation studies of WTC dust in mice; and clinical examinations, community surveys, and prospective epidemiologic studies of exposed populations. WTC dust was found to consist predominantly (95%) of coarse particles and contained pulverized cement, glass fibers, asbestos, lead, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polychlorinated furans and dioxins. Airborne particulate levels were highest immediately after the attack and declined thereafter. Particulate levels decreased sharply with distance from the WTC. Dust pH was highly alkaline (pH 9.0-11.0). Mice exposed to WTC dust showed only moderate pulmonary inflammation but marked bronchial hyperreactivity. Evaluation of 10,116 firefighters showed exposure-related increases in cough and bronchial hyperreactivity. Evaluation of 183 cleanup workers showed new-onset cough (33%), wheeze (18%), and phlegm production (24%). Increased frequency of new-onset cough, wheeze, and shortness of breath were also observed in community residents. Follow-up of 182 pregnant women who were either inside or near the WTC on 11 September showed a 2-fold increase in small-for-gestational-age (SGA) infants. In summary, environmental exposures after the WTC disaster were associated with significant adverse effects on health. The high alkalinity of WTC dust produced bronchial hyperreactivity, persistent cough, and increased risk of asthma. Plausible causes of the observed increase in SGA infants include maternal exposures, to PAH and particulates. Future risk of mesothelioma may be increased, particularly among workers and volunteers exposed occupationally to asbestos. Continuing follow-up of all exposed populations is required to document the long-term consequences of the disaster.",

keywords = "Air pollution, Airway hyperresponsiveness, Asbestos, Occupational lung disease, PM, PM, Small for gestational age (SGA)",

author = "Landrigan, {Philip J.} and Lioy, {Paul J.} and George Thurston and Gertrud Berkowitz and Chen, {L. C.} and Chillrud, {Steven N.} and Gavett, {Stephen H.} and Georgopoulos, {Panos G.} and Geyh, {Alison S.} and Stephen Levin and Frederica Perera and Rappaport, {Stephen M.} and Christopher Small and Mark Becker and Breysse, {Patrick N.} and Beverly Cohen and Max Costa and Christos Efstathiou and Steven Eisenreich and Gary Foley and Robert Frank and McGee, {John K.} and Groopman, {John D.} and Robin Herbert and Julie Herbstman and Eric Jayjock and Michaela Kendall and Lederman, {Sally A.} and Lim, {H. J.} and Morton Lippman and Polina Maciejczyk and J. Millette and Ady Miretzky and Ng, {Sheung P.} and Offenberg, {John H.} and {\"O}zkaynak, {Haluk A.} and Pleil, {Joachim D.} and Francesca Pozzi and Chunli Quan and Joan Reibman and J. Ross and Samet, {Jonathan M.} and Santella, {Regina M.} and Margo Schwab and Pamela Shade and Mary Sobo and G. Stenchikov and Qing Sun and Symons, {J. Morel} and Barbara Turpin and Vikram Vyas and Wang, {Sheng Wei} and Weisel, {Clifford P.} and Williams, {D'Ann L.} and Wolff, {Mary S.} and Yiin, {Lih Ming} and Mianhua Zhong and Gallo, {Michael A.}",

year = "2004",

month = may,

doi = "10.1289/ehp.6702",

language = "English (US)",

volume = "112",

pages = "731--739",

journal = "Environmental health perspectives",

issn = "0091-6765",

publisher = "Public Health Services, US Dept of Health and Human Services",

number = "6",

}

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T1 - Health and environmental consequences of the World Trade Center disaster

AU - Landrigan, Philip J.

AU - Lioy, Paul J.

AU - Thurston, George

AU - Berkowitz, Gertrud

AU - Chen, L. C.

AU - Chillrud, Steven N.

AU - Gavett, Stephen H.

AU - Georgopoulos, Panos G.

AU - Geyh, Alison S.

AU - Levin, Stephen

AU - Perera, Frederica

AU - Rappaport, Stephen M.

AU - Small, Christopher

AU - Becker, Mark

AU - Breysse, Patrick N.

AU - Cohen, Beverly

AU - Costa, Max

AU - Efstathiou, Christos

AU - Eisenreich, Steven

AU - Foley, Gary

AU - Frank, Robert

AU - McGee, John K.

AU - Groopman, John D.

AU - Herbert, Robin

AU - Herbstman, Julie

AU - Jayjock, Eric

AU - Kendall, Michaela

AU - Lederman, Sally A.

AU - Lim, H. J.

AU - Lippman, Morton

AU - Maciejczyk, Polina

AU - Millette, J.

AU - Miretzky, Ady

AU - Ng, Sheung P.

AU - Offenberg, John H.

AU - Özkaynak, Haluk A.

AU - Pleil, Joachim D.

AU - Pozzi, Francesca

AU - Quan, Chunli

AU - Reibman, Joan

AU - Ross, J.

AU - Samet, Jonathan M.

AU - Santella, Regina M.

AU - Schwab, Margo

AU - Shade, Pamela

AU - Sobo, Mary

AU - Stenchikov, G.

AU - Sun, Qing

AU - Symons, J. Morel

AU - Turpin, Barbara

AU - Vyas, Vikram

AU - Wang, Sheng Wei

AU - Weisel, Clifford P.

AU - Williams, D'Ann L.

AU - Wolff, Mary S.

AU - Yiin, Lih Ming

AU - Zhong, Mianhua

AU - Gallo, Michael A.

PY - 2004/5

Y1 - 2004/5

N2 - The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyses of outdoor and indoor settled dust; high-altitude imaging and modeling of the atmospheric plume; inhalation studies of WTC dust in mice; and clinical examinations, community surveys, and prospective epidemiologic studies of exposed populations. WTC dust was found to consist predominantly (95%) of coarse particles and contained pulverized cement, glass fibers, asbestos, lead, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polychlorinated furans and dioxins. Airborne particulate levels were highest immediately after the attack and declined thereafter. Particulate levels decreased sharply with distance from the WTC. Dust pH was highly alkaline (pH 9.0-11.0). Mice exposed to WTC dust showed only moderate pulmonary inflammation but marked bronchial hyperreactivity. Evaluation of 10,116 firefighters showed exposure-related increases in cough and bronchial hyperreactivity. Evaluation of 183 cleanup workers showed new-onset cough (33%), wheeze (18%), and phlegm production (24%). Increased frequency of new-onset cough, wheeze, and shortness of breath were also observed in community residents. Follow-up of 182 pregnant women who were either inside or near the WTC on 11 September showed a 2-fold increase in small-for-gestational-age (SGA) infants. In summary, environmental exposures after the WTC disaster were associated with significant adverse effects on health. The high alkalinity of WTC dust produced bronchial hyperreactivity, persistent cough, and increased risk of asthma. Plausible causes of the observed increase in SGA infants include maternal exposures, to PAH and particulates. Future risk of mesothelioma may be increased, particularly among workers and volunteers exposed occupationally to asbestos. Continuing follow-up of all exposed populations is required to document the long-term consequences of the disaster.

AB - The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyses of outdoor and indoor settled dust; high-altitude imaging and modeling of the atmospheric plume; inhalation studies of WTC dust in mice; and clinical examinations, community surveys, and prospective epidemiologic studies of exposed populations. WTC dust was found to consist predominantly (95%) of coarse particles and contained pulverized cement, glass fibers, asbestos, lead, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polychlorinated furans and dioxins. Airborne particulate levels were highest immediately after the attack and declined thereafter. Particulate levels decreased sharply with distance from the WTC. Dust pH was highly alkaline (pH 9.0-11.0). Mice exposed to WTC dust showed only moderate pulmonary inflammation but marked bronchial hyperreactivity. Evaluation of 10,116 firefighters showed exposure-related increases in cough and bronchial hyperreactivity. Evaluation of 183 cleanup workers showed new-onset cough (33%), wheeze (18%), and phlegm production (24%). Increased frequency of new-onset cough, wheeze, and shortness of breath were also observed in community residents. Follow-up of 182 pregnant women who were either inside or near the WTC on 11 September showed a 2-fold increase in small-for-gestational-age (SGA) infants. In summary, environmental exposures after the WTC disaster were associated with significant adverse effects on health. The high alkalinity of WTC dust produced bronchial hyperreactivity, persistent cough, and increased risk of asthma. Plausible causes of the observed increase in SGA infants include maternal exposures, to PAH and particulates. Future risk of mesothelioma may be increased, particularly among workers and volunteers exposed occupationally to asbestos. Continuing follow-up of all exposed populations is required to document the long-term consequences of the disaster.

KW - Air pollution

KW - Airway hyperresponsiveness

KW - Asbestos

KW - Occupational lung disease

KW - PM

KW - Small for gestational age (SGA)

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JO - Environmental health perspectives

JF - Environmental health perspectives

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Health and environmental consequences of the World Trade Center disaster

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