Breathing the Aftermath: A Review of Respitory Health Effects in Diverse Groups Exposed to 9/11 WTC Dust

Abstract

The September 11, 2001 terrorist attacks on the World Trade Center (WTC) in New York City resulted in a complex mixture of airborne pollutants that posed significant health risks to various exposed populations. This literature review examines the short-term and long-term respiratory health impacts on residents, passers-by, children, and rescue and recovery workers. A literature search was conducted using Web of Science, PubMed, and the CDC World Trade Center Health Program databases. Twenty-six studies meeting specific eligibility criteria were included in the final analysis. This review focused on general respiratory symptoms, asthma, and sarcoidosis. Findings show general respiratory symptoms were widespread, with passers-by showing the highest prevalence (69.2%), followed by rescue workers (68.9%), residents (65.9%), and children (53%). Asthma prevalence increased over time across all populations, with rescue workers showing an increase from 3.2% (2003-2004) to 18.1% (2015-2016), and children from 5.7% (2003-2004) to 25.5% (2005-2006). Children under 5 years old at the time of the attack showed higher vulnerability to asthma compared to other age groups. Sarcoidosis incidence was elevated among firefighters, with a short-term peak of 54 per 100,000 person-years (2003-2004) and long-term rates of 22-25.5 per 100,000 person-years over 14 years. Webber et al. (2017) reported a standardized incidence ratio of 4.2 (95% CI: 3.1-5.6) for WTC-exposed firefighters compared to unexposed populations in the first five years. Limitations of the reviewed studies include potential recall bias in self-reported data, variations in study methodologies, and challenges in accounting for other environmental or occupational exposures. The persistence of respiratory health issues across different groups and over time highlights the need for continued monitoring and care for affected populations.