11-S Anniversary: ​​Why do firefighters and police continue to die?


Theattacks of September 11, 2001they left some sequels in American politics and society, whose echoes resonate almost twenty years later. These consequences are the most remembered, but they are not the only ones: lEmergency service workers, police and firefighterswho helped in the rescue efforts of the Twin Towers yetsuffer side effects, physical and psychological.

The list of evils is long: chronic cough, respiratory difficulties, congestion, liver damage, cancer, depression, etc.

The 11S killed 343 New York firefighters. Since then,another 200 have died of related diseaseswith rescue efforts in the area where the attacks occurred in New York.
The list of ills suffered by these veterans is long: chronic cough, respiratory difficulties, congestion, liver damage, cancer, depression, stress-related disorders and excessive alcohol consumption, among others.

The main responsible for the physical damage that these workers endure isthe famous dust that covered the so-called Zero Zone, after the collapse of the buildings. Subsequent investigations demonstrated its high toxicity due to the high alkalinity of the cement powder mixture.

This was deposited in the respiratory passages, from the head to the lungs of the rescuers in an amount several orders of magnitude above the recommendations of the US Environmental Protection Agency (EPA).

Lung damage and cancer

"Lung wounds are the most common impact caused by exposureto dust and smoke at the World Trade Center ", explains to New York University researcher Michael Weiden, who has studied the damage suffered by this organ as a result of the attack.

The increase inthe incidence of cancer is the most serious impact in terms of lost livesbetween emergency service workers, firefighters and police

Such injuries, caused by inhalation, can cause inflammation even years later. According to Weiden, they can be treated similarly to asthma, with inhaled anti-inflammatory steroids and beta agonist bronchodilators.

On the other hand, the scientist comments that "the increase in the incidence of cancer is the most serious (effect) in terms of lost lives" among emergency service workers, firefighters and police.

A study published in 2011 in the magazine 'The Lancet' determined thatFirefighters who worked in 11S were 19% more likely to develop cancercompared to the rest of his classmates, and up to 10% more than the general population.

In 2018, another one published in JAMA Oncology found that veterans are more likely to develop multiple myeloma, a type of blood cancer. Already this year, the highest incidence of head and neck cancer was revealed among emergency service workers.

Firefighters working during 9/11. LIBRARY OF CONGRESS

The incidence of thyroid cancer among emergency service workers who experienced the attack is also higher,triple compared to other citizens. A study published this year in the journal Environmental Research and Public Health also showed that this increase cannot be explained by an overdiagnosis due to the high monitoring to which these veterans are subjected.

Pulmonary ailments and the increased risk of cancer are not the only consequences of exposure to toxic dust. "Prolonged contact can extremely inflame the endothelial lining of blood vessels that go to the liver," says the researcher at the Icahn School of Medicine at Mount Sinai, Mary Ann McLaughlin. This whatmay cause the failure of this organto the point of needing a transplant, says the scientist, who has been investigating possible liver damage since 2013.

In spite of everything, Weiden assures that the total mortality of those who collaborated in the rescue tasks is not even higher compared to the rest due to the "effect of the healthy worker". This bias causes workers to have a lower mortality than the rest of the population, because people with chronic and disabled diseases tend to be excluded from the labor sector, especially in the case of firefighters and police.

The danger of psychological sequelae

If the toxic dust left physical consequences in those who helped in the rescue efforts,The psychological effects of the fateful day are not far behind. An article published in 2015 analyzed this "mental burden" as well as physics. The results showed that up to 12 years after the attack,the incidence of posttraumatic stress in these workers was 7% higher than in the restof his classmates; that of depression 16.7%; and that of harmful alcohol consumption, 3%.

Firefighters are exposed to the same traumatic events as civilians, but the nature of their work makes them live more frequently.

Sandra Morissette is a psychologist at the University of Texas at San Antonio who has studied the mental health of 11S veterans. "Firefighters are exposed to the same traumatic events as civilians, but the nature of their work makes them live more frequently," explains Sinc.

However, similar to what happens with the effect of the healthy worker,firefighter resilience is high. "Despite the high rates of exposure to traumatic events, most firefighters do not develop posttraumatic stress," adds the psychologist.

In fact, it highlights that although some studies give figures as high as 60% of addictive behaviors, 37% of post-traumatic stress and 20% of depression, "the majority – 80% – complete their career, with an average of 25 years of service".

This does not mean that the mental health of firefighters who experienced the attacks should be neglected. Morissette believes thatit is necessary to "reduce the stigma" that exists around the psychic state, "which can prevent them from seeking the treatment they need." It emphasizes that "there are magnificent treatments for posttraumatic stress, depression and addictive behaviors, but people should support patients."

A lot of work and few funds

Although the list of side effects after 11S is long, it is not even complete, the researchers warn. "We still founddiseases associated with exposure to the Twin Towersand many of the conditions that the first workers have developed are for a lifetime, "Anna Nolan, a researcher at the University of New York, tells Sinc that this month has published a study on new therapeutic targets forfight lung damageof these firefighters.

The continuous support of the Government through subsidized programs is of great importance.

For Nolan, "the continuous support of the Government through subsidized programs is of great importance." Michael Weiden, of the University of New York, considers for his part that the monitoring and treatment programs are "robust and well financed".

In addition, the expert ensures that "the recentrenewal of compensation funds to victimsit shows that there is public support, "and encourages those who were exposed to continue monitoring their health so that researchers can understand the new diseases they may develop.

Taking these aspects into account, a report by the National Academy of Sciences, Engineering and Medicine in the US recommended in 2018 the creation of a research and monitoring program for the health of 11S veterans and the Gulf War. almost two decades later in one case, and almost three in the other.

The University of Arizona researcher and committee chairman, Kenneth Ramos, summarizes the objective of the program. "First establish a database of veterans, their peers and descendants; second,assess exposure in detail during deployment; finally, develop biomarkers that allow measuring their susceptibility to diseases. "

Although the experts interviewed for this report agree that 11S veterans are being sufficiently helped, the management has been criticized by the comedian and television presenterJon Stewart, which in early summer protested in Congress.

The problem is that, although the compensation funds were renewed in 2015, last February the Department of Justice indicated that they were running out quickly and that the aid would have to be reduced by up to 70%.

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