Death by Dust: 9-11 toxic cloud and cancer
Mon Dec 11, 2006 20:09

Death by Dust: The frightening link between the 9-11 toxic cloud and cancer

Want more evidence of the government's criminal disregard for the healthy and safety of citizens? Consider: due directly to the lack of care shown for the lives of Ground Zero first responders by their leaders, more people will die from the toxic fallout at Ground Zero than were killed in the initial attacks.

A looming medical crisis could have been mitigated by swift, decisive action on the part of the EPA. But rather than declare lower Manhattan off limits until it performed a comprehensive evaluation of the hazards posed by airborne toxins emitted from the "pile" and provide appropriate protective gear to volunteers sifting through the debris, the White House pressured the EPA into declaring the air at Ground Zero safe.

And now that hundreds of Ground Zero first responders are dying from rare cancers, diminished lung capacity, and toxins in their blood, the same politicians have yet to respond to their plights and pleas for help. Apparently, there isn't adequate funding for monitoring, testing and treating the heroes politicians were all too happy to use for political gain.

Even the medical community has been in denial about the connection between their work after 9/11 and the rapid development of diseases that normally take significantly longer to appear. When these diseases appear in clusters, as they have in those who worked to clean up Ground Zero and those exposed to toxic clouds for months, it is time to drop the word 'coincidence' and take responsibility for caring for the men and women we lauded for their heroism and courage. We cannot let them become disposable heroes.

To date, 75 recovery workers on or around what is now known as "the Pile"--the rubble that remained after the World Trade Center towers collapsed on the morning of September 11, 2001--have been diagnosed with blood cell cancers that a half-dozen top doctors and epidemiologists have confirmed as having been likely caused by that exposure.

Those 75 cases have come to light in joint-action lawsuits filed against New York City on behalf of at least 8,500 recovery workers who suffer from various forms of lung illnesses and respiratory diseases--and suggest a pattern too distinct to ignore. While some cancers take years, if not decades, to develop, the blood cancers in otherwise healthy and young individuals represent a pattern that experts believe will likely prove to be more than circumstantial. The suits seek to prove that these 8,500 workers--approximately 20 percent of the total estimated recovery force that cleared the rubble from ground zero--all suffer from the debilitating effects of those events.

The basis for the suits stems from the plaintiffs' argument that the government--in a desperate attempt to revive downtown in the wake of the catastrophic events on 9-11--failed to protect workers from cancer-causing benzene, dioxin, and other hazardous chemicals that permeated the air for months. Officials made these failures worse by falsely reassuring New Yorkers that they faced no long-term dangers from exposure to the air lingering over ground zero.

"We are very encouraged that the results from our monitoring of air-quality and drinking-water conditions in both New York and near the Pentagon show that the public in these areas is not being exposed to excessive levels of asbestos or other harmful substances," Christine Todd Whitman, the then administrator of the EPA, told the citizens of New York City in a press release on September 18--only seven days after the attacks. "Given the scope of the tragedy from last week, I am glad to reassure the people of New York . . . that their air is safe to breathe and the water is safe to drink."

Those statements were not only false and misleading, but may even play into the basis for the city's liability for millions of dollars in the recovery workers' lawsuits. Last February, U.S. District Judge Deborah Batts cited Whitman's false statements as the basis for allowing a different class-action lawsuit to proceed--this one, against the EPA and Whitman, is on behalf of residents, office workers, and students from Lower Manhattan and Brooklyn, many of whom suffer from respiratory illnesses as a result of 9-11.

"No reasonable person would have thought that telling thousands of people that it was safe to return to Lower Manhattan, while knowing that such return could pose long-term health risks and other dire consequences, was conduct sanctioned by our laws," Batts wrote in her February 2 ruling. "Whitman's deliberate and misleading statements made to the press, where she reassured the public that the air was safe to breathe around Lower Manhattan and Brooklyn, and that there would be no health risk presented to those returning to the areas, shocks the conscience."

And that was before anyone knew of the apparent cancer link, first reported in the New York news media in the spring of 2004. Even more shocking is the incidence of cancer and other life-threatening illnesses that have developed among those participating in the recovery workers' lawsuits. Given the fact that some cancers are slower to develop than others, it seems likely to several doctors and epidemiologists that many more reports of cancer and serious lung illnesses will surface in the months and years to come. The fact that 8,500 recovery workers have already banded together to sue, only five years later--with 400 total cancer patients among their number--leads many experts to predict that these figures are likely to grow, meaning a possible death toll in the thousands.

In many ways, these illnesses suggest the slow but deteriorating health issues that faced the atomic-bomb survivors of Hiroshima and Nagasaki, where thousands died in the years and decades that followed the United States' use of nuclear weapons. And that similarity has not been lost on David Worby, the 53-year-old attorney leading the joint-action suits on behalf of those workers who are already sick, and even dying.

"In the end," Worby declares, "our officials might be responsible for more deaths than Osama bin Laden on 9-11."

In the five years since the attacks, much of the focus on the 9-11 health crisis has missed a broader question, the one that every ground zero worker fears most and the one that Ernie Vallebuona has already had to ponder: What about cancer? What if all that pulverized concrete and ground glass and caustic mist that Vallebuona inhaled while on the Pile didn't attack his lungs but instead went straight for his lymph nodes? Could this noxious mix have caused his lymphoma?

No one has done a comprehensive study of the health consequences on the estimated 40,000 rescue and recovery workers who raced to ground zero after the attacks. A study by Mount Sinai Medical Center--one that received widespread media attention two months ago--released statistics on the five-year anniversary of 9-11 that focused almost exclusively on respiratory problems and bypassed any mention of cancer today.

But David Worby has tracked the cancer patients among his growing client base for the last two years. Here are the latest tallies: Of the 8,500 people now suing the city, 400, or about 5 percent, have cancer. The biggest group by far consists of people like Vallebuona, who have blood cell cancers. Seventy-five clients suffer from lymphoma, leukemia, multiple myeloma, and other blood cell cancers; most are men, aged 30 to 60, who appeared in perfect health just five years ago.

The field of cancer research is not known for consensus. But six prominent specialists on cancer and the link to toxins--on the faculty of the nation's top medical schools and public health institutions--all come to the same conclusions when told these statistics. They are Richard Clapp and David Ozonoff, professors of environmental health at Boston University School of Public Health; Michael Thun, director of epidemiological research at the American Cancer Society; Francine Laden, assistant professor of environmental epidemiology at Harvard School of Public Health; Jonathan Samet, chairman of the epidemiology department at Johns Hopkins Bloomberg School of Public Health; and Charles Hesdorffer, associate professor of oncology at Johns Hopkins School of Medicine. These doctors and epidemiologists agree that the incidence of cancer among this subset of workers sounds shockingly high, that they cannot and should not be dismissed as coincidence, and that the toxic dust cloud that hung over downtown Manhattan, and particularly the Pile, likely caused or promoted the diseases. Some even went so far as to say that the blood cancer cases, especially, indicate what could become a wave of cancer cases stemming from 9-11 over the next decades.

"Those numbers seem quite outrageous," is how Hesdorffer puts it. Now at Johns Hopkins, Hesdorffer directed until last year the tumor immunotherapy program at Columbia University Medical Center, where he treated two recovery workers who got cancer post--9-11. He notes that the average healthy adult person has a 20 percent risk of having cancer over a lifetime. Calculate that risk over five years--the time frame from the events of 9-11 until today--and it drops to about 1 percent. Yet 5 percent of the suits' workers--1 percent of the overall worker population--have already been diagnosed with malignancies. And these patients don't include the thousands whose illnesses have yet to be recorded because they aren't participating in the lawsuits or in the World Trade Center medical-monitoring programs.

What the experts find most telling are the types of cancer now emerging. They say the blood cancer cases seem too disproportionate to be random. Two percent of these workers have been diagnosed with what amounts to related diseases, none of which fall into the "high-frequency" category, which includes prostate cancer. One out of 9,000 people nationwide gets lymphoma a year; for myeloma, it's one out of 30,000. By contrast, the 75 blood cancer patients translate into several dozen new cases a year.

"That's not just a fluke," says Ozonoff, who studies cancer clusters and toxic waste sites.

Samet, a worldwide expert on smoking and cancer, notes that when so many cases of related cancers emerge, it can signal a forming cluster. "It sounds like an impressive cluster of cancer cases, and I would want to study it," he says.

To be sure, the experts advise caution until more evidence is collected. They acknowledge that the data needed to draw a definite link between 9-11 and cancer don't exist. None of the cancers emerging now are the kinds that come only from toxic exposures--like, say, asbestosis, which is caused by asbestos and can take two decades to grow. This sentinel cancer would go a long way toward proving a 9-11 connection. Absent that, scientists would want to determine whether a higher proportion of cancer patients exists among the workers than in the general public. But because there are no independent data on the 40,000-strong group, they can't make this calculation yet. Meanwhile, the latency periods for most cancers from the time of a full-blown carcinogenic exposure to a full-blown malignancy can take years, if not decades. Says Thun, of the American Cancer Society: "It is the exception rather than the rule to have cancers develop this quickly."

Despite the lack of definitive data, we may still be in the midst of a cancer epidemic. Indeed, according to these experts, traditional data don't help much here because 9-11 represents such a singular exposure. No one can deny that the workers were exposed to a blend of pulverized and aerosolized toxins that had never existed in any occupational setting before. And this mix of toxins alone is enough to cause more aggressive cancers.

"It's also enough to throw out prescriptions on timing," Hesdorffer adds.

Back in May 2004, before most doctors even contemplated a 9-11 link to cancer, Hesdorffer provided testimony to the federal government's September 11 Victim Compensation Fund on behalf of one police officer who had developed pancreatic cancer within a year after his recovery stint. Hesdorffer finds it odd that two of his patients had been diagnosed with the rare cancer after working on the Pile. "It's strange to have two people who were subjected to the same exposure," he says, "developing the same cancer in the same time frame." Now that he has learned of Worby's statistics, he is convinced that "there is definitely more than a likely link between the 9-11 exposures and cancer."

Francine Laden, who specializes in air pollution and cancer, agrees. Because so many of Worby's clients have blood cancers--which have faster incubation periods than tumor cancers, forming in as little as five years--Laden confirms that it's not a stretch to attribute their diseases to the dust cloud. "Blood cancers are different," she says, noting the tie between benzene and leukemia, as well as dioxin and lymphoma. "It's not beyond the realm of feasibility that these chemicals caused these cancers."

Ozonoff puts it more firmly: "For an acute episode like this, it's definitely possible these blood cancers were caused by 9-11."

Ozonoff echoes all five of his colleagues when he draws parallels between the aftermath of 9-11 and that of another massive exposure: the atomic-bombs dropped on Japan. Bomb survivors experienced excessive spikes in leukemia rates within the first five years, a surprising discovery for epidemiologists in the mid 20th century. While this outbreak resulted from radiation, both it and 9-11 involved a sudden and intense blast of carcinogens. For bomb survivors, leukemia appeared first, followed by breast and lung cancer. "That could happen with 9-11," says Samet, the Johns Hopkins epidemiology department chair. "It might be what we're seeing today."

It's also possible that the carcinogens in the Trade Center dust accelerated cancers already dormant or developing in the recovery workers, epidemiologists say. According to Richard Clapp, who directed the Massachusetts Cancer Registry from 1980 to 1989, toxins can not only instigate the genes that cause cancerous cells to divide, but also hasten their dividing. That means that a person with an undetected cancer will develop it faster and in a more virulent manner. He calls this the "promotional effect" and says some toxins associated with 9-11 have been known to speed up lymphomas and leukemias. "The promotional effect could have happened already," he says.

Either way, Clapp adds, "It's hard not to attribute these cancers to 9-11." His gut, he says, is telling him one thing: "We'll be seeing a cancer explosion from 9-11, and we're starting to see it today."


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