Rescuing the rescuers

With thousands of first responders ill after the 9/11 attacks, stakeholders hope to apply lessons learned to keep future responders safer

By Kyle W. Morrison, senior associate editor

As the twin towers fell 10 years ago in New York City, hundreds of people fled, streaming out of the World Trade Center buildings. But a smaller group went against the flow, rushing into the buildings to do their job: save lives.

It is part of the job description of first responders – including firefighters, police officers and paramedics – to literally put their lives on the line to save others. Of the approximately 3,000 people who died on Sept. 11, 2001, about 400 were first responders. But in the past decade, hundreds more have died and thousands are ill as a result of diseases acquired during rescue efforts.

“Though the dust has settled and the ruins of the 9/11 attacks have been cleared away, the physical effects of the attack are still being felt,” Sen. Charles E. Schumer (D-NY) said two years ago. “The first responders who made it home safely that day are still, nearly eight years later, suffering from medical conditions resulting from the dust they breathed in as they helped rescue countless victims.”

Schumer made his comments on June 24, 2009, as he introduced the James Zadroga 9/11 Health and Compensation Act (S. 1334). The bill would provide health care to workers exposed to toxic chemicals released by the collapse of the twin towers. Although first responders were receiving treatment prior to the introduction of the bill, it was provided through a variety of programs that did not establish consistent funding.

Help for the ill

In late 2010, after a bitter congressional fight, a compromise was reached and the bill moved to the president, who signed it into law.

The bill placed the various programs providing health care to workers under the NIOSH-operated World Trade Center Health Program, and will provide about $1.5 billion in funding for the program over the course of five years. The program, which officially began July 1, expanded to include responders of the Pentagon crash and the crash site of United Airlines Flight 93 near Shanksville, PA.

In addition to treating responders for conditions related to exposure to the disasters, the program also monitors and provides health assessments for enrollees to detect the onset of symptoms related to working at the attack sites.

Several conditions are covered in the bill, but one of the most prominent – cancer – is not. A recent NIOSH report examining current medical data and research concluded no causal association existed between first responders’ cancers and exposures from the terrorist attacks. NIOSH Director John Howard, however, stressed in a statement that this lack of evidence does not mean no link exists, and another institute study will be conducted in early to mid-2012.

Nearly 55,000 responders were enrolled in the WTC program as of March 31, according to the most recent data available. Of those, about 15,900 had received treatment in the past year. At press time, the data was scheduled to be updated Sept. 15.

The program could accommodate an additional 25,000 responders, but Congress would have to authorize increasing that cap, as well as reauthorizing funding for the program beyond 2016. Howard, who also is coordinator for the program, said in an interview with Safety+Health that he did not know how many new participants may join or what trends would be seen among illnesses.

“One aspect of the new program will be our ability to address that question by having authority and funding to better gather data and stimulate new research,” he said.

Lessons learned

Gathering data and monitoring the health of first responders was one of the important lessons learned after 9/11, Howard said. A roster of responders and rescue workers who rushed to the scene of the attacks did not exist 10 years ago, making monitoring their health over the long term difficult.

Response personnel applied this lesson to the Deepwater Horizon oil spill cleanup last year. More than 55,500 workers voluntarily signed a roster. This established a record of all workers who participated in cleanup efforts and provided NIOSH with a mechanism to contact workers regarding possible work-related symptoms.

Stakeholders in the emergency response profession are taking a closer look at how best to protect employees. “People in this profession tend to be patient-focused,” said Glenn Luedtke, a retired emergency medical services director in Sussex County, DE, and current chair of the National Association of Emergency Medical Technicians’ EMS Safety Committee. “We really didn’t design our systems with safety in mind; we didn’t design our equipment with safety in mind.”

Due in part to 9/11 and a growing awareness of statistics related to first responder on-the-job deaths and injuries, efforts are being made to change attitudes and the culture to be more aware of risks, Luedtke said.

Among the efforts that Clinton, MS-based NAEMT is pursuing is a new course dedicated to EMT safety – the first such program in the country, as far as Luedtke is aware. The advocacy association also is looking into ergonomic issues to prevent back and shoulder injuries, and vehicle design to keep paramedics safer while attending to patients in ambulances.

“No one should be at risk of injury or illness at work or in the line of duty,” Howard said. “It is vital that we help build and support a culture of preparedness in which we identify the hazards that responders may encounter in often hectic and intrinsically dangerous situations, and provide tools, strategies, training and equipment to help them stay safe during response activities.”