The 9/11 World Trade Center first-responders who worked at the site searching first for survivors and then for remains have an elevated risk of developing dementia and changes to their blood chemistry similar to that of Alzheimer's patients, according to a pair of medical studies by Stony Brook University researchers.
The research also found that some WTC responders suffering from post-traumatic-stress-disorder and mild cognitive impairment saw protein changes in their blood consistent with that found in Alzheimer's patients.
One of the studies indicated that many responders with cognitive impairment exhibited reduced gray-matter thickness in their brain consistent "with neurodegenerative conditions and evidence their brain 'age' is about 10 years older on average" than the general population.
The research project was the first "to use MRI imaging to assess the brain matter of WTC responder patients with and without symptoms of cognitive impairment," according to a press release. "The goal of this study is to determine if WTC responders in their midlife have developed cognitive impairment due to changes in their brain possibly caused by neurotoxins they were exposed to at Ground Zero."
"The environmental exposures and psychological pressures experienced by responders during 9/11 and its aftermath have had an insidious effect on their health and well-being," said Dr. Benjamin Luft, Director of the Stony Brook WTC Health and Wellness Program. "Now nearly 20 years post-911, clinicians who care for these individuals are seeing more patients who are showing signs of cognitive disorders and possible dementia."
He continued, "Findings from our new studies provide data for the first time that support the idea that this population of patients who have cognitive impairment not only have psychological problems such as PTSD but may be at high-risk for neurodegenerative disorders, a possibility that needs immediate and continued investigation."
"The findings are concerning—it is clear that with more time we are learning more and more about the deleterious effects of the dust on the 9/11 community," wrote Dr. Jacqueline Moline, director of the Northwell Health Queens World Trade Center Health Program. "Given that many of the dust components have potential neurological impacts, it isn't surprising."
She added, "This important study—with objective evidence of cognitive loss—makes the WTC monitoring programs even more critical and provides additional evidence that neurological symptoms should be included as covered conditions, and cognitive assessments should be part of the monitoring examination for all 9/11 responders."
Under the 9/11 Victim Compensation Fund, those with PTSD and other psychological conditions do not qualify for monetary compensation. However, they can be covered by the World Trade Center Health Program for free treatment and are eligible for disability pensions.
Close to 80,000 first-responders are registered with the WTC Health Program, which provides health care and free annual screening. According to the program's website, 12,237 of them have been diagnosed with PTSD or other mental-health conditions.
EMS Union: Devastating
"This is a devastating blow to those of us who were involved with the WTC response and experienced that chronic exposure to all of those airborne toxins," said Oren Barzilay, president of District Council 37's Local 2507, which represents EMTs and paramedics. "I am approaching 50 and I am just one of the tens of thousands with this hanging over me. It seems it was a real mistake not to include these health conditions under the 9/11 VCF."
Police Benevolent Association President Patrick J. Lynch said in a statement, "This is the sad reality for our 9/11 heroes. Their sacrifice wasn't a monetary decision. Many will be paying for it their entire life. The VCF should honor its commitment to these heroes and their families by expanding coverage as they have done in the past."
Michael Barasch, a leading 9/11 WTC claims attorney, said the Stony Brook studies bolster the case for having the 9/11 VCF revisit its exclusion of PTSD and other psychological conditions, as well as make it easier for WTC first-responders to substantiate their disability claims.
"I always thought it was so unfair to treat people with mental-health issues differently than physical injuries," he said during a phone interview. "PTSD is no less real than asthma and cancer, and now there seems to be empirical evidence linking mental-health illness to the WTC toxins."
Jeffrey Goldberg, who also handles 9/11 first-responders' claims, said that previously mental-health claims could be dismissed as malingering because they were backed up solely by self-reporting of symptoms by the claimant.
"I have watched as a lot of people got turned down for physical ailments and then start seeing psychiatrists and psychologists and come up with a diagnosis of PTSD, which means they can't collect on VCF but can get a three-quarters disability pension," he said. "Now, with this Stony Brook study, we are headed in the right direction where we can put physical findings to a mental disability. And now, with dementia and review of the MRIs, it is an even-bigger link."
Mr. Goldberg represents the family of retired Firefighter Joe Battista, who died in April 2018 in a Florida mental hospital, where he choked to death on his food. He was 63.
Mr. Battista worked on the WTC pile for more than three months and then was assigned to the Fresh Kills Landfill to continue retrieving body parts. He retired in 2007.
According to his cousin, Joe Ciacco, and Nancy Dormi, his wife, the retired Firefighter, who lived with them in Florida, battled PTSD and depression but his WTC disability claim was rejected by the Fire Department, which determined he suffered from dementia, which did not qualify.
"We were in and out of doctors in New York," recalled Ms. Dormi. "You could see he was getting more and more withdrawn. He wasn't getting any better and nobody would help us."
The FDNY rejected his request four times, according to the Daily News, which reported "the FDNY's medical board said Battista suffered from a form of early-onset dementia even though several psychiatrists diagnosed the retired firefighter with PTSD that could be linked to his work history."
Handled Happy Land Fire
A former Police Officer, he became a Firefighter in 1982 was assigned to Engine Co. 90 in The Bronx's Morris Park neighborhood.
The terrorist attack was not Mr. Battista's first mass casualty event. He was one of the first Firefighters to respond to the Happy Land social club fire in 1990, where 87 people died, according to Mr. Ciacco. "He was first-due on that job and helped break down the door," he said. "They had to go all over to find enough body bags."
"And then when he dies, the FDNY told us he was not entitled to a line-of-duty death because he did not pass due to a 9/11 condition," he said.
Departing Uniformed Firefighters Association President Gerard Fitzgerald, a former member of the World Trade Center Scientific Advisory Steering Committee, was optimistic that would change, saying that "as more medical evidence comes in like this, the panel will make the appropriate recommendations going forward. That's the way all of the WTC-linked cancers became certifiable WTC health conditions."
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