Before the Illnesses

BEFORE THE ILLNESSES: Nicholas Wexler, right, a 28-year Correction Officer, developed the debilitating Chronic Obstructive Pulmonary Disorder (COPD) after briefly responding to the Sept. 11, 2001 attacks (where he and colleagues are pictured) and then working near the site for several months. On July 5, COPD and acute traumatic injury were added to the list of illnesses covered by the World Trade Center Health Program and the Victim Compensation Fund, which covers out-of-pocket costs.

Around the time Paul Gerasimczyk retired from the NYPD in 2004, his doctors gave him a full-body scan, looking for any unexpected masses. He felt all right, but they wanted to be sure that he was okay. The films came out clear.

Mr. Gerasimczyk, now 57, had been a Police Officer stationed in Brooklyn on Sept. 11, 2001 when he was ordered to the World Trade Center, where the towers had just been hit by terrorists’ planes.

100 Days at Ground Zero

Along with hundreds of other first-responders, he put in an 18-hour day that Tuesday, only to sleep for a few hours at home and return early the next morning. He worked in rescue and recovery for at least 100 days, cleaning and searching the site where some of his close colleagues had perished.

He estimates he was down there for at least four or five days before he received proper protective equipment.

It wasn’t until 2005 that he started coughing one night and couldn’t stop. Beads of sweat broke out all over his face.

It was the beginning of his respiratory troubles: an asthma attack that turned into chronic asthma, then reactive airways dysfunction syndrome (RADS) and, eventually, chronic obstructive pulmonary disorder (COPD). Then, just a few months after the first coughing fit, a tumor was discovered in his kidney.

Mr. Gerasimczyk was lucky in a few respects. He was able to have surgery to remove the tangerine-sized cancer, and his generous insurance as a retired cop helped him pay for his many breathing medications. His diagnoses of asthma and RADS—both covered World Trade Center illnesses—also allowed his medicine to be paid for.

More Coverage for COPD

On July 5, many 9/11 survivors and first-responders with less-generous insurance who have developed COPD since the attacks learned that they, too, would be covered for the debilitating illness. The ailment was added to the list of conditions covered under the Federal Zadroga Act.

Previously, only COPD developed before Sept. 11 that was exacerbated by the toxic dust was covered under the World Trade Center Health Program, Chris Baione of the law firm Pitta Giblin Baione explained last week. Mr. Baione and his colleagues represent many 9/11 first-responders, and he said that new scientific studies had shown a direct link between the illness and the attacks.

Dr. John Howard, the administrator for the Health Program, also allowed coverage for acute traumatic injury. Any physical injury received during the attacks or during the recovery and cleanup efforts will now be eligible for free medical care, including treatment for ongoing effects like chronic pain.

“It’s completely ridiculous that it wasn’t covered before,” Mr. Gerasimczyk said. “Everybody is getting the same types of illnesses. The kidney cancers, the GERD and subsequent Barrett’s [Esophagus, a pre-cancerous complication of GERD], and problems with the lungs, breathing problems.”

Another COPD Victim

Nicholas Wexler, a retired Correction Officer, also developed COPD after working downtown in the months after the Sept. 11 attacks. While his time at the actual disaster site was brief, he was exposed at close range a couple of days after the attacks, and continued to work nearby, at the Manhattan Detention Complex, in the months after.

Though a former smoker, he’d quit years before he first became short of breath, dizzy and nauseous in the late 2000’s. He had by then become quite athletic, working out regularly and performing martial arts.

He soon discovered he’d developed lung conditions common to 9/11 survivors, including lung tumors that were removed in 2014. His doctor told him his type of lung cancer was unusual in smokers, but was typical for asbestos workers and others exposed to similar fumes.

Mr. Wexler, now 61, said he has good health insurance from his union. But a month’s supply of three of his inhalers would be at least $300 if he weren’t covered—a cost that would be dwarfed by the scans and doctor’s visits and treatments he also receives.

He is very surprised that new-onset COPD was just now covered, considering the many survivors and workers who have been diagnosed.

The Case for Coverage

Dr. Michael Crane, medical director of the World Trade Center Health Program Clinical Center of Excellence at Mt. Sinai Hospital, was among the physicians who wrote to Dr. Howard to urge the inclusion of new cases of COPD.

He said there was initial concern that COPD caused by smoking could get mistaken for 9/11-related illness. But new studies showed a link, and the fine print will likely require that there be proper evidence of World Trade Center exposure.

Dr. Crane has seen hundreds of patients sickened by breathing in the toxic dust from the attack, and it became clear to him that coverage was crucial, though before Sept. 11, he tended to see the illness among smokers.

“I saw previously healthy people who are not smokers come to my program with a cough, and a few years later their breathing tests got worse and their chest X-rays looked a little bit funny. All of a sudden when I was sending them to really excellent doctors, they’d say this guy has COPD. And I’d say, this person is not a smoker—what are you talking about?”

“We’re very, very grateful to Dr. Howard,” he added.

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(1) comment

jmcauley

It's amazing that it took 15 years to cover new onset COPD as a World Trade Center exposure related illness. Chronic Bronchitis was directly observable amongst world trade center responders within months of 9/11. How many people should have been helped but werent because of this decade and a half delay in recognizing this illness as a new onset consequence of exposure at the WTC. Even more difficult to understand is why exposure was recognized early on as an exacerbation of already established COPD but not as a cause of COPD. Nobody in the World Trade Center Health Program seems to have any sense of urgency about first responders and survivors who suffer a variety of illnesses such as autoimmune conditions, kidney illnesses and peripheral neuropathy, even though there are studies out there that show a much higher incidence rate amongst those exposed to WTC toxins than the general population. As an example, responders have a 1500% higher rate of peripheral neuropathy than the general population, yet only months ago, the addition of peripheral neuropathy as a covered illness was rejected by the World Trade Center Program. The clock continues to tick and responders and survivors continue to suffer and die and wait, always the waiting.
Yes, thanks and gratitude to Dr. Howard, the Director of the World Trade Center Health Program, for adding new onset COPD and traumatic injury to the list of covered conditions, but there is still so much more to do and time is short for so many.

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