9/11 responders with high dust exposure have increased dementia risk

The September 11 terror attacks continue to have severe effects on the health of first responders and other workers and volunteers who toiled at ground zero and elsewhere following the collapse of the World Trade Center towers. 

Researchers at Stony Brook University have concluded that people who were exposed to the toxic dust and debris that lingered for months at ground zero and at the Fresh Kills landfill on Staten Island are developing early onset dementia at a higher rate than those present at the pile who had no exposure or wore protective equipment. 

The multi-year study found that 4.6 percent of responders developed neurodegenerative symptoms, about nine times the rate typical for the general population. 

“This rate of dementia in those reporting many exposures and limited protection is not only statistically significant, it is alarming for a patient cohort that clearly shows a strong association between exposure and the incidence of dementia under the age of 65,” the study’s lead author, Sean Clouston, a professor in the Program in Public Health at Stony Brook University, said in a press release. “Also, the rates remained statistically significant over the less exposed group even after adjusting for social, medical, and demographic factors.”

The research team evaluated more than 5,000 people, all of them 60 years old or younger at the time of their first assessment, starting in November 2014 and found that 228 developed dementia during the next five years. 

The researchers noted that dementia in the general population is “fairly rare.” 

Dr. Benjamin Luft, a co-author of the study and the director of the Stony Brook WTC Health and Wellness Program, said it was critical to continue clinical research on the responders’ cognitive health.

“These findings are a major step forward in establishing that the dust and toxins which were released as a result of the calamitous terrorist attacks on 9/11 continue to have devastating consequences on the responders,” said Luft, who has been monitoring and evaluating 9/11 responders for 20 years. “The full extent of neurodegenerative disease still needs to be determined.”

The study’s interdisciplinary research team and co-authors consisted of experts in public health, preventive and family medicine, psychiatry, medicine, psychology, and applied mathematics and statistics.

They diagnosed dementia through the presence of new-onset cognitive impairment in two domains of cognitive functioning, episodic memory and executive function. Episodic memory involves the ability to learn, keep and retrieve information about personal experience. Executive functions are mental processes that together control behavior, manage tasks and help plan and carry out goals.  

Role of PPE

The study, conducted from November 2014 and through 2022, included 5,010 people, all of them living in Long Island and all 60 or younger without dementia at the time of their first assessment.

Evaluations were followed up every 18 months, on average, for up to five years. 

The researchers considered the “heightened likelihood” of exposure to neurotoxic dust for workers and volunteers who performed general manual labor, whether they sifted through debris, worked indoors and if they were exposed to chemicals, fumes and smoke. They established severity and length of responders’ exposure to dust and potentially neurotoxic debris through answers to a detailed questionnaire and then, accounting for the use of PPE, split exposure level into five categories, from low to severe.

The study found that responders had an increased risk of dementia if they labored in dusty locations and did relatively dangerous work for 15 or more weeks on or near the pile. 

Of the workers and volunteers who wore PPE or said they had no exposure to dust, about five to six of every 1,000 responders who were evaluated developed dementia each year. 

For those who dug through debris from the towers or did other work where significant amounts of toxic dust was present and did not use PPE, the dementia incidence rates reached 42.36 per 1,000 people each year.

The medical monitoring program was available to workers or volunteers who were verifiably in lower Manhattan, at the Fresh Kills landfill in Staten Island or on barge-loading piers in the days, weeks and months following the attacks.

More than 130,000 people living with illnesses, disorders and injuries attributable to toxins released by the collapse of the Twin Towers had enrolled in the federal World Trade Center Health Program as of March, about 25,000 more than just four years ago. The program provides medical monitoring and treatment of WTC-related health conditions for 9/11 responders and survivors.

Nearly 3,000 were killed at the World Trade Center the day of the attacks. Since then, nearly 7,000 people who contracted respiratory illnesses, cancers and other ailments and enrolled in the WTC Health Program have died because of exposure to the toxic debris and dust released when the towers collapsed, according to the Centers for Disease Control and Prevention. Just over 5,000 of them were responders from the FDNY, NYPD, DSNY and other city agencies and departments, and volunteers.

richardk@thechiefleader.com

We depend on the support of readers like you to help keep our publication strong and independent. Join us.