9/11: Safety and Health Lessons Learned

On Sept. 11, 2001, the nation recoiled in horror as two planes crashed into the World Trade Center towers in New York City, claiming the lives of thousands of people. After the towers collapsed, firefighters, policemen and other emergency responders and volunteers rushed to ground zero to rescue anyone who still was alive beneath the rubble. Once rescue efforts became recovery and cleanup efforts, workers continued to toil at the site.

But the calamity did not end on that day. From the moment the towers collapsed, a toxic cloud filled with asbestos particles, shards of fiberglass and other toxins shrouded ground zero. Consequently, many of the responders and volunteers – some say as many as 40,000 – who spent days or even months at the World Trade Center site have reported a slew of irreversible and chronic illnesses ranging from upper and lower respiratory ailments to gastro-esophageal reflux disease, post-traumatic stress disorder and cancer.

As more first responders are diagnosed with illnesses related to 9/11 dust, lessons have emerged for occupational and environmental health professionals who might one day face a similar disaster.

Lesson One: Get the Facts Straight

John Feal, an operating engineer contracted to work at the site on Sept. 12, 2001, is a textbook example of how respiratory protection was essential for the workers on site – a lesson learned the hard way, since respirators were scarce commodities in the early days of the cleanup.

In addition to suffering a painful and disabling injury when a 6,000-pound steel beam crushed his left foot as he was working on the site on Sept. 17, Feal also incurred sarcoidosis, a disease that scars lung tissue, and was troubled by acid reflux, a painful form of heartburn. He only worked at the site for 5 and a half days, he said, and was never ordered to wear any type of respiratory protection. Like many other emergency responders, he pointed the finger at EPA for assuring 9/11 responders and the rest of New York the air was safe to breathe, an assurance later revealed to be unfounded.

“I never smoked in my life,” Feal said. “I am an Army veteran. I used to wrestle. For this to happen to me, in my mind ... I thought I was invincible.”

Lesson Two: Provide PPE and Training

One of the lessons both responders and government agencies learned following 9/11 was the importance of not only providing protective equipment, but also training first responders on how to properly use respirators.

Appropriate half- or full-faced air-purifying respirators weren’t made available to workers in adequate numbers until several weeks after the attack, said David Newman, an industrial hygienist from the New York Committee for Occupational Safety and Health (NYCOSH). He pointed out that there already was a short history of people not wearing respirators even though they were available, creating a culture of casualness among the workers. In addition, the nature of the respirators themselves was an impediment, according to Newman. Not only could they be uncomfortable to wear – especially when not fit-tested, as was the case at ground zero – but the design itself didn’t allow responders to communicate with one another.

Lesson Three: Don’t Suspend Enforcement

Joel Shufro, NYCOSH’s executive director, pointed to what he called OSHA’s failure to enforce the respiratory protection standard and other regulations (the agency suspended enforcement of occupational safety and health regulations at the World Trade Center site) as another lapse in worker protections at ground zero. He expressed concerns that if such standards are not enforced during national emergencies, more workers risk getting injured, sick or killed in the future.

Lesson Four: Worry About the Worker, Not Liability

In the years following 9/11, the New York City government was criticized for allegedly failing to address the safety and health risks for workers and volunteers at ground zero. According to Shufro and Newman, the city seemed more interested in protecting itself from liability than protecting public health.