25 Years After 9/11, ‘World Trade Center Cough’ Is Still Affecting First Responders

Twenty-five years after the September 11 terrorist attacks, the health consequences of what happened at Ground Zero are still unfolding.

Among the earliest warning signs was a persistent respiratory condition that became known as “World Trade Center cough.” Within weeks of the attacks, first responders began reporting persistent coughing, shortness of breath and other respiratory symptoms after breathing the dust and smoke that blanketed Lower Manhattan.

As ABC News reports on the 25th anniversary of the attacks, thousands of first responders and survivors continue to navigate health problems associated with their exposure at the World Trade Center site, even decades later.

The cause of many of those respiratory problems can be traced to what was in the air.

When the Twin Towers collapsed, enormous clouds of pulverized concrete, glass, asbestos and other building materials filled Lower Manhattan. Fires and burning jet fuel added gases and chemicals to the mix. According to The Mesothelioma Center at Asbestos.com, an estimated 410,000 to 525,000 people were exposed to toxic dust containing pulverized glass and concrete, asbestos fibers and other hazardous materials. 

“Think about what happens when the lungs suddenly encounter an enormous concentration of dust, smoke and microscopic particles,” says Dr. Gustavo Ferrer, pulmonologist and CEO of the Moxie Health Group.  “The airways become irritated and inflamed. For some people, that inflammation did not simply disappear when the dust settled. It became a chronic respiratory problem.” What became known as World Trade Center cough was more complicated than a lingering cough.

What is World Trade Center Cough?

The Mesothelioma Center reports that World Trade Center cough syndrome can involve chronic rhinosinusitis, asthma and bronchitis, conditions that can also be worsened by gastroesophageal reflux disease, or GERD.

Research has also found that respiratory problems were more severe among those with more intense exposure to the toxic dust, particularly people who were at Ground Zero on September 11 and those exposed for extended periods. 

“These patients remind us that a cough can involve more than the lungs,” Ferrer says. “Inflammation in the sinuses and airways, asthma-like changes and acid reflux can all contribute to a cough and keep triggering one another. That helps explain why symptoms can become persistent and difficult to treat.”

A Health Crisis That Continues

A quarter-century later, the health consequences extend far beyond respiratory disease.

U.S. News & World Report, in its 25th-anniversary coverage published September 11, describes Ground Zero’s toxic legacy as one that is still claiming lives. The illnesses associated with 9/11 exposure now include respiratory and digestive diseases as well as numerous cancers.

ABC News reports that more than 9,400 people have died from 9/11-related illnesses over the past 25 years. This year, for the first time, the 9/11 Memorial & Museum is adding a seventh moment of silence to its annual commemoration to honor those who have died from illnesses related to their time at or near the World Trade Center site. Clearly, the health story of September 11 is not over.