Medical care for workers exposed to the WTC disaster

Over 50 000 workers were exposed while responding to the World Trade Center (WTC) incident, attempting to rescue survivors and recover the dead, clearing the site, or cleaning the surrounding buildings.2 These workers were exposed to an incompletely characterised mix of asbestos, alkaline cement dust, pulverised building materials, and fire smoke for many days and weeks, often without proper protection.3 Hundreds of these people are disabled and can no longer work, and thousands have become ill and continue to receive medical treatment nearly 10 years after 9/11.4 Until now, documentation of illnesses in WTC rescue and recovery workers has been based on data collected during medical examinations or follow-up health interviews.4-6 The only study on cancer outcomes in these workers was a small case series of multiple myeloma (n=8).7 Case studies, although useful for alerting the health-care community about the potential for new or late emerging illnesses, are of little value for determining WTC-exposure-related health outcomes due to self-selection and case-ascertainment biases.