The WTC Medical Working Group, a group of physicians and researchers appointed by Mayor Bloomberg in 2007 to assess the state of 9/11 health and related services on an annual basis, reviewed more than 100 scientific articles that have been published since the 2001 attack on the World Trade Center. Our key findings from these studies published as of June 2008 are presented in this report. Recommendations follow to guide policy makers, researchers and other constituencies with an interest in 9/11 health. Both clinical studies and population-based surveillance indicate that symptoms of post traumatic stress disorder are highly prevalent among rescue and recovery workers and Lower Manhattan residents, two directly affected populations. Studies of rescue and recovery workers also indicate that respiratory problems, asthma and gastroesophageal reflux disease are common among this group, particularly those who arrived early at the WTC site and those who worked there for long periods of time. Similarly, Lower Manhattan residents and area workers - including those who worked in Lower Manhattan, though they may live elsewhere - have reported elevated levels of respiratory problems and new onset asthma. Studies are ongoing to characterize the kinds of exposures that may have contributed to this illness and to determine its persistence. This review of research to date also makes clear that significant questions remain unanswered. For example, how extensively did the disaster affect the health of residents, area workers, and students in Lower Manhattan, and what kinds of exposures increased their risks? How persistent are the mental and physical health symptoms in thousands of rescue, recovery and clean-up workers? How effective has treatment been among the people who have received it? From our review of services, informed by the medical directors of New York City's three Centers of Excellence who are members of this group, current health care resources are adequate for the more than 10,000 WTC-exposed individuals who have sought treatment for conditions related or potentially related to 9/11 exposure. What is not clear, however, is if all the people eligible for these programs are aware of them. Monitoring and treatment services available through the Centers of Excellence would be strained if greater awareness of these programs - particularly among Lower Manhattan residents, area workers and students - significantly increased demand. Furthermore, uncertainty in the availability of ongoing federal support for 9/11-related health care means that the people currently in these programs do not know if they will continue to receive their treatment and medications free of charge. Both FDNY and the New York/New Jersey WTC Clinical Consortium are funded through 2009 only, and the New York City Health and Hospitals Corporation's (HHC) WTC Environmental Health Center has not received any federal funding to date.
Worker-health; Emergency-responders; Fire-fighters; Police-officers; Occupational-diseases; Occupational-exposure; Occupational-health-programs; Occupational-health-services; Health-care; Biological-effects; Surveillance-programs; Epidemiology; Health-surveys; Bronchial-asthma; Mental-stress; Respiratory-system-disorders