Journal of Occupational & Environmental Medicine:
DEPARTMENTS: Letters to the Editor
To the Editor:
Lange raises many issues related to suspected health effects among workers and Manhattan residents who were directly or indirectly involved with the World Trade Center disaster. Many of the issues raised in the letter are beyond the scope of our focused evaluation. The objective of our evaluation was to assess occupational exposures and the prevalence of symptoms among workers in an office building near the disaster site at a point in time 3 months after the disaster. Information from our evaluation may have been useful in assisting in the delivery of appropriate occupational health services to office workers in the area of the World Trade Center site, and may be useful if similar situations arise in the future.
Lange appears to draw conclusions from our study that are not supported by our data. Given the limitations of our survey, we found no occupational exposures to substances at concentrations that would explain the reported constitutional symptoms. Our data did suggest that factors (such as work organization and level of social support) unrelated to airborne contaminants from the disaster site might have been important in understanding the reported symptoms.
Finally, there is much evidence contrary to the assertion that there has been a “lack of concern” related to the disaster among health officials, or that local residents have been “forgotten.” Immediately after the disaster, and in continuing efforts, government officials and academic researchers, among others, have been actively assessing health effects, concerns about air quality, the need for assistance regarding household cleaning, and the need for supportive counseling services. A primary goal of these activities has been to provide information necessary for appropriate clinical care and public health support in response to the World Trade Center disaster. Important gaps remain in our knowledge concerning occupational and environmental exposures, and potential health effects, in the aftermath of disasters, such as the collapse of the World Trade Centers. The close partnerships that have formed among many agencies and organizations should improve the ability of public health officials and the medical community to respond to similar disasters that could possibly occur in the future.
Douglas B. Trout, MD, MHS
Trout D, Nimgade A, Mueller C, Hall R, Earnest GS. Health effects and occupational exposures among office workers near the World Trade Center disaster site. J Occup Environ Med. 2002; 44: 601–605.
Kramer R, et al. Community needs assessment of lower Manhattan residents following the World Trade Center attacks—Manhattan, New York City, 2001. MMWR. 2002; 51(special issue): 10–13.
Fagan J, et al. Self-reported increase in asthma severity after the September 11 attacks on the World Trade Center–Manhattan, New York, 2001. MMWR. 2002; 51; 781–784.
New York City Department of Health. A community needs assessment of lower Manhattan following the World Trade Center attack.December 2001.
CDC. Press release: The Agency for Toxic Substances and Disease Registry to aid New York City in establishing a registry of those who may have been exposed to hazardous substances from the World Trade Center collapse. Available at http://www.cdc.gov/od/oc/media/pressrel/r020805.htm