Truth delayed is still truth—but delayed truth can cost lives.
Twenty-five years after September 11, 2001, our nation continues to mourn those who were killed that morning. We must also remember the responders, recovery workers, office workers, residents, students and children whose health was damaged by what they breathed, swallowed and carried home afterward.
The attacks ended in a day. The health emergency did not.
Soon after 9/11, I began collecting research about what became known as World Trade Center cough and World Trade Center illness. I first published the information on a GeoCities website. When GeoCities discontinued its service, I preserved part of that work in my 2009 blog entry, “World Trade Center Illness Research.”
At that time, many connections between World Trade Center exposure and later illnesses were still being investigated. Researchers repeatedly said that the numbers were small, the latency periods were uncertain and more monitoring was needed.
The passage of time has now supplied evidence that could not have been available during those early years.
What We Know Now
When the World Trade Center buildings collapsed, an enormous cloud of pulverized building materials, glass fibers, asbestos, metals, concrete, plastics, combustion products and other contaminants spread through Lower Manhattan. Responders and recovery workers experienced some of the most intense exposure, but they were not the only people placed at risk.
Residents, workers, students, building occupants and people caught in the original dust cloud were also exposed. Dust was carried into apartments, offices, schools, vehicles and clothing. Some young people who were exposed are only now reaching ages when certain long-latency illnesses may appear.
The federal World Trade Center Health Program now recognizes and provides monitoring or treatment for numerous categories of certified 9/11-related conditions, including:
Asthma and other upper and lower airway disorders
Chronic cough and chronic obstructive pulmonary disease
Gastroesophageal reflux disease
Certain cancers
Post-traumatic stress disorder, depression and anxiety disorders
Acute traumatic injuries and medically associated conditions
This does not mean that every illness experienced by every exposed person was caused by 9/11. Medical certification requires evidence that a person’s condition and exposure meet the Program’s criteria. It does mean that the overall health consequences are now established beyond reasonable dispute.
According to New York City’s newly released World Trade Center 25-Year Health Impact Report, 10,562 FDNY members are certified with at least one physical health condition related to their World Trade Center service. Another 4,496 are certified with at least one mental-health condition, and 4,257 members currently have a cancer certification.
Behind every number is a human being—and a family.
The report also contains a reason for hope: 86 percent of World Trade Center responders in the FDNY program who were diagnosed with cancer were alive five years after diagnosis, compared with 63 percent of New York State residents diagnosed with the same cancers who were not exposed at the World Trade Center. Differences in monitoring and early detection may contribute to that survival advantage.
Monitoring saves lives.
Felicia Dunn-Jones Must Still Be Remembered
The New York City medical examiner later determined that her exposure to World Trade Center dust contributed to her death and added her name to the official list of victims.
Her story mattered then, and it matters now. She helped make visible a truth that would become clearer over the following decades: some people survived the attack only to face illnesses resulting from their exposure.
Mental Health Is Part of the Health Story
The continuing impact of 9/11 is not limited to lungs, digestive systems or cancer diagnoses. Survivors and responders may also live with PTSD, depression, anxiety, grief, substance-use disorders and the emotional strain of repeated illness and loss.
Physical and mental health must not be separated into competing priorities. Whole-person care recognizes that the body, mind, family and community can all carry the consequences of catastrophe.
A Call to Everyone Who Was There
You did not have to be a firefighter to have been exposed.
If you responded, worked, lived or attended school in the affected area—or participated in rescue, recovery or cleanup operations at the World Trade Center, Pentagon or Shanksville sites—do not assume that too much time has passed to ask questions.
The World Trade Center Health Program provides eligible responders and survivors with no-cost medical monitoring and treatment for certified 9/11-related conditions. Its services are available through clinical centers in the New York metropolitan area and a nationwide provider network for eligible people who now live elsewhere.
Even if you feel healthy, documented exposure history and appropriate medical monitoring may matter. If you have persistent respiratory, digestive, mental-health or other symptoms, talk with a qualified healthcare professional and investigate whether you are eligible for the Program.
This section fits beautifully immediately before “Never Forget Must Be an Action.” It completes the circle: remember those who passed, care for those who became ill, and express gratitude to those still among us.
Let Us Honor Those Who Are Still Here
Albert did not write his history from a distance. He lived it. He found a way through the guarded perimeters, became a volunteer and reached Ground Zero. He worked amid the dust, smoke, rubble, grief and extraordinary human determination of those early days.
Albert survived. He is still here—and I am deeply grateful.
His presence reminds us that honoring 9/11 must not be reserved only for those who have passed. We must also honor the responders, recovery workers, volunteers, survivors, residents and witnesses who are alive today.
Let us thank them while they can hear our gratitude.
Let us listen while they can tell their own stories.
Let us ask how they are doing—not only during anniversary ceremonies, but throughout the year. Let us make certain they receive the healthcare, recognition and human support they deserve.
Albert’s book, Getting to Ground Zero: A Volunteer’s Story, preserves the experience of an ordinary citizen who answered an extraordinary call. His testimony helps us remember that, after the destruction, people stepped forward to help America rise again.
Some of those courageous souls are still here, including Albert Davis. We should all be answering the questions about how can we prepare for the future in the event of this or something worse happening again.
May we give them their flowers, our gratitude and our loving attention now.
“Never Forget” Must Be an Action
Twenty-five years later, remembrance must mean more than ceremonies, flags and moments of silence.
To never forget means:
Never abandon those who became ill while serving others.
Never dismiss residents, workers or children whose symptoms appeared years later.
Never allow political convenience to replace honest environmental-health information.
Never stop researching illnesses that may take decades to emerge.
Never place institutional protection above public protection.
Never tell people an environment is safe until the evidence supports that conclusion.
This is not only a lesson about the past. It is a principle for every future disaster, demolition, industrial accident and technological development:
Tell the truth about risks as early as possible. Preserve the evidence. Protect the people. Continue monitoring for as long as the science requires.
In 2009, I wrote that World Trade Center cough and World Trade Center illness were real health issues. Today, extensive medical research, federal healthcare programs and 25 years of patient histories confirm the magnitude of that warning.
We honor those who died on September 11.
We honor those who survived.
We honor those who ran toward danger—and those who are still living with what followed them home.
May remembrance lead to care.
May research lead to healing.
May truth lead to protection.
Only the truth is true.
