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This week, the Unites States remembers the terrorist attacks of September 11, 2001. We’ve had 17 years now of grieving and lesson-learning, but the emotional scars will always remain.

For many people who were near Ground Zero of the WTC attacks, especially first responders called to the scene and their loved ones, the pain of the tragedy actually worsened during the years after the attacks because of exposures to hazardous materials and their resulting health effects. Let’s take a moment to review some of the details of the aftermath of the attacks, focusing on lessons we can learn about emergency planning.

The Aftermath of the WTC Attacks

After the WTC buildings collapsed, much of their mass was converted into huge dust clouds of particles that settled throughout the surrounding area. The smallest particles were 2.5 micrometers (µm) in size. For context, the average human hair is about 70 µm in diameter, which is 30 times larger than the smallest particles. This very small size is what enables these particles to penetrate deep into the lungs, where they can cause damage leading to respiratory problems. The particles were were mostly comprised of a highly alkaline mixture of crushed concrete, gypsum, and synthetic vitreous fibers (SVFs).

There were also asbestos, dioxins, polynuclear aromatic hydrocarbons (PAHs) and various heavy metals present. Air quality monitoring conducted at the time to provide guidance to exposure prevention programs focused on this latter group of contaminants, all of which were present at lower concentrations, and did not account for the much more abundant WTC dust from debris. First responders, who worked long hours in the ruins of the WTC, had the most significant exposures to these hazards. One of the clearest early results of exposure, according to a 2002 study, was a persistent cough usually accompanied by bronchial hyper-reactivity and respiratory distress, so common it became known as “WTC Cough.”

Extensive peer-reviewed literature in the years since 9/11 documents both chronic and acute health effects in rescue workers and volunteers. The WTC Worker and Volunteer Medical Screening Program (WVMS) was created to provide free medical assessments, clinical referrals, and occupational health education for workers and volunteers who undertook recovery and response efforts at Ground Zero.  A 2004 Center for Disease Control (CDC) study found that 1,138 of 11,768 participants evaluated between July 16 and December 31, 2002 experienced new-onset or worsened preexisting lower and upper respiratory symptoms that frequently persisted months after their work at WTC had stopped.

Demonstrating the persistence of these health effects, a 2008 study of 42 former WTC emergency responders found that 71.4% had a dry cough, 69% had shortness of breath, 74% had upper respiratory ailments, and 40.5% had lower respiratory conditions. Additional information and data about health effects of WTC dust exposure is available in this long and very detailed journal article at the National Institute of Health (NIH) page.

Because of growing evidence of health effects among people who were near Ground Zero during or directly after the WTC attacks, President Obama signed the James Zadroga 9/11 Health and Compensation Act of 2010 (Zadroga Act), which established the World Trade Center Health Program. The program provides medical monitoring and treatment for eligible people who were present near Ground Zero, including emergency responders, recovery and cleanup workers and volunteers. The program is certainly a great benefit to those affected by exposure, and its existence speaks to the size of the problem created by uncontrolled exposures after 9/11, and to the huge impacts created by long-term health symptoms.

Emergency Planning and Response Lessons

Much public discussion of “lessons learned” from 9/11 has focused on the flow of intelligence information about planned terrorist activities and on the movements of the perpetrators themselves, and how to ensure more efficient sharing of information to prevent future attacks.

Receiving much less attention have been the gaps in emergency planning and response that led to the high incidence of both short and long-term health effects among exposed populations, including emergency response personnel. The growing body of evidence about the health symptoms of those exposed to dust at Ground Zero indicates that we should change that.

There appear to have been two main pitfalls in emergency planning and response at Ground Zero. First, not all hazards were properly identified, and so risk evaluations and personal protective equipment (PPE) selection had gaps. The exposure monitoring showed that there was an awareness of many hazards easily identifiable as “chemicals,” like asbestos and dioxins, but missed the hazards inherent in the much more common building materials and the dust created by the destruction of the buildings. It’s those hazards that ultimately caused such widespread health symptoms within exposed populations. A major contributing factor was the relative scarcity of toxicological information discussing the health effects of such materials at the time of the attacks.

Second, the initial risk assessments and exposure monitoring were not updated in light of emerging information during the response activities. For example, the identification of the symptoms of what came to be called “WTC Cough” should have triggered awareness of hazards inherent in the dust, which could have prompted re-evaluation of the hazards analysis, and revision of exposure guidelines and PPE selection. However, as a retrospective article available at the NIH page concludes, “Unfortunately, the initial focus of the air quality monitoring and guidance on exposure prevention programs on low-concentration components was never revised. “

Some things have changed since 9/11. For instance, OSHA revised the Hazard Communication (HazCom) Standard in 2012 to align with the Globally Harmonized System (GHS) of Classification and Labelling of Chemicals. The updated HazCom standard changed the way chemicals are classified, and as a result, chemicals that were not hazardous in 2001 may be classified as hazardous now. Shipping labels and safety data sheets (SDSs) for chemicals were also updated to improve access to hazard information. That, coupled with awareness of dust hazards from the aftermath of 9/11, means that chemical hazard information is more likely to be available now than it was back in 2001.

Sadly, some things have not changed, especially as it relates to effectively sharing the hazard information available. As we wrote on this page last year, the damage created in the wake of Hurricane Harvey caused several major chemical incidents (including an explosion at the Arkema Inc. plant in Crosby, Texas) that placed not only the surrounding community, but also emergency responders, at risk of chemical exposures. A big part of the danger facing emergency personnel in these situations continues to be uncertainty about whether all chemical hazards are known before response operations begin, and whether responders have appropriate PPE for the hazards they are likely to encounter.

What Can We Do?

The best way to honor a tragedy is to learn from it. We can never completely eliminate the hazards involved in emergency response – it’s a dangerous job, full stop. But we can do everything can we to improve our emergency planning and hazard communication practices to protect our communities, and those who do the important work of protecting those communities at their most vulnerable moments.

There are many potential emergency scenarios that can happen, some involving chemicals stored at the facility, others involving construction materials within the building structure itself, and some involving a combination of the two. Therefore, we need to think broadly when putting together our emergency preparation and response plans.

There are actions we can all take to make sure hazard information is available when we need it the most, including:

  • Confirming that first responders are aware of building construction materials present in your facility, and have taken it into account in their emergency response plans.
  • Sharing information about chemicals at your facility with your local fire department. It’s a good idea to give them the clearest picture of your chemical storage locations and practices possible, because that increases the chances for a timely and safe response in the event of an emergency. Share not just chemical inventory lists and copies of SDSs, but also building diagrams or layout drawings showing exactly where chemicals are stored.
  • Maintaining a site-specific written plan detailing all aspects of your company’s HazCom program, including how chemical information is made available to employees, how and where safety data sheets (SDSs) are kept, and what training efforts are in place to make sure employees know how to properly access and use this information.
  • Keeping an up-to-date chemical inventory list, documenting every hazardous chemical in the workplace (even those not in use), along with their quantities and where they are located. Be sure you maintain SDSs for every hazardous chemical in your inventory, and ensure employees have right-to-know access to them. Remember, the real test of that access is whether employees can quickly locate an SDS, without obstacles or delays.
  • Ensuring that your workplace labeling system for secondary containers makes all hazard information available to employees, and that employees understand how the system works.
  • Training employees to know and understand the specific chemical hazards they are exposed to in the workplace.

Let VelocityEHS Help!

With the safety of emergency responders in mind, VelocityEHS created the Plan1 First Responder Share Service. Available through the VelocityEHS Chemical Management module, Plan1 gives companies a more efficient way to provide first responders with quick and easy access to information about their chemical inventory, including a virtual floor plan of their facility displaying the locations of chemicals down to the container, along with each chemical’s corresponding SDS, right from their mobile device.

Though chemical hazards can be difficult to anticipate, VelocityEHS, through its chemical inventory management module, offers instant mobile access to millions of SDSs to help prepare you for virtually any chemical hazard you may encounter. Visit our solutions page, or give us a call at 1.888.362.2007 to learn how we can help you.