Direct Care

Health effects of 9/11 continue 22 years after the attacks

Cases of chronic rhinosinusitis, gastroesophageal reflux disease, and cancer are common among first responders and survivors.
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4 min read

In the 22 years since airplane hijackers killed nearly 3,000 people on 9/11, thousands more have been diagnosed with or have died from health issues triggered by airborne toxins and other hazardous conditions they were exposed to following the terrorist attacks.

The collapse of the twin towers blanketed New York City in clouds of ash and debris, including metal, asbestos, and concrete. Fires at the debris pile—known as Ground Zero—burned for months, exposing relief workers, first responders, and Manhattan residents to additional contaminants. Responders to the crash sites in Shanksville, Pennsylvania, and the Pentagon in Arlington, Virginia, also faced hazardous conditions due to smoke, jet fuel, and fires.

The rising rates of 9/11-related cancer cases, mental health problems, and aerodigestive conditions cost the US more than an estimated $338 million each year in assistance funds, and have sparked calls for more federal support for first responders and other survivors.

By the numbers

As of June 30, about 125,500 people have enrolled in the World Trade Center (WTC) Health Program—which offers healthcare to people directly affected by the 9/11 attacks—including 67,600+ general responders, 17,000 New York Fire Department responders, 1,250 Pentagon and Shanksville responders, and 39,500 survivors, according to federal data. More than 6,300 of enrollees in the federal Department of Health and Human Services-administered program have died.

The most common certified conditions among program participants are: chronic rhinosinusitis, gastroesophageal reflux disease, cancers, asthma, sleep apnea, post-traumatic stress disorder, chronic respiratory disorder, WTC-exacerbated chronic obstructive pulmonary disease, anxiety disorder, and major depressive disorder.

Cancer is the leading cause of death for deceased WTC Health Program members, followed by aerodigestive issues, mental health conditions, and musculoskeletal and acute traumatic injuries.

More than 49,000 enrollees received health monitoring or screening exams between July 2022 and June 2023. Almost 43,000 received treatment, including medications, and 22,500+ had diagnostic evaluations during that period. The WTC Health Program further reported that 35,000+ members got outpatient treatment, 1,000+ members had inpatient treatment, and about 200 members received emergency treatment in the last year.

Care costs

Congress included $1 billion for the WTC Health Program in a spending bill that was passed at the end of 2022, but critics have since argued the funding is not enough to cover the expected costs for all participants. A bipartisan group of lawmakers from New York and New Jersey introduced federal legislation in February to close that anticipated spending gap and allow previously excluded Pentagon and Shanksville responders to join the program.

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The Senate voted in late July to add $676 million to the program as part of the new 2024 National Defense Authorization Act.

The WTC Health Program spent more than $338 million on health services for 114,000 members in fiscal year 2021—an 85% increase from FY 2016, according to a Government Accountability Office report.

A separate program, the 9/11 Victim Compensation Fund (VCF), provides financial awards to people who have been diagnosed with an eligible 9/11-related illness. The Department of Justice-administered program received more than 85,000 claims as of August 31, including almost 5,000 in 2023 alone. To date, VCF has awarded a total of more than $12 billion.

New York Representatives Jerrold Nadler and Dan Goldman have further urged New York City Mayor Eric Adams to release documents on how “the harmful impacts of the toxins released in the 9/11 attack has directly harmed September 11th responders, recovery workers, residents, and survivors.”

“It is long past time for full disclosure of what the city knew about harmful toxins circulating lower Manhattan following the 9/11 attack and how long it knew of the dangers,” Goldman said in a February statement. “This information is not only important for transparency but it is essential so we can better address medical problems arising out of exposure to those toxins, especially for those who were children at the time.”

Navigate the healthcare industry

Healthcare Brew covers pharmaceutical developments, health startups, the latest tech, and how it impacts hospitals and providers to keep administrators and providers informed.