LONG TERM RESPIRATORY DISORDERS Long-term respiratory disorders among World Trade Center Healthcare Providers LONG TERM RESPIRATORY DISORDERS Long-term respiratory disorders among World Trade Center Healthcare Providers The World Trade Center disaster that happened on September 11, 2001, led to the loss of lives as well as health problems to not only the individuals who were targeted by the terrorist attackers but also their rescuers. The incident led to controversy as well as the uncertainty that has continued about seventeen years after the occurrence. Research has shown that even though the debris may not have hit most rescuers from the collapse of the building, they inhaled poisonous dust and gases from the explosion. Therefore, they have remained at risk of the health dangers posed by dust as well as the fires and cleanup efforts that followed (Prezant et al., 2002). Also, the issues of the immediate, as well as the chronic effects of the dust and gases to the respiratory system of the first responders as well as clean up workers and neighboring residents among others, has caused panic about the long-term problems like asthma and cancer of the lungs (Heinrich, 2004). According to research, further issues such as psychological issues are also linked to the respiratory issues. Even though some responders have already been treated and that the governments of Washington State as well as New York State have already treated and compensated some responders and victims, the problems continue to take a toll on the responders currently. Heinrich (2004) examined the rates of different health problems that were associated with the world trade center responders after the attack. According to the author, even though the disaster was treated as one mainly because of the 3000 people that died as the direct effect of the blasts and the debris of the building falling on them. There are more people that were affected health wise, and therefore it is important that focus is shifted from the immediate victims to those that for some reason, were exposed and thus are developing some chronic illnesses. About LONG TERM RESPIRATORY DISORDERS between 250,000 to 400,000 people were exposed to the dust and smoke from the building (Crane, Cho & Landrigan, 2014). The number of people includes those that responded to the emergency such as the firefighters, the team that did the clean up of the site, search teams and those who were part of the medic teams. Heinrich (2004) proposed that the survivors of the terror attack and the responders suffered respiratory problems that have led to the psychological trauma that they experience later. Even though the people who were exposed to the fumes and therefore suffer chronic symptoms were treated and continue being monitored, the symptoms related to respiratory illnesses keep being reported in the various monitoring centers. The primary health problems that Heinrich reported after the attack on the World Trade Center include various respiratory issues as well as mental problems that came in the long term. The respiratory problems were due to the inhalation at the site of the attack. According to Heinrich (2004), responders had various symptoms of respiratory problems that were noticed after ten months. The symptoms include shortness of breath, asthma, wheezing as well as a new problem that they called the World Trade Center cough (Jordan et al., 2015). The WTC cough was described as a condition that involved a chronic cough, as well as other severe symptoms that are common with other respiratory infections and diseases. Close to all the responders and especially firefighters, reported having the respiratory symptoms. Therefore, many firefighters and medics quit their jobs. The symptoms of the respiratory problems of those who were already affected by the respiratory disease increased after they responded to the 9/11 attack. Mauer, Cummings, and Hoen (2010) examined the levels of the different respiratory disorders after the attack. According to Mauer, Cummings, and Hoen (2010), the people with pre-existing conditions suffered more attacks of the conditions. People with asthma reported their symptoms worsening within the next LONG TERM RESPIRATORY DISORDERS 12 months after their exposure to the debris of the attack. Research showed that the healthcare givers who were exposed to the debris of the 9/11 attack reported that they had higher rates of respiratory problems when compared to their colleagues who were not exposed to the dust, air, and debris from the attacked buildings five years after the attack (Farfel et al., 2008). The severity of the symptoms of the respiratory issues was proportional to the time of exposure of the healthcare workers who participated in the rescue as well as treatment of the survivors of the terrorist attack. Illnesses that were commonly reported included chronic bronchitis because of the obstructive processes that the responders went through during their response to the disaster. More studies indicated that at least 79 of the responders of the World Trade Center disaster resulted in upper airway diseases. Those who experienced the lower airway conditions were about 46 percent of the respondents. The irritant compounds that came from the debris were also associated with the World Trade Center Cough that may responders reported to have suffered from after the exposure. Therefore, it was clear from the study by Mauer, Cummings, and Hoen (2010) that responders suffered long after the disaster and consequently continuous attention is needed to ensure that their lives are not adversely affected by the respiratory conditions. However, unlike the study by Heinrich (2004), Mauer, Cummings, and Hoen (2010) found that asthma was not associated with the exposure to the compounds from the WTC exposure. The difference in findings could either be due to misdiagnosis or misreporting by the participants as the study by Heinrich (2004) involved self-reporting in questionnaires. The respiratory issues that the healthcare providers have also been associated with other problems. According to several studies, the respiratory problems have resulted in stress and also post-traumatic stress disorder (Updegraff, Silver & Holman, 2008). The symptoms of the respiratory illnesses have worsened due to the psychological disorders that came after the LONG TERM RESPIRATORY DISORDERS exposure of the people. Posttraumatic stress disorder happens when patients recreate the events of the day and relive them later in their lives. People with the respiratory illnesses feel the shortness in breath, asthma, as well as other problems and therefore, re-experience the events of 9/11 (Luft et al., 2012; Brackbill et al., 2011). The experiences lead them to have attacks of posttraumatic stress disorder as well as panic attacks. Therefore, studies have suggested that it is important to not only treat the people with the respiratory symptoms of their symptoms but also offer psychotherapy when the need arises (Webber et al., 2011). Based on the findings from the various studies, it is important to ensure that people with respiratory disorders keep receiving treatment. Measures that are in place to provide treatment should continue. For example, the federal governments and the state governments should ensure that continuous treatment of the healthcare providers is ensured so that the professionals are willing to offer their services in case of such emergencies if they happen again in the future. LONG TERM RESPIRATORY DISORDERS References Heinrich, J. (2004). September 11: Health Effects in the Aftermath of the World Trade Center Attack: GAO-04-1068T. 1. Mauer, M. P., Cummings, K. R., & Hoen, R. (2010). Long-term respiratory symptoms in World Trade Center responders. Occupational Medicine, 60(2), 145-151. doi:10.1093/occmed/kqp176 Jordan, H. T., Stellman, S. D., Reibman, J., Farfel, M. R., Brackbill, R. M., Friedman, S. M., ... & Cone, J. E. (2015). Factors associated with poor control of 9/11-related asthma 10–11 years after the 2001 World Trade Center terrorist attacks. Journal of Asthma, 52(6), 630637. Crane, M. A., Cho, H. G., & Landrigan, P. J. (2014). Implications of the World Trade Center Health Program (WTCHP) for the public health response to the Great East Japan Earthquake. Industrial health, 52(1), 5-12. Updegraff, J. A., Silver, R. C., & Holman, E. A. (2008). Searching for and finding meaning in collective trauma: Results from a national longitudinal study of the 9/11 terrorist attacks. Journal of personality and social psychology, 95(3), 709. Farfel, M., DiGrande, L., Brackbill, R., Prann, A., Cone, J., Friedman, S., ... & Williamson, D. (2008). An overview of 9/11 experiences and respiratory and mental health conditions among World Trade Center Health Registry enrollees. Journal of Urban Health, 85(6), 880-909. Luft, B. J., Schechter, C., Kotov, R., Broihier, J., Reissman, D., Guerrera, K., ... & Pietrzak, R. H. (2012). Exposure, probable PTSD and lower respiratory illness among World Trade LONG TERM RESPIRATORY DISORDERS Center rescue, recovery, and clean-up workers. Psychological medicine, 42(5), 10691079. Prezant, D. J., Weiden, M., Banauch, G. I., McGuinness, G., Rom, W. N., Aldrich, T. K., & Kelly, K. J. (2002). Cough and bronchial responsiveness in firefighters at the World Trade Center site. New England Journal of Medicine, 347(11), 806-815. Brackbill, R. M., Hadler, J. L., DiGrande, L., Ekenga, C. C., Farfel, M. R., Friedman, S., ... & Yu, S. (2009). Asthma and posttraumatic stress symptoms 5 to 6 years following exposure to the World Trade Center terrorist attack. Jama, 302(5), 502-516. Webber, M. P., Glaser, M. S., Weakley, J., Soo, J., Ye, F., Zeig‐Owens, R., ... & Prezant, D. (2011). Physician‐diagnosed respiratory conditions and mental health symptoms 7–9 years following the World Trade Center disaster. American journal of industrial medicine, 54(9), 661-671. 
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