Beyond the Rubble: The Hidden Health Impacts of 9/11
When we remember September 11, 2001, we think first of the immense loss and bravery
of those who ran toward danger to save others.
But for many survivors, first responders, and cleanup crews, the tragedy didn’t end that day. Long after the smoke cleared, an invisible danger lingered: the toxic dust cloud that covered Lower Manhattan. Made up of debris, ash, and harmful particles like silica, asbestos, metals, and glass, that cloud left behind a lasting health crisis.
On that day and the months that followed, an estimated 400,000 people were exposed to toxic materials, physical injuries, and physical and emotional stress. In the following years, tens of thousands of World Trade Center (WTC) responders developed some kind of cancer, reminding us of the ongoing impact of 9/11 and the importance of continued support, research, and treatments for those involved.
The Toxic Cloud of Ground Zero
When the Twin Towers collapsed, they created dust clouds that completely covered the ground and filled the air for hundreds of highly populated city blocks.
So what was the toxic cloud at ground zero made of? The WTC Health Program’s report, the Development of the Inventory of 9/11 Agents, highlights that over 350 hazards may have been in the disaster areas. Toxic chemicals like arsenic, asbestos, formaldehyde, lead, and mercury – many of which are closely linked to the development of cancer – were identified in the air, settled dust, and surfaces of the disaster areas.
While visible debris and dust remained in the area for months following the collapse of the towers, the contaminants remained in Lower Manhattan and parts of Brooklyn for an unknown amount of time. Into the next year, fires within those piles of debris burned with ongoing flare-ups. This continued to release by-products of the debris, meaning that not only were first responders affected, but residents, local workers, and students may have also been exposed to toxins.
Short-Term Health Impacts and Cancer Links to 9/11
Just weeks after 9/11, responders, residents, and other advocates shared concerns about immediate health impacts, namely what they called the “WTC cough.” Early the next year, healthcare professionals began documenting a new onset of coughing, wheezing, and shortness of breath among residents of Manhattan.
But the impact didn’t stop there. Long-term effects of being exposed to toxins are well-documented, and years of research began to reveal even more health concerns, including cancer. One report of nearly 70,000 WTC responders showed the highest risk of cancer compared to the general population being melanoma, thyroid cancer, and prostate cancer. Other studies have found potential links to blood cancers, such as leukemia and lymphoma.
Of the over 120,000 people enrolled in the WTC Health Program, nearly 7,000 have died from an illness or cancer linked to 9/11.
Ongoing Research and Support for 9/11-Exposed Populations
Once early effects of exposure to these toxic materials were identified, research and support for affected populations began. New York City was the first to provide funds to cover treatment for some first responders, followed by other philanthropic funds that helped expand these efforts. In 2002, the New York Fire Department and the Mount Sinai School of Medicine (now the Icahn School of Medicine at Mount Sinai) were given federal funding to screen responders for health concerns.
Despite these important programs, thousands of other community members were initially overlooked. Thanks to local organizations and eventually national programs, other populations began to have access to screening and treatment for 9/11-related health issues.
Additional programs continued to periodically support affected individuals, much of which was funded by the National Institute for Occupational Safety and Health. In 2010, these programs became part of what is now called the WTC Health Program, which covers monitoring and treatment for 9/11-related acute traumatic injuries, airway conditions, mental health conditions, and cancer. In addition, the September 11th Victim Compensation Fund (VCF) offers financial support to individuals and families impacted by illness or loss related to 9/11.
Together, these programs have served as lifelines for thousands of first responders, workers, survivors, and families who continue to navigate their health journeys.
Support, Advocacy, and Lessons Learned
The health crisis that followed 9/11 has highlighted vital lessons for public health. For one, swift protective measures can help ensure first responders and community members are shielded from toxic exposures as much as possible following a catastrophe.
It also underscored the importance of long-term health monitoring. Because many 9/11-related cancers didn’t appear for years, it shows that ongoing screening is critical for those who may have been exposed to toxic materials.
Finally, the aftermath of 9/11 reminds us of the need for advocacy and funding. Without the efforts of survivors, families, and healthcare leaders, programs that have protected the lives of responders and survivors might not exist today.
Now, more than two decades later, the health impacts of 9/11 continue to unfold. But the resilience of survivors and advocates has shown the need for research and resources in events like these. As we honor the memory of 9/11, we also honor those who are still fighting. In this way, the legacy of that day becomes not just one of tragedy, but of determination, compassion, and hope.