Thoracic surgeon Dr. Raja Flores, like so many other patriotic Americans, rushed to help after the horrific 9/11 terrorist attack at the World Trade Center in New York City.
As the world prepares to commemorate the 15th anniversary of the 9/11 attacks, Flores' work is far from done.
While the memory of that fateful Sept. 11, 2001, is beginning to fade for many, the threat of a resulting and significant rise in mesothelioma cancer is looming large on the horizon.
The alarming number of future mesothelioma cases will stem from the weeks-long rescue and cleanup efforts performed under the toxic cloud that contained more than 400 tons of pulverized asbestos from the collapse of the Twin Towers.
“I feel stronger about this today than ever. We're going to see a very significant rise in [mesothelioma] cases,” Flores, the chief of thoracic surgery at Mount Sinai Medical Center in New York, told Asbestos.com.
The inhalation or ingestion of microscopic asbestos fibers 15 years ago is leading to serious health issues, including asbestosis, lung cancer and mesothelioma, a rare but aggressive cancer with no cure. The latency period between exposure and diagnosis of mesothelioma is typically 15-50 years.
Flores, a mesothelioma specialist with more than 20 years' experience treating asbestos-related diseases, says “we're just scratching the surface” when it comes to new diagnoses.
“We're still waiting for the critical numbers where we'll be able to prove to the outside world, or to the people who don't want to see the relationship, that this is unequivocal,” Flores said. “We're starting to see the uptick.”
Cancer Cases Increase at WTC Health Program
Since 2011, more than 5,400 people diagnosed with a 9/11-related cancer have enrolled in the World Trade Center Health Program (WTC). The number has tripled in the last 30 months.
That cancer registry includes emergency responders, recovery and cleanup workers, volunteers, as well as survivors who lived, worked or attended schools in the area near the WTC.
The top cancers represented in the program are nonmelanoma skin cancer (1,707 cases) and prostate cancer (1,140 cases), according to the latest data released by the World Trade Center Health Program.
“You see an alarming increase,” Dr. Michael Crane, medical director of the Mount Sinai Hospital WTC Health Program told the New York Post. “It's been steady for at least the last year and a half.”
Colon, stomach, thyroid, lung and kidney cancers are also among the top 15 cancers in the WTC program. Mesothelioma, one of the 60 cancers covered by program, is not among the top diseases.
A spokeswoman for the National Institute for Occupational Safety and Health, which administers the initiative, said there are “less than 10 certified cases” within the health program.
An official at the WTC Health Program told Asbestos.com that there have been fewer than 10 confirmed cases of mesothelioma.
Flores predicts that because of mesothelioma's long latency period of 10-50 years after exposure, the disease will become more prominent in the WTC program.
“The lung cancers develop differently, quicker than mesothelioma,” Flores said. “We're seeing more lung cancer now, more esophageal. By 20 to 25 years out [from 9/11], it's going to be real obvious with mesothelioma.”
Timeline of Events Linked to 9/11
Sept. 11, 2001
Terrorists attacked the U.S. in a series of coordinated strikes with hijacked airplanes, killing 2,996 people and injuring more than 6,000 others at the World Trade Center, Pentagon and a crashed plane in Shanksville, Pennsylvania.
National Institute for Occupational Safety and Health and American Red Cross launched the World Trade Center Medical Monitoring and Treatment Program to help people developing health issues related to 9/11.
Aug. 14, 2006
New York Governor George Pataki signed legislation expanding death benefits to families of Ground Zero workers who died from 9/11-related cancer or respiratory diseases.
Sept. 30, 2008
The CDC awarded a grant to the New York City Health and Hospitals Corporation to provide health services to nonresponders affected by the World Trade Center attack.
Jan. 2, 2011
President Obama signed the James Zadroga 9/11 Health and Compensation Act of 2010. The law also included the Victim Compensation Fund (VCF).
Oct. 12, 2012
More than 50 types of cancer, including mesothelioma, added to the list of 9/11-related health conditions covered by the WTC Health Program.
Dec. 18, 2015
Congress passed bill to reauthorize James Zadroga Health and Compensation Act. The WTC Health Program was extended to 2090. The law also included the reauthorization of the VCF, allowing people to submit their claims until Dec. 18, 2020.
The VCF, which provides financial help for those hurt by 9/11, received an additional $4.6 billion to disperse.
Sept. 11, 2016
World commemorates 15th anniversary of 9/11 terrorist attacks.
9/11 Asbestos Contamination Similar to Incident in Libby, Montana
Flores compared the impending surge of mesothelioma cases to what happened in Libby, Montana, where seven decades of asbestos mining led to the longest-running asbestos health disaster in American history. And it's not over yet.
Although the last asbestos mine in Libby was closed in 1990, the health issues continue today. More than 400 people in the small town have died from an asbestos-related disease, and another 3,000 residents have been sickened from the deadly mineral.
Miners and nonminers who lived in the surrounding areas have been stricken with asbestos-related diseases. The asbestos dust traveled for miles through the air, endangering the entire community.
The Environmental Protection Agency (EPA) placed Libby on the National Priorities List in 2002, earning the Superfund site designation. The designation started a massive cleanup effort that has cost more than $540 million and covered more than 7,000 properties in the area. More than 1 million cubic yards of dirt and building materials were removed to reduce the risk of future exposure.
Experts, though, know that because of the long latency period of asbestos diseases, future health problems will continue for several more years. Libby has its own Center for Asbestos Related Disease (CARD) Clinic, which as recent as 2013 was diagnosing at least 40 new patients monthly.
What Does the WTC Health Program Cover?
Cancer is just one of the many diseases and conditions now covered by the WTC Health Program, which provides medical monitoring, health care and treatment to almost 75,000 people directly affected by the 9/11 attacks.
More than 16,000 have been diagnosed with respiratory disorders or asthma related to the toxic cloud covering the 9/11 site.
The WTC Health Program, along with the Victim Compensation Fund, became part of the $4.3 billion James Zadroga 9/11 Health and Compensation Act in 2010.
The United States Congress reauthorized the Health and Compensation Act in 2015 with another $8.1 billion commitment after months of debate. As part of the legislation, the WTC Health Program was extended until 2090, assuring a lifetime of coverage for all those affected.
The Sept. 11 terrorist attack killed 2,996 people at three different sites, including 2,606 people at the World Trade Center. Another 6,000 were injured that day.
“We're 15 years out now, so it's like out of sight, out of mind,” John Feal, president of a prominent 9/11 first-responders advocacy group, told Asbestos.com. “As human beings, we're programmed to move on from traumatic events. I understand that. I look back now, and can't believe it's been 15 years.”
More Asbestos Diseases Will Be Diagnosed
Feal, a demolition supervisor from Long Island, New York, lost part of his left foot during a rescue and recovery accident following the attack.
He became a relentless leader in lobbying Congress for legislation to help first responders in need. Many have credited him and his FealGood Foundation for helping push through the 9/11 Health and Compensation Act.
“I believe a quarter to a third of the 9/11 community, those who worked directly on the pile, and that includes me, are going to get asbestos cancer eventually,” Feal said. “You don't have to be a doctor to know what is coming.
“Most of the certified cancers to this point are not the asbestos cancers. Ninety-five percent of the people who were there working didn't have the proper respiratory gear. Or the proper clothes to be there. We worked, ate, slept and lived there day after day. I look back now, and it was a recipe for disaster.”
Feal will be speaking, like he does now every year around Sept. 11, at Commack High School in Long Island, his alma mater. Eight graduates of Commack High died in the terrorist attack. Almost 80 from Commack High were involved in the rescue, recovery and cleanup efforts alongside Feal.
Many of those have experienced health problems because of their involvement.
“It's funny, they used to tell me I'd never graduate,” he said. “And now they put my plaque on the wall, right next to Rosie O'Donnell's.”
Helping Those Who Sacrificed Their Lives After 9/11
Some of those people he will speak to later this month were not born when the attack occurred. Most were infants at the time. Several know little of the details of what happened.
“I challenge them to do a good deed for others every day. I talk about how those who went to Ground Zero remind us how great our country is. I talk about how patriotic we are now, compared to where we were then,” he said. “I talk about paying respect to those who died.”
Feal, like Flores, was greatly relieved when President Obama in December reauthorized the 9/11 Health and Compensation Act. But they also feel there's fading interest in the cause today.
They both know the horror for those who lived through 9/11 is not over. The asbestos diseases are only beginning.
“There are going to be a significant number who develop problems as we move forward,” Flores said. “And I think we have to make sure we take good care of them. They saved us. Now it's our turn to save them. It's the right thing to do.”