20 years later, Stempel College professor reflects on 9/11 toxic dust exposure and its impact on first responders

On September 11, 2001, Dr. Roberto Lucchini was treating patients in a hospital in Brescia, Italy, when he got word that two planes had flown into the twin towers of the World Trade Center. Like much of the world, Dr. Lucchini turned to the nearest tv to watch the horror unfold—his eyes fixated on the cloud of toxic dust that hovered over the collapsed buildings.

Photo of the World Trade Center before 9/11. Photo of the World Trade Center before 9/11. Credit: Thomas Svensson

"It was a traumatic experience," he said. "I thought about the toxic cloud I was watching [and the impact] it would have on not only the victims of 9/11 but also the first responders and other people that were breathing that dust."

Dr. Lucchini knew of the short and long-term health consequences inhaling this dust could bring on. As a doctor, he specialized in occupational medicine, a field that focuses its efforts on treating workplace injuries and illnesses. His patients were workers from the heavy industrial part of Italy—many of whom were battling severe respiratory problems from exposure to toxins like silica and asbestos. From his experience, he knew that inhalation of toxic dust could lead to health problems like chronic obstructive pulmonary disease (COPD), interstitial lung disease and cancer.

Back then, what Dr. Lucchini didn't know was that he would eventually utilize his expertise to support those who responded to the tragic event. In 2012, he was tapped to serve as a director of the World Trade Center Health Program at the Mount Sinai School of Medicine in New York City. He would end up dedicating many years – eight years – to helping establish a program that would support first responders who, to this day, are still battling health problems due to their time at Ground Zero.

Today, Dr. Lucchini is a professor at the Robert Stempel College of Public Health & Social Work, where he teaches occupational and environmental health in the Department of Environmental Health Sciences. He spoke with us to share his experience working to support first responders. Answers have been edited for clarity and length.

What kind of work were you doing at the World Trade Center Health Program?

Dr. Roberto Lucchini

I was the director of the data center. There was a lot of data that was being collected on the first responders and their exposure during 9/11. Data like their jobs, physical and mental health, and socio-demographics. We are talking about many first responders (>60,000) that we were tracking. Not to mention, there are different clinics in New York and New Jersey that the responders, firefighters and survivors (this term indicates individuals who were residing in South Manhattan on 9/11) would go to periodically for their health checks and treatment. So, whenever there was new data, it needed to be collected, checked and managed for ongoing statistical analyses. So, I was in that particular position, but I became familiar with everybody in the program. I became emotionally invested, too, because you get in touch with people and listen to their stories.

What were some of the health challenges these first responders had to deal with after 9/11?

Well, I joined the program in 2012, so I wasn't there at the beginning. But I know that the first problem was the 'World Trade Center cough.' The first responders couldn't stop coughing. It was a devastating problem for them. They immediately went to Mount Sinai, where there is a clinic for occupational medicine. That was a good place for them to go since they have specialists that focus on similar issues. Unfortunately, there was not much funding available at the beginning.

When I arrived in 2012, that was right after the James Zadroga 9/11 Health and Compensation Reauthorization Act was put in place. With that particular legislation, the government started to pay for this program. They paid for periodic and annual monitoring, screening, and treatment of any World Trade Center disease. It took 10 years of efforts from health professionals, unions and celebrities like Jon Stewart to have that law promulgated and now further extended for many years.

What kind of health issues are these first responders now dealing with?

They are experiencing physical and mental health problems. The ‘World Trade Center cough’ was the first impact because the cement dust is highly irritant. They were inhaling dust that was causing a lot of irritation in their upper airway and digestive tract. Over time, they started developing chronic rhinosinusitis and laryngitis, asthma, COPD, interstitial lung disease, post-traumatic stress disorder (PTSD), anxiety and depression. Then, after 20 years, cancers. Now, another thing that is coming out is cognitive impairment. We see that they are forgetful; they are having memory problems. They are now in their 60s, and this is an earlier time than the average age when these sorts of symptoms can come out. Overall, these health issues resemble what is also seen among veterans who were exposed to chemicals and psychological trauma in war zones.

You're now a professor at Stempel College. How have you stayed connected to this work with the first responders?

I'm doing research on aging and the impacts on aging as a result of this particular exposure. I'm also looking at cognitive impairment to understand whether this is related to the 9/11 exposure. I still work with my colleagues at Mount Sinai and am connecting with colleagues here at FIU who may be interested in this work. That way, we can work with the first responders that are increasingly relocating to Florida after they retire. Hopefully, we will be able to provide care to these heroes also here.

What do you hope to accomplish with your research?

Research is important. Science is key to understanding what is happening and what can be done. If we see an exposure is causing something, especially at an early stage, we can intervene and do whatever we can provide in terms of personalized medicine, personalized prevention.

Anything else you would like to share?

9/11 was a tragedy, and when we explain what happened and what is still happening, there are many unfortunate messages shared with first responders about their health problems. But I think there is still a positive outcome out of this when I see the dedication and solidarity of all the people who are there to help them. So I am happy and honored to have been part of this.