Experts: Dramatic Lung Aging for NYC 9/11 Responders

Respiratory function has been so severely compromised in some World Trade Center rescuers that even as the fifth anniversary of the attack approaches, experts are reporting a dramatic aging effect in the lungs of firefighters and others.

While some first responders have regained near-normal lung capacity, others have been forced into retirement because of persistent pulmonary disorders typified by asthma-like symptoms and a characteristic World Trade Center cough.

An analysis of New York City firefighters and other responders exposed to World Trade Center dust found that rescuers experienced a decrease in lung function equivalent to more than a decade of age-related decline in the first year following the 9/11 attacks.

Conducted by lung specialists at Montefiore Medical Center in the Bronx, the research indicates that for those hardest hit, breathing disorders remain chronic and may progress to the type of damage seen in people sickened by decades of smoking.

"The aging portion of the study was used as a convenient yardstick to make understandable the drop in lung function that we found," said Dr. Gisela Banauch, a Montefiore pulmonologist. She and colleagues report their study today in the American Journal of Respiratory and Critical Care Medicine.

They analyzed lung function tests of 12,079 New York Fire Department members and other rescue workers, most of whom were at Ground Zero during or immediately after the World Trade Center collapse.

For those first to arrive, exposure was worst.

Still, a dramatic aging of the lungs - equivalent to a 12-year loss of lung function - is an unusual finding, said Dr. Ashok Karnik, chief of pulmonary and critical care medicine at Nassau University Medical Center in East Meadow.

Karnik works in collaboration with researchers at Stony Brook University Hospital and The Mount Sinai Hospital in Manhattan, monitoring patients exposed to Ground Zero debris.

"I can't say we have found anything equivalent to 12 years of age-related decline," Karnik said. "Some patients do suffer from upper respiratory problems and asthma-like symptoms. For some patients' symptoms are persistent, but for many others, symptoms have decreased over time."

Karnik suggested Banauch may have treated patients who had longer exposures to the dust than those in his program.

Banauch used a measure called FEV-1, which stands for forced expiratory volume and is a standard test administered by pulmonologists.

"This is a basic measure of lung function. When we want to determine if a patient has moderate or severe lung disease we talk in terms of FEV-1," said Dr. Stuart Garay, a clinical professor of pulmonology at NYU Medical Center in Manhattan who also treats patients for respiratory problems caused by World Trade Center dust.

"For every year we live, the normal individual loses 30 milliliters" in lung function, Garay said. "That's really a small amount. So you can live into your 80s and 90s without losing much lung function. A smoker by comparison will lose 60 or 70 milliliters a year. So by the time these individuals are 50 years old they're short of breath."

Banauch found responders with the worst exposures lost a staggering 372 milliliters within the first year after the attack. She theorizes that for the most disabled, the loss of function ultimately could lead to chronic obstructive pulmonary disease, often diagnosed in smokers.

She cites pulverized concrete, which becomes alkaline when inhaled as a powder, as the culprit that seared lungs.

Richard Picciotto, 55, a former FDNY chief who participated in Banauch's research, said his exposure to World Trade Center debris has had an adverse effect on his pulmonary function. He has World Trade Center cough.

"I was taking medication for the first year and half to two years - inhalers and stuff like that - but I've kind of weaned myself off of them," said Picciotto, who retired from FDNY in 2003 because of other injuries sustained on 9/11.

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