In the 20 years since the World Trade Center attacks, researchers and physicians working with first responders have identified a variety of health issues that may have been linked to their time at the site.
As towers collapsed, buildings were shredded into particulate matter, a toxic form of pollution typically produced by wildfires and the burning of fossil fuels. The smoky result also contained carcinogens and other dangerous chemicals. Many first responders worked at Ground Zero in the months following 9/11, sometimes without the appropriate protective gear to protect against airborne toxins.
“The smell was bad,” recalls Dr. Tammy Kaminsky, a chiropractor who volunteered at Ground Zero for several months. But she didn’t realize the full impact of this risk until she was diagnosed with uterine cancer in 2015.
dr John Howard, WTC Health Program Administrator, said most cancers were included in the coverage list by early 2010. The program has helped more than 83,000 first responders and 33,000 survivors. Researchers have linked common cancers to WTC exposure for years. Skin cancer, prostate cancer and breast cancer are the types most commonly covered by the program. It combined all rare cancers into one comprehensive guideline provided they would not show up among a sufficient number of first responders to be investigated.
Howard said that cervical cancer is not considered uncommon in the broader US population, as it affects more than 15 in every 100,000 people. However, it is less common among first responders as this group is very male.
It was not until late 2010 that the lead investigator for the WTC Health Office at Rutgers University, Dr. Iris, the situation among her patients, including Kaminsky.
“I have many patients with uterine cancer,” said Udasi. She began to wonder, “Why do these patients have a type of cancer that isn’t covered by world trade and could this be related to their risk?”
In September 2020, Udasi, along with doctors from four other WTC health clinics, wrote a letter to Howard asking her to add uterine cancer to the list. Typically, requests for new conditions come through a formal petition process, in which patients write to Howard with scientific evidence and arguments as to why the conditions should be covered, he said. But he took the doctor’s letter seriously and initiated an investigation.
Investigating the link between WTC exposure and cervical cancer was a years-long process, complicated by the small number of first responders involved. Although WTC survivors are also eligible for treatment through the health program, research tends to focus on first responders, such as firefighters, who participate in long-term studies.