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Case Study: Captain in the US Army National Guard
A 34-year-old Captain and AUH-60 Black Hawk Pilot in the US Army National
Guard was deployed to the WTC rescue effort between September 11,
2001 and March 2002. Prior to deployment, he had an excellent health
history with no tobacco, alcohol, or drug history. He was hospitalized
on September 16th for breathing difficulties, and his medical records
indicate several subsequent hospitalizations for asthma and pneumonia
requiring intubation. His mental condition deteriorated including
flashbacks of the WTC incident. Additional symptoms characteristic
of chemical exposures developed over time including severe stomach
and chest pain, memory problems, and disturbed sleep. By December
2003, the Army had revoked his flight orders, after investing approximately
$3 million in his flight training.
He was referred to the New York Rescue Workers' Project by
physicians after discussing the alternate possibility of a long-term
steroid regimen.
At enrollment into the program, he was taking ten medications daily
including Albuterol, Advair, and Nexium. Laboratory tests results including
CBC, comprehensive metabolic panel, thyroid panel, lipid panel, ECG,
and urinalysis were all within normal ranges. Diagnosed with WTC exposure,
he elected to undergo detoxification treatment.
During treatment and coincident with improved symptoms, he gradually
discontinued use of all medications. On completion of sauna detoxification,
he was medically evaluated by internal medicine specialists at the
Deployment Health Clinical Center, a unit at Walter Reed Army Medical
Hospital. His irritable bowel syndrome, cough, and breathing difficulties
were completely resolved, medical records state, "He is now able
to run five miles in 50 minutes." Other symptoms improved, including
sleep apnea and congestion; he has mild pollen allergies. Within months
of treatment completion, he had passed all physical tests necessary
and was deployed to Iraq in a non-flight capacity. Eighteen months
following treatment, he passed all medical and mental tests to receive
full flight clearance. He then directed the airspace for rescue efforts
in New Orleans following the destruction of hurricane Katrina and has
subsequently been promoted to the rank of Major.
Summary of Results
Review of initial test results and medical history questionnaires reveals
the following:
- All clients reported
improvement in subjective symptoms.
- All clients reported improved
perception of health.
- Health History and Symptom Survey (selected
questions) found considerable reductions in days of work missed
on the start of the detoxification
program, leading to reduced concerns about forced retirement.
- Due
to symptom improvement, 84% of those clients requiring medications
to manage symptoms related to WTC exposure were able to
discontinue their use.
- Over half the clients required
multiple pulmonary medications on entry to achieve near-normal
pulmonary functions
(measured as
FVC & FEV1).
On completion of detoxification, 72% of these individuals
were free of pulmonary medication yet had improved pulmonary function
tests (data
not shown).
- There was a statistically significant improvement
in thyroid function tests.
- There was a statistically significant improvement
in Choice Reaction Time (CRT) and Intelligence Quotient (IQ), suggestive
of improvement in cognitive function.
- Statistically significant improvement
in Postural Sway Test that indicated improvement in vestibular
function.
Discussion
While the data presented in this paper was collected in the context
of routine outcome monitoring rather than in a controlled study,
the results are encouraging. The number of WTC-exposed individuals
(more
than 500) who have achieved the rehabilitative goals of sauna detoxification
therapy, restoring quality of life and job fitness, is significant.
The improvements in self-reported symptoms, an indication of a
marked return to wellness, are supported by reduced need for medication.
These findings are further confirmed by objective measures.
This regimen has greatly reduced the number of work days that rescue
workers miss due to illness and has resolved anxieties that careers
will be end prematurely in disability retirement. Anecdotal reports
from spouses, family members, and employers describe dramatic changes
in the quality of family life as a result of such improvements.
Initially, public health officials expected that the majority of
the manifesting symptoms would reduce with the passage of time.
This hope
has not been realized. Not only are symptoms persisting after more
than four years of customary treatment, rescue workers who previously
had not reported significant health problems are now falling ill.
Workers and residents alike have persistent, new-onset respiratory
symptoms27,37
and increased risk of asthma,25 particularly among children.50
A recent FDNY study indicates that all the WTC-exposed FDNY rescue
workers experienced
accelerated declines in lung function in the year following the
attacks.1
In addition to rescue workers, the WTC Health Registry enrolled
14,725 residents who reported living below Canal Street on September
11,
2001, representing 25% of the total residential population south
of Canal
Street at the time, according to the 2000 U.S. Census. Enrollment
interviews between September 5, 2003 and November 20, 2004 indicate
persistent
respiratory and mental health symptoms in this population.26
Although EPA officials initially downplayed the potential hazards
of WTC air and dust, subsequent government response reflects significant
concern regarding
the potential public impact of this unprecedented exposure event. Public
funds now support six health screening programs to monitor ground
zero workers.
While this work is important, it is made complicated by the nearly
infinite variations in individual exposure in such incidents – including the number and type
of toxic agents involved, the level of each toxin present at a specific location,
the form of the toxic particle, and the route of exposure. Further, little is
being done to determine what forms of treatment and rehabilitation might be appropriate
in the aftermath of a toxic event of this magnitude.
This omission has precedents. Veterans returning from Vietnam and the first
Gulf War, convinced that their health had been impaired by chemical exposures,
have
been offered little in the way of relief. Public health efforts and government
funding have focused on characterizing exposures and identifying relationships
between observed health effects and specific toxins.
Advising health care providers and public health agencies regarding response
to terrorist incidents that might involve chemical weapons, the Centers for
Disease Control (CDC) recently observed that, "Treating exposed persons by
chemical
syndrome rather than by specific agent probably is the most pragmatic approach
to the treatment of illnesses caused by chemical exposure."6
There are good reasons to apply this perspective to occupational and environmental
exposures, increasing the emphasis on providing relief whenever possible.
Given the probability of future terrorist events or chemical accidents, proactive
remedies for known effects of chemical exposure, including chronic effects
that, though
not life-threatening, are sufficient to destroy quality of life, must be
identified
and implemented.
The Hubbard method is the only such treatment being offered to New York rescue
workers. The improvements attained in almost 500 cases argue for broader
implementation of the program, supported by additional evaluation and research
efforts. That
a large percentage of those affected by 9/11 exposures are not responding
to existing treatments after more than four years; that the opportunity to
improve
the job fitness of first responders in one of the nation's most important
cities exists; and that the possibility that syndromes being treated as "post
traumatic stress" are in fact the result of toxin-induced damage – all
this argues strongly for and adds urgency to this initiative. 
Marie
Cecchini, MS, is the Research Director of the Foundation for Advancements
in Science and Education (FASE), a non-profit organization
involved in broad range of public interest research and communications.
After a decade developing diagnostic tools and clinical treatments
with Amgen, Inc., she did doctoral work at the University of Colorado
in developmental neuroscience. She has directed a number of health
care programs in the fields of physical therapy and drug rehabilitation;
David Root, MD, MPH is a Board-Certified Occupational Medicine
specialist. Prior to entering private practice, he served the United
States Air
Force as a flight surgeon for more than 20 years. As Medical Director
of an occupational medical facility in Sacramento, California,
he has supervised the detoxification of about 4,000 individuals suffering
from the effects of occupational or environmental exposure to toxic
chemicals and drugs over the last 20 years. He has been a co-investigator
in a number of published studies of the use of detoxification in
treating workplace exposures and evaluating the reduction of various
chemicals including drugs of abuse, pesticides, and other synthetic
compounds. Dr. Root is Senior Medical Advisor for the International
Academy of Detoxification Specialists; Jeremie R. Rachunow, MD
is
the Medical Director for the New York Rescue Workers Detoxification
Project in lower Manhattan. She is Board Certified by the American
Board of Family Practitioners and holds memberships in the American
Medical Association, American Academy of Family Physicians, and
New York State Medical Society. She received her medical degree at
Ross
University School of Medicine, New York in 1996, with internships
in Emergency Medicine and Trauma Surgery at Yale Medical School;
and Phyllis M. Gelb, MD is a medical practitioner at the New York
Rescue Workers Detoxification Project. Certified by the American
Board of Family Practitioners, her interests include wellness and
women's health. She received her medical degree from the
State University of New York at Brooklyn in 1993.
Correspondence
Marie Cecchini
FASE
Foundation for Advancements in Science and Education
4801 Wilshire Blvd, Suite 215
Los Angeles, CA 90010
323-937-9911
www.fasenet.org
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