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From the Townsend Letter
April 2006


Chemical Exposures at the World Trade Center
by Marie A. Cecchini, MS; David E. Root, MD, MPH; Jeremie R. Rachunow, MD; and Phyllis M. Gelb, MD

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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.

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.

Marie Cecchini
Foundation for Advancements in Science and Education
4801 Wilshire Blvd, Suite 215
Los Angeles, CA 90010

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