Auto-Immune Disease New Post-9/11 Concern

Chief Leader – March 31, 2015

by SARAH DORSEY

Emergency workers who responded to the Sept. 11 attacks have a new ailment to watch out for: autoimmune diseases like lupus and rheumatoid arthritis.

A new study looking at firefighters and Emergency Medical Service workers found that the longer a person spent at the Trade Center site, the more likely he or she was to develop an autoimmune disorder. Each additional month spent on the Pile raised the odds by 13 percent, and those who remained after 10 months had triple the risk of those who spent a month there.

Zadroga Act Inclusion? The World Trade Center Health Program is reviewing the study to decide whether to cover such conditions under the Zadroga Act.

Autoimmune diseases occur when the body mistakenly attacks its own healthy tissue.

The study was led by Mayris P. Webber of Montefiore Medical Center and the Albert Einstein College of Medicine and co-authored by a panel of experts including the FDNY’s Chief Medical Officer, David Prezant. It was supported by the National Institute for Occupational Safety and Health and published in the journal Arthritis & Rheumatology.

A Surprising Discovery

The authors found that autoimmune disorders were rare even among Sept. 11 responders. Just 59 of the more-than 13,000 responders studied were diagnosed with an autoimmune disease between the day of the terrorist attacks and Sept. 11, 2013, though others believe they, too, may be affected.

Most common were forms of arthritis, including rheumatoid and spondyloarthritis. Other responders developed myopathies—disorders causing muscle inflammation and weakness—or lupus, which affects many internal organs and can be fatal. A handful of other conditions affected just a few people, including disorders of the skin, eyes and mouth such as systemic schlerosis and Sjogren’s syndrome.

The authors called the findings “unexpected,” noting that until now the only systemic autoimmune disorder known to be triggered by exposure to Sept. 11 dust was sarcoidosis. According to the Mayo Clinic, doctors believe sarcoidosis is typically triggered by an inhaled substance unfamiliar to the body.

Autoimmune disorders are generally thought to have a genetic component, according to the American Autoimmune Related Diseases Association (AARDA). But an outside trigger often seems to be involved, such as exposure to bacteria, viruses, or toxins.

The attacks on the Twin Towers unleashed a dust cloud containing a potent brew of toxins including dozens of known carcinogens, respiratory irritants, and other harmful substances, such as asbestos, pulverized glass, silica, lead, and various neurotoxic and endocrine-disrupting chemicals.

Because firefighters tend to be fitter than the general population, the researchers compared their rates of autoimmune disease with other firefighters and EMS workers of the same gender, ethnicity and year of hire.

The Federal Government covers medical care for those with a host of Sept. 11-related illnesses, including respiratory and gastrointestinal disorders, post-traumatic stress disorder and dozens of cancers. The Victim Compensation Fund also covers out-of-pocket medical expenses, lost wages and other costs for those sickened or hurt in the attacks.

Advocates have begun their push to renew the Zadroga Act, which authorized the spending for Sept. 11 victims. Portions of the law are due to expire in October 2015 and October 2016.

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