Investigators track ground zero lung disease

As they push their investigation into the health risks to workers in the recovery and cleanup operations at ground zero, medical detectives are focusing on a group of lung diseases that develop quickly and can lead to long-term disabilities and, in some cases, death. There are already clear signs that the dust, smoke and ash that responders breathed in have led to an increase in diseases that scar the lungs and reduce their capacity to take in and let out air.

US Fire Department tracked a startling increase in cases of a lung scarring disease, known as sarcoidosis, among firefighters, which rose to five times the expected rate in the two years after September 11. Experts who see workers who were at ground zero in the 48 hours after the towers’ collapse expect monitoring to show many more cases of lung scarring disorders among that group.

New evidence also suggests that worker who arrived later or worked on the periphery may also be susceptible to debilitating lung ailments. We have thousands of people who were down there with unprotected exposures, said by a director of the World Trade Center Workers and Volunteer Medical Screening Program. Many will develop asthma and a few will develop this terrible lung scarring that leads to disability or death.

The clues that lead to this new area of investigation were drawn from cases of statistically unexpected respiratory disease among young responders. The ailments now seen are far more serious than the general hacking and congestion known as ‘Trade Center cough’ that initially hit most responders. Rather these are a set of diseases and disorders that typically take a few years to develop, and in some cases get progressively worse.

The most worrisome to medical experts are granulomatous pulmonary disease, which show a particular type of swirling marks left on the lungs by foreign matter like dust. Doctors say the severity of the disease include pulmonary fibrosis and sarcoidosis, the sometimes fatal disorder that can be set off when exposure to dust causes the body’s immune system to attack itself.

Some people can live with the scarring if they limit their activities, but in others the exposure to foreign material sets off a cascade of ailments that can lead to more debilitating conditions and, eventually, death. Detective patient, 34 died in January when his badly scarred lungs weakened and his heart gave out. The coroner’s report gave the cause of death as "granulomatous pneumonitis." The autopsy found swirls throughout his lungs caused by foreign material consistent with dust.