The 2001 terrorist attacks in New York City caused anenvironmental disaster of epic proportions, exposing workers to aerosolized cement, glass, minerals, metals, and combustion soot and later plaguing them with chronic health problems. Since the attacks, Paul Lioy, director of exposure science at the Environmental and Occupational Health Sciences Institute, has studied the disaster and the U.S. government’s response, ultimately publishing a book in early 2010 entitled Dust: The Inside Story of its Role in the September 11th Aftermath.

“Merely having a plan is not enough. You have to be willing to implement it as quickly and efficiently as possible,” says Lioy of the handling of environmental exposure to toxins. “In the beginning, people won’t be carrying respirators or Tyvek suits. They have to make judgments to save people who can’t wait to be saved. But as soon as you get a handle on the situation – and with modern, real-time monitoring equipment, we can do that more quickly – you have to protect your emergency responders.”

Lioy recounts that during the first two days after the attack, the Government thought asbestos would be the primary threat, as it can cause such fatal diseases as asbestosis, lung cancer and mesothelioma, a rare cancer of the lining of the chest and abdomen. However, most of these diseases require prolonged exposure to asbestos.

“Once the “World Trade Center cough” started appearing, we realized it wasn’t caused by asbestos. There were three other things that caused health problems. First, cement dust was very alkaline – the pH was above 10. That irritated the linings of the lungs. Second, glass fibers got stuck in people’s upper airways, like wooden logs in a narrow stream. That trapped the cement particles and enhanced the irritation. And there were very coarse particles that comprised the vast quantity of the dust mass,” explains Lioy.

However, those exposed to the dust for months, i.e. Ground Zero workers, may have to face the adverse effects of asbestos related disease further in the future, as illnesses such as mesothelioma take decades to develop. Often caught in the later stages of the cancer, mesothelioma treatment, although aggressive, is rarely enough to prolong a patient’s life expectancy past 18 months; a very sad prognosis for national heroes.

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