Det. Greg Semendinger/NYC Police Aviation Unit
Keystone, Colorado —After the World Trade Center collapsed on 9/11, the City of New York kept track of tens of thousands of people who breathed in the toxic dust that billowed out through city streets.
By tracking over 70,000 rescue workers and passersby over the course of nine years, the city’s health department discovered new cases of asthma and post-traumatic stress disorder linked to the air pollution.
Federal officials are now looking at that tracking system, called an exposure registry, as a possible tool to track the health of workers exposed to other particles – those that are manipulated on the near-atomic level to form engineered “nanomaterials.”
The idea was discussed at a nanotechnology conference convened last week in Keystone, Colorado by the National Institute for Occupational Safety and Health (NIOSH).
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Though the risks of nanomaterials are unknown, growing evidence suggests some may be hazardous, said Paul Schulte, director of NIOSH’s Education and Information Division. For that reason, the federal agency held the conference to discuss what else government and industry can do to get ahead of any health and safety issues that may arise.
Exposure registries like the one that proceeded the Sept. 11, 2001 attacks were at the top of his list for next steps in monitoring the nanotech industry.
An exposure registry is “a system for collecting and maintaining info on people with known or suspected occupational or environmental exposure to a hazardous substance,” in Schulte’s words.
A registry is a tool, he said — “a means to detect a failure of control or prevention.”
“They’re a way of society saying, ‘We’re not going to make the same mistakes that we’ve made with other technologies,’” Schulte said.
As an example, he brought up asbestos. Like nanotechnology, the asbestos industry grew rapidly. Asbestos was heralded as a “miracle” material. There was “knowledge of potential health affects that never really got acted on.” People exposed to asbestos ended up with cancer and scarred lungs.
“More precautionary action might have saved a lot of lives in the long run,” Schulte said.
“Unprecedented” Exposure
Schulte, who chaired the conference, invited Dr. Jim Cone, medical director of the World Trade Center Health Registry, to share how New York City’s health department used an exposure registry to monitor survivors of the 9/11 attacks.
When the Twin Towers collapsed, he said, a vast cloud of airborne pollutants swept through Manhattan and parts of Brooklyn. The cloud included burning jet fuel, gases caused by combustion, as well asbestos, gypsum, concrete, wood, paper, and man-made mineral fibers. The scope of the health impact was unknown.
It was an unprecedented event, and “the concentration of people exposed was also unprecedented,” he said.
More than 410,000 people were directly exposed to the disaster, including: over 91,000 rescue and recovery workers, 57,000 people who lived south of Canal Street, 15,000 children and staff in nearby schools and over 360,000 people who were in the twin towers, or were passing by at the time of the attacks.
The registry was created in 2002 with federal funding. Researchers collected data from 71,427 people, including over 3,000 children, in a first survey done in 2003-04. Of those, 68 percent took a second survey in 2006-08.
People who took the survey were asked to report their health conditions, pre and post-disaster. Health officials augmented the data with info from cancer registries and state hospital discharge databases.
The registry was a huge undertaking, Cone said. Keeping people’s contact information up to date was itself a full-time job.
Through the registry, health officials found new health problems that appeared to be triggered by the disaster. A total of 12 percent of workers developed new cases of asthma, and 23.8 percent developed post-traumatic stress disorder (PTSD) for the first time.
The registry was used to guide policy and interventions, such as offering treatment to workers with PTSD, Cone said.
Nanotubes Found In Workers’ Lungs
Coincidentally, New York City may have inadvertently created one of the first nanomaterial registries in the U.S.
A recent study showed that the dust from the World Trade Center collapse contained nanomaterials caused by combustion. Researchers at the Mt. Sinai School of Medicine and Memorial Sloan-Kettering Cancer Center found carbon nanotubes in dust from 9/11 and in the lungs of 9/11 responders who developed lung disease. Animal research has shown some types of carbon nanotubes cause lung damage when inhaled by mice.
Authors said the presence of nanotubes in the dust and lungs “is unexpected and requires further study.”
Click here to read the 9/11 nanotube study, published in April in the journal Environmental Health Perspectives.
Those in the audience debated the merits of setting up an exposure registry for nanoworkers. Because of the vast variety of nanomaterials, the unknown risks, and because it’s difficult to measure workers’ exposure to them, some questioned the usefulness of such a registry at this point.
Cone concluded his talk by encouraging those who oversee nanotechnology to follow NYC’s lead.
“I congratulate you for considering a registry,” he told the crowd of industrial hygienists, nanotech company representatives and government health and safety watchdogs.
“This is a unique opportunity to do this in a proactive way that builds on the lessons of the past,” he said.