Health and environmental consequences of the World Trade Center disaster

Philip J. Landrigan*, Paul J. Lioy, George Thurston, Gertrud Berkowitz, L. C. Chen, Steven N. Chillrud, Stephen H. Gavett, Panos G. Georgopoulos, Alison S. Geyh, Stephen Levin, Frederica Perera, Stephen M. Rappaport, Christopher Small, Mark Becker, Patrick N. Breysse, Beverly Cohen, Max Costa, Christos Efstathiou, Steven Eisenreich, Gary FoleyRobert Frank, John K. McGee, John D. Groopman, Robin Herbert, Julie Herbstman, Eric Jayjock, Michaela Kendall, Sally A. Lederman, H. J. Lim, Morton Lippman, Polina Maciejczyk, J. Millette, Ady Miretzky, Sheung P. Ng, John H. Offenberg, Haluk A. Özkaynak, Joachim D. Pleil, Francesca Pozzi, Chunli Quan, Joan Reibman, J. Ross, Jonathan M. Samet, Regina M. Santella, Margo Schwab, Pamela Shade, Mary Sobo, G. Stenchikov, Qing Sun, J. Morel Symons, Barbara Turpin, Vikram Vyas, Sheng Wei Wang, Clifford P. Weisel, D'Ann L. Williams, Mary S. Wolff, Lih Ming Yiin, Mianhua Zhong, Michael A. Gallo

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

321 Scopus citations


The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyses of outdoor and indoor settled dust; high-altitude imaging and modeling of the atmospheric plume; inhalation studies of WTC dust in mice; and clinical examinations, community surveys, and prospective epidemiologic studies of exposed populations. WTC dust was found to consist predominantly (95%) of coarse particles and contained pulverized cement, glass fibers, asbestos, lead, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polychlorinated furans and dioxins. Airborne particulate levels were highest immediately after the attack and declined thereafter. Particulate levels decreased sharply with distance from the WTC. Dust pH was highly alkaline (pH 9.0-11.0). Mice exposed to WTC dust showed only moderate pulmonary inflammation but marked bronchial hyperreactivity. Evaluation of 10,116 firefighters showed exposure-related increases in cough and bronchial hyperreactivity. Evaluation of 183 cleanup workers showed new-onset cough (33%), wheeze (18%), and phlegm production (24%). Increased frequency of new-onset cough, wheeze, and shortness of breath were also observed in community residents. Follow-up of 182 pregnant women who were either inside or near the WTC on 11 September showed a 2-fold increase in small-for-gestational-age (SGA) infants. In summary, environmental exposures after the WTC disaster were associated with significant adverse effects on health. The high alkalinity of WTC dust produced bronchial hyperreactivity, persistent cough, and increased risk of asthma. Plausible causes of the observed increase in SGA infants include maternal exposures, to PAH and particulates. Future risk of mesothelioma may be increased, particularly among workers and volunteers exposed occupationally to asbestos. Continuing follow-up of all exposed populations is required to document the long-term consequences of the disaster.

Original languageEnglish (US)
Pages (from-to)731-739
Number of pages9
JournalEnvironmental Health Perspectives
Issue number6
StatePublished - May 2004
Externally publishedYes


  • Air pollution
  • Airway hyperresponsiveness
  • Asbestos
  • Occupational lung disease
  • PM
  • PM
  • Small for gestational age (SGA)

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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