'World Trade Center Cough'

His lungs were a study in contrasts-his right lung still spongy and pink, his left lung rigid and white. As I hefted the cancerous lung from his chest cavity, I was startled to discover that it felt like a chunk of concrete in my hands. I could only imagine the constant agony this gentleman must have endured in his waning years-reduced, no doubt, to laboring for breath from his one good lung as his heart hammered against the hostile, inflexible mass that no longer permitted it any room for expansion. Here's the tragedy: Judging by the appearance of his good lung, this man probably never smoked a cigarette in his entire life; he was simply doing his job. This sobering moment was one of many fascinating experiences I had while studying anatomy and physiology this past summer. Here at UW-La Crosse, students have the unusual opportunity to learn "A&P" on human cadavers. Every year a fresh cadaver arrives at Ms. Kerry Hoar's anatomy lab. Every year a lucky group of students hones their dissection skills under Kerry's watchful eye. The cadaver then remains in the department as a valuable educational tool for four years, after which it is returned for cremation and burial. This summer the new cadaver presented with a condition known as mesothelioma, a rare form of malignant cancer associated with long-term occupational exposure to asbestos. Last week, as our nation commemorated the seventh anniversary of the September 11, 2001, attacks on the World Trade Center, I found myself contemplating that damaged lung. In the weeks and months that followed 9/11, reports Andrea Kane on CNN.com, tens of thousands rescue and recovery personnel labored at ground zero without the benefit of proper respirators or masks. Inhaling "caustic dust" and smoke containing a plethora of noxious chemicals-including asbestos-over seventy percent of workers succumbed to an array of health concerns, ranging from post-traumatic stress disorder (PTSD) to the mysterious ailment dubbed the "World Trade Center cough." Workers afflicted with the "WTC cough" flocked in droves to the I.J. Selikoff Center for Occupational and Environmental Medicine at Mount Sinai Hospital. As reported at MSSM.edu, patients complained of a litany of symptoms eerily reminiscent of chronic bronchitis and emphysema, diseases common in lifelong smokers. Moreover, a five-year study released by the hospital revealed that fifty-nine percent of patients examined between July 2002 and April 2004 reported that their respiratory symptoms persisted at time of examination. Alarmingly, twenty percent of nonsmokers showed evidence of reduced lung capacity, an astounding fivefold increase over the national average of four percent. To be fair, however, the issue may not be entirely clear cut. In his January 2002 editorial on FoxNews.com, Steven Milloy, publisher of JunkScience.com, notes that in the aftermath of 9/11, residents of Manhattan also reported an upsurge in asthma attacks and severe headaches, attributing their symptoms to elevated levels of airborne asbestos and fiberglass. The problem with these claims is that neither asbestos nor fiberglass has ever been shown to cause asthma. Milloy cites Environmental Protection Agency (EPA) measurements demonstrating that airborne contamination around ground zero remained well within established safe limits. Mocking the I.J. Selikoff Center for choosing a namesake "well-known for greatly exaggerating the risks of asbestos," Milloy argues that the so-called "WTC cough" was simply a manifestation of the yearly flu outbreak and dismisses the spike in asthma and headaches as hypochondria, noting that stress is a common trigger for both these conditions. In a 2004 piece, he similarly debunks the Sierra Club's claims that workers at ground zero are at increased risk of mesothelioma. Time has vindicated Milloy's skepticism to some extent. Kane writes that diagnoses for certain respiratory conditions have returned to pre-9/11 levels, symptoms of PTSD have proven to be transitory for most patients, and any short-term effect on infant mortality was negligible. So while we honor the suffering these courageous rescue workers endured as they struggled to rescue victims and return the City of New York to a state of normality, we can also take comfort in the likelihood that none of these heroes will ever experience the indignity of having a nosy student like myself pulling a rock-hard lung from their chest wall.

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