Under the Plume

From his healthy head of hair to his running shoes, Andy Reeve, a young computer programmer, was covered in white soot and ash. He had just arrived for work across the street from World Trade Center that horrible September morning, when a commercial jet slammed into the tower at his back.

"I was on Wall Street when the explosion happened. You couldn't see anything. It was completely dark. It was hard breathing. In 20 minutes I made it outside and it was like snowing ... snowing the World Trade Center," Reeve told me as we stood on the Brooklyn Bridge the morning of September 11. Dazed and brushing clouds of white ash off his clothing, the young man seemed oblivious to the steady shower of debris and ash still falling upon him, a mile and a half from Ground Zero. Reeve looked down at his pants and mumbled, "Look at me, I'm completely covered in the World Trade Center."

A year later, scientists and physicians in New York City are still trying to figure out just what Reeve and tens of thousands of others inhaled that fateful day. Nonetheless, since the first weeks after the attacks, Christie Whitman, head of the Environmental Protection Agency, has been telling the nation that there is nothing to worry about.

New York politicians, notably Rep. Jerrold Nadler and Sens. Hillary Clinton and Chuck Schumer (all Democrats), have responded furiously, saying it is impossible that inhaling all the debris from two of the tallest buildings in the world, as well as shorter nearby structures, was safe. Legislators and community activists want the EPA to admit that a pollution catastrophe occurred in lower Manhattan and to acknowledge its responsibility to do something about it.

The EPA, however, just repeats the mantra that nothing detected in the air on September 11 or for weeks thereafter -- except on a single September day for unrelated reasons -- exceeded the legal pollution limits established under the Clean Air Act.

Stalemated, the two sides have been dickering for months over the need for further asbestos testing and the possibility that levels of lead, other heavy metals and polychlorinated biphenyls (PCBs) actually have exceeded legal limits -- contrary to EPA assertions -- and therefore should trigger agency cleanup activities and studies.

All the while, three key elements of the catastrophe have been largely overlooked. First, that it was a disastrous air pollution event not only for lower Manhattan but also for Brooklyn, home to some 2.5 million people, at least half of whom live in areas that, like Reeve on the Brooklyn Bridge, were cloaked in debris on 9-11. Second, a bona fide new disease seems to have emerged. Dubbed "World Trade Center Cough," it appears to be caused by a combination of pollutants not previously known to produce human disease and thus not covered by Clean Air Act standards or subject to EPA monitoring. And third, the EPA is probably correct that no Clean Air Act standards were exceeded, which points up a crucial deficiency in the regulatory approach that all sides are taking to the problem.

It is now clear, thanks to NASA space photographs first published in August by Newsday, that the black, toxin-laden plume of World Trade Center debris blew for more than 30 hours directly from Ground Zero to the East River, which separates Manhattan from Brooklyn and Queens. The plume obscured the Brooklyn Bridge, as well as dozens of Brooklyn neighborhoods all the way out to Coney Island, from aerial view. Until the Ground Zero fires finally burned out in early December, prevailing winds on most days carried smoke and fumes along the same path.

Yet every health and stress survey conducted to date by the New York Academy of Medicine, the EPA, the Occupational Safety and Health Administration, the U.S. Centers for Disease Control and Prevention, and the state and city health departments of New York has been limited to Manhattan. Even the $90 million air pollution study that Congress agreed to fund -- under a bill sponsored by Clinton that President George W. Bush so far has refused to sign -- would only study Manhattan residents and Ground Zero workers.

To date, the number of people who have been ruled eligible for federal services as a result of exposure to the 9-11 pollution in Brooklyn is, in the words of Dr. Marc Wilkenfeld of the Columbia University Health Sciences Division, "exactly none."

As complaints about the fumes pouring across the East River mounted last fall, Rep. Nadler made it his particular business to be the bane of EPA chief Whitman's existence. Of this he proudly boasts. Nadler recalls: "In January I said, 'Get a satellite photo. See where the plume went.' And the EPA said, 'There are no satellite photos.' And when I saw the NASA photos in Newsday six months later, I was livid because I was lied to."

"That is not true," EPA spokeswoman Bonnie Bellow says. "He was not told that. We would have no reason to tell the congressman that they didn't exist when they did." In either case, the EPA apparently did not see a reason to use the photographs to guide its investigations.

Paul Lioy heads up a large team of scientists from Rutgers University's Environmental and Occupational Health Sciences Institute, the EPA, OSHA, New York University and other institutions trying to determine precisely what was in the plume of debris and smoke, and where it all fell day by day. The team collected dust samples from three lower Manhattan locations on Sept. 12 and submitted them to a battery of costly and tedious analytical tests, from electron microscope scrutiny to gas chromatography.

"This was a very horrendous air-pollution event," Lioy told me when I reported on his team's work for Newsday. "The tremendous crush of all this material was horrific. You had dust, smoke, fires, fumes, the remnants of those tragic planes. It was a very complex event, unlike anything we or anybody else has ever seen."

As detailed in Newsday, the 110 stories of the twin towers featured thousands of plate-glass windows that exploded into invisible, microscopic projectiles of lung-piercing silica glass. The dust samples contained large amounts of microscopic glass fibers, most of them less than a micron in diameter and more than 75 microns long -- miniscule enough to wreak havoc with human lungs.

"The glass fiber was a surprise to everybody," Lioy said. "It was one of those things that we never anticipated." It was also a surprise that debris content varied based on distance from the towers. Samples collected just one block from the World Trade Center on Cortlandt Street were composed of pulverized concrete, glass, unburned or partially burned jet fuel, and construction materials. The pH of the material (a measure of its acidity or alkalinity) was an astonishing 11.5 -- far more alkaline than anything the human lung, with a normally acidic pH of about 4.0, is equipped to handle.

Samples collected on Market Street, about a half mile from the site, were less alkaline but still had a remarkable pH of 9.3. While the concrete content seems to have decreased with distance, the Market Street sample contained three times more asbestos than did dust from close to the World Trade Center -- though still no more than EPA standards tolerate. Heavy metal content -- zinc, strontium, lead and aluminum -- also increased with distance. So did potentially toxic organic chemicals, some of which are considered carcinogens, such as PCBs and polycyclic aromatic hydrocarbons (PAHs).

Fire experts speculate that the area immediately around the World Trade Center got hit with the heaviest substances in the building -- pulverized concrete, steel, office equipment, cars and construction material. But the tremendous heat produced by the jet-fueled inferno created an updraft that lifted lighter particulates and gases upward, away from the first blocks around the Trade Center and toward the East River. It is also probable that chemicals in the drifting plume were affected by the strong ultraviolet radiation that bathed New York on that sunny, cloudless day. Most organic chemicals are altered by UV light, and some are transformed into compounds more toxic to human beings.

Unfortunately, Lioy writes in a scientific report titled "Lessons Learned," little is known about the content of the debris that reached Brooklyn because nobody ever collected samples there.

There are, however, human "monitors" in Brooklyn, as elsewhere in the city. Directly across the East River from Ground Zero, Dr. Tucker Woods was running the emergency room of Long Island College Hospital on September 11 when, he recalls, the hospital staff handled a "huge influx" of respiratory cases. "I personally this year have seen a real increase in asthma complaints and chronic bronchitis," Woods said recently. "It's World Trade Center Cough -- absolutely new cases. And it's also a worsening of old, chronic respiratory cases," such as asthma and sinusitis.

Many Brooklyn physicians, as well as doctors who have treated Ground Zero workers, report the same thing. Dr. Walfred Leon, of SUNY Downstate Medical Center, conducted a small pilot study, funded by the Patrolmen's Benevolent Association, of police officers who worked at Ground Zero between 9-11 and Halloween and who subsequently experienced respiratory problems. He says most of the people he studied were young, previously healthy adults, and many had respiratory problems so severe as to require intubation and hospitalization.

"We've never encountered anything like this before in medicine," Leon told me. He thinks the sheer chemical and particulate complexity of the debris and smoke exceeded anything pulmonologists have previously encountered. World Trade Center Cough, he argues, may very well be a new disease syndrome.

The ailment, as described Sept. 19, 2002, at the New York Academy of Medicine by the Fire Department of New York's chief medical officer, Dr. Kerry Kelly, is characterized by reduced lung capacity and a hyper-reactivity of the airways to any and all particles, bacteria and viruses that the individual inhales. The cough that goes with this is a dry, nonproductive one that can leave the sufferer gasping for air. Like sea anemones that suddenly ball up tightly when touched by a finger, the airways of these patients recoil from microscopic foreign objects, becoming tightly constricted. A least 350 firefighters who worked at Ground Zero remain on the disabled list because of World Trade Center Cough, Kelly said, and at least some of them are likely to be permanently disabled.

Health and environmental activists have focused their fears on the enemies they know -- asbestos and PCBs -- and are demanding a costly program to cleanse lower Manhattan of all traces of asbestos. But the New York City Department of Health has found little in its air and home sampling that could explain the syndrome, says Dr. Jessica Leighton, assistant health commissioner. Only 1 percent of the samples in Lower Manhattan were "above EPA standards" for asbestos or other legally controlled air pollutants. Indeed, there was little asbestos in the twin towers because the city health department stopped use of the compound in World Trade Center construction during an early stage; less toxic substances were used for insulation on all the upper floors.

Meanwhile, the contaminants and large particulates that appear to be responsible for World Trade Center Cough are not even measured by the monitoring devices in place around New York. These check for violations of the EPA's Clean Air standards, which cover only a specific list of chemicals and substances, such as asbestos and PCBs, ozone and carbon monoxide.

Nor is much known about what happens next. Which people are at risk for the new syndrome? Who will suffer for the rest of his or her life? And what, exactly, will be the nature of his or her ailments 10 or 20 years hence? The closest analogy to the 9-11 event may be massive volcanic eruptions.

Dr. Sonia Buist of Oregon Health Sciences University in Portland, Ore., has spent years studying the impact that the 1980 eruption of the Mt. St. Helens volcano had on the lungs of loggers who carried out seasonal clean-up operations on the mountain for half a decade after the eruption. The ash they inhaled from Mt. St. Helens, like the World Trade Center debris, was very high in ground glass; though in the volcanic case it was a natural product of the eruption, much of it was in the same size range that Lioy found in his dust samples.

Buist's findings could be great news for New Yorkers. While the loggers she studied experienced plenty of lung irritation, most of them, she says, eventually regained full health because the particles cleared from their lungs. The human lung has a mechanism called the "mucous escalator," in which irritating particles trigger an immune response, which in turn causes the release of large amounts of mucous. The mucous surrounds the troubling particles, which are then coughed up. In this manner, Buist says, loggers were able to survive inhalation of enormous gulps of ash.

But the Mt. St. Helens analogy has its limitations. Volcanoes produce acidic material -- not a phenomenally alkaline mixture such as that found in World Trade Center debris, the effect of which on human lungs is unknown. Further, Buist found that glass fibers coated with chemicals were harder for the mucous escalator to clear from the lung and potentially more dangerous. Lioy's electron microscope studies showed that all the glass fibers emitted from Ground Zero were chemically coated, often with human cell fragments, lead or fungi.

"There is no precedent for this," says Wilkenfeld at Columbia. "This is a new experience for all of us, and we are learning as we go along."

The most immediate and inescapable lesson -- though it is yet to be fully absorbed by any player in these events -- is that the regulatory framework in which environmental problems are addressed in the United States is probably too narrowly conceived to be useful in the face of events of the scale and complexity of the 9-11 disaster. It could be argued -- and Nadler does -- that a more environmentally motivated EPA would have looked beyond its shopping list of known carcinogens and toxins in an effort to understand what was going on. But it is also true that the EPA had no mandate to do so.

Moreover, health and environmental activists -- and their legal teams -- have focused on the same list, despite mounting evidence that asbestos, PCBs and the like are not the major problems. Neither the activists nor the agency has yet put science in its rightful place in the front seat of this journey into the unknown.

Now that all sides know about the plume, the glass and the alkaline debris, residents of the region can only hope for a change -- and, in particular, hope that scientific principles will guide the long-term health investigations planned by the federal cdc and the New York City Department of Health. Top of the list would be the World Trade Center Registry, which will follow the health of 200,000 New Yorkers for 20 years. But as yet, that registry is limited to Ground Zero workers and residents of lower Manhattan; it does not include those who live or work within the larger area of the plume documented by the NASA space photos.

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