TESTIMONY BY DR. KERRY KELLY
CHIEF MEDICAL OFFICER
NEW YORK CITY FIRE DEPARTMENT
Before the Senate Committee on Environment
And Public Works Subcommittee on Clear Air, Wetlands and Climate Changes
Monday, February 11, 2002
Good morning and thank you for inviting me to appear before this Subcommittee.
I am the Chief Medical Officer of the New York City Fire Department. I responded to the World Trade Center at 9:30am on September 11th, and participated in the rescue and recovery efforts that thousands of our members undertook on that day and in the days that followed.
The FDNY response to the WTC event placed our members at the epicenter within moments of the first plane hitting the North Tower. Members from emergency squads, rescue companies, engines, ladders and medical teams from across the city responded to the call. Firefighters about to end their daily tour of duty stayed on; off-duty firefighters commandeered vehicles; retirees and members on sick leave found their way to the scene. Within a matter of minutes, these rescuers became victims, soldiers in the worst terrorist attack on our nation’s soil.
343 members lost their lives that day. Over 200 members were seen in emergency rooms for physical trauma. Many members required hospitalization and surgical intervention for significant orthopedic injuries. The rescue and recovery effort involved hundreds of members, following a job-wide recall during the first few days of the operation.
In the initial moments and hours after the collapses, firefighters and emergency workers continued to work without pause in the desperate search for survivors. The air was full of thick debris and dense dust clouds, and visibility was so bad that one could not see people more than three feet away. With the collapse of the towers, an avalanche of acrid debris, metallic meteors and a shower of gray dust descended on the survivors, blanketing the new wave of rescuers as they rushed in to assist. It seemed as though day had turned to night, but still our members continued searching for survivors in a surreal black blizzard of debris. Fine dust coated every crevice, making features indiscernible. Debris and dust choked breath and irritated eyes.
Due to the vast numbers of FDNY personnel at the scene, respirators were not available for all members working at the site. Many also found it more difficult to operate while wearing respirators, and many chose to carry on their search for survivors unprotected.
Members ignored or fought against symptoms, and many did not sleep for days, pushing themselves to continue the search for survivors. In the immediate aftermath of the collapse, as the rescue work began, many members complained of eye irritation, as well as cough and congestion. As the air quality improved, eye irritation symptoms improved, but cough complaints continued. Pulmocort inhalers, an inhaled steroid, were offered to offset the allergic cough symptoms.
Concerns for the physical and mental health of members were raised by FDNY medical staff in those first few hours and days. Due to the cough symptoms that members exhibited, questions were also raised about the exposure levels that were present at the scene. It was, and still is, unclear what exposures members might have experienced following the fall of two 110-story towers combined with the combustion of two planes and jet fuel.
Within a week of the tragedy, the Fire Department’s Bureau of Health Services (BHS) began preparing for an unparalleled medical monitoring procedure for all members exposed at the site. BHS partnered with National Institute for Occupational Safety and Health (NIOSH) and the U.S. Centers for Disease Control and Prevention (CDC) on this project. We are very grateful for the funding we received from CDC to conduct this initial analysis of our members. From October 6 – 12, an initial sampling of 400 exposed members were given a comprehensive medical evaluation. BHS, NIOSH and CDC were satisfied with the logistics and implementation of the medical evaluation, and BHS immediately began the vast project of testing the remaining members.
We worked seven days a week, with three shifts a day, and were able to evaluate approximately 180 members per day. From October 31 until January 31, the medical monitoring of all personnel who responded to the WTC was undertaken. Almost 10,000 firefighters and 800 EMS personnel have now been evaluated. I am proud to say that our initial medical evaluation of all the members who responded to the World Trade Center is now complete.
Medical monitoring consisted of ECGs, pulmonary function tests, chest x-rays, hearing evaluations, and blood testing consisting of cbcs, chemistries, liver functions, lipid profile, lead, beryllium, pcbs and urine mercury and urinalysis testing. In addition, testing of dioxins and hydrocarbons was done at the CDC lab on the initial group of 400. Blood from all remaining members was banked, to be tested at a later time if the need arises. Although some of these tests are part of routine medical examinations, other more specialized testing was also conducted due to environmental concerns.
At the time of the medical monitoring members also completed a computerized survey regarding their physical complaints to assist the Department in tracking the symptoms that members are experiencing. BHS has compiled a very complete record of each of our members from prior annual exams to use as a baseline for comparison.
Since the testing was completed less than two weeks ago, the complete results from this computer survey are still being tallied. Preliminary blood tests have not indicated any significantly elevated levels of toxic metals or abnormal chemistries or blood counts. At the time of completing the computer survey, 25% of our members reported cough and shortness of breath on exertion. The pulmonary function tests taken during the medical evaluation have shown a decline that matches this complaint. In most cases, this change has not affected overall functional capacity. Some members remain “off the line” with active symptoms, while others have returned to work. Our current medical leave rate is a reflection of both the rise in respiratory symptoms and post-traumatic stress. There has been a two-fold increase in both respiratory problems and stress related problems in the last five months.
It remains to be seen how members will recover from this event.
However, in order to measure recovery, we must continue to monitor all of the members who responded to the WTC event. We are grateful to have received funding from CDC for one additional medical examination per member in the future. We remain concerned about potential health problems in the future. We are also concerned about longitudinal follow up with our members. Those who become ill, or experience a trauma of this level in their working life, may choose to retire from this job when they can no longer withstand the rigors of this work. We want to ensure that our members continue to receive monitoring in the future, whether or not they retire from the Department. For this reason, the Fire Department’s Bureau of Health Services is now actively seeking funding for this project.
We must affirm our commitment to the members of our Department who gave so much to this City and this country, and who have inspired people around the world with their courage and determination. We owe it to them continue to monitor the effects that their exposure on September 11th will have on their future. BHS has the pre- and post- WTC records, the expertise and the logistical set-up to conduct an unprecedented and thorough investigation of the effects of the exposure our members experienced on that terrible day. Let’s not forget that more of our members experienced a far greater level of exposure than any other group in this City.
As far as I know, there are no hard-and-fast answers to the potential effects of exposures. Many unknowns remain. That is why it is critical that we continue our monitoring.
The events of September 11th were catastrophic. In a matter of moments, our members became participants in a battlefield. The FDNY response was outstanding when we review the numbers of civilians saved and we measure the heroic efforts of so many individuals. Our losses are deep felt with the deaths of members from every rank and every branch of our service. Our memories are filled with the experiences of that day and the many days that followed. Both physically and emotionally, we have been challenged by this event. As we rebuild our Department, we must also restate our commitment to our members who worked so hard to save others. I am sure we can all agree it is no less than they deserve.
Thank you for your time.