CHIEF MEDICAL OFFICER
September 24, 2002
Good morning, Chairman Jeffords, Ranking Minority Smith and members of the committee. My name is Dr. Kerry Kelly, and I am the chief medical officer for the New York City Fire Department. Thank you for the opportunity to speak to you today.
It has been a year since our view of the world was changed forever. It has been a year when unimaginable brutality was met by extraordinary acts of humanity.
As chief medical officer for the fdny, it has been my privilege to care for the health and well being of our 15,000 fire fighters, fire officers, emergency medical technicians and paramedics. On 9/11 our members responded to the call for help at the World Trade Center. The members of fdny came from every Borough and from every rank to assist in the rescue of victims and suppression of fire. Focused on their tasks, they acted without regard for their own safety to help their fellow citizens. Three hundred forty-three members of the Fire Department gave their lives that day. We should not overlook the lives saved by their heroism. The members of the New York City Fire Department facilitated the evacuation of more than 25,000 people, the largest rescue operation in United States history.
Despite these staggering losses, the members of the FDNY persisted in their work after the collapse of the towers. Over the course of the following weeks and months, our members worked around the clock, seven days a week in both the suppression of fires, which burned until December, and the rescue and recovery efforts that continued until may.
Obviously, this has been a difficult year for our surviving members, whose physical health and emotional well being have both been deeply affected.
In the initial collapses, the pulverized towers sent a caustic cloud of black soot, gritty powder and choking debris showering down on the survivors, blanketing our members and the surrounding area. Every breath was made difficult as the air became thickened with particulate matter. The injuries to our workforce during this last year have been described in detail in the attached two manuscripts published in the 9/10/02 issues of the CDC – MMWR (morbidity and mortality weekly report) and the New England journal of medicine. Two hundred and forty firefighters and emergency medical technicians were seen in emergency rooms that day. Most were treated and released with respiratory and eye irritation, but over twenty-eight members remained in the hospital, some with life threatening trauma-related and inhalation injuries. Over 90 members remain off the line with orthopedic injuries due to the WTC attack.
As our other members continued to work at the site, medical leave remained low as members dedicated themselves to the task at hand. But as the weeks passed, respiratory difficulties grew with increasing symptoms of cough, wheezing and congestion. In response to these symptoms, our FDNY Bureau of Health Services partnered with the CDC and the National Institute of Occupational Safety and Health (NIOSH) to develop a specialized comprehensive medical examination to evaluate our members who had been at the WTC. Our existing infrastructure with the pre-existing database for the uniformed forces gave us the ability to evaluate pre- and post-WTC results. From October through February over 10,000 medical examinations were performed. The most significant changes occurred in pulmonary function testing and in hearing evaluations.
Approximately 90 percent of our rescue workers experienced cough symptoms within 48 hours after the WTC attack. Fifteen hundred of the members showed a decline in pulmonary function testing but because their pre-WTC baseline was way above normal, their pulmonary function remained acceptable and they could continue to work. During the months after the attack, over 1,876 members required medical leave for significant cough and respiratory symptoms. Although some of these members were treated and returned to duty, over 332 firefighters had cough and other respiratory symptoms severe enough to require four or more consecutive weeks of medical leave. The majority of these individuals showed significant changes in their pulmonary function tests as well as cough complaints. Despite treatment, 52 percent of these individuals have not recovered sufficiently to return to full duty firefighting duties. It is estimated that nearly 500 members may have persistent respiratory disability.
Since the attack our members have also struggled with the emotional consequences of losing colleagues, near-death experiences and digging through tons of rubble to find those who perished. The emotional toll of this event has been great. Again our Department was fortunate to have in place an existing counseling services unit. This unit has been expanded with funding provided by project liberty through the Federal Emergency Management Administration (FEMA). Utilizing this important funding, we have been able to provide needed services to our members. Over 3,000 members have been evaluated for stress reactions, grief and bereavement, as well as post-traumatic stress symptoms. New counseling programs and initiatives have been developed to meet the new needs created by this event. These programs include bereavement groups for members and their families, WTC survivor groups, couples connections, a program to facilitate communication between spouses, as well as individual counseling. Fortunately, with treatment some members have been able to return to full duty. Currently about 250 members remain on leave with service-connected stress problems.
One year after the attack, the Fire Department of New York continues to rebuild and recover, forever changed by the events of 9/11. For our members it has been a difficult year. Our members experienced the direct trauma of the World Trade Center collapse. They faced the loss of friends and family members. They spent months searching and recovering those who perished, while attending daily memorial and funeral services for their fallen brothers. The Department has been further affected by the retirement of senior and seasoned members. While there are many factors to the increased retirements, a significant portion of the decisions are affected by the psychological trauma of September 11. We also expect that up to 500 of those suffering from respiratory problems will be permanently disabled by the condition, including many whose careers will be shortened by their disability.
The members of the NYC Fire Department responded to the call for help on 9/11 and they have not stopped responding since that day. They have given many times over as they dedicated themselves to the recovery at the site and in their support of the deceased families. The initial Federal resources that our Department was given have been utilized to help us begin to rebuild. But our ongoing efforts must be supported as we continue to monitor the health of our members as they cope with the physical and emotional stress of 9/11. Senator Clinton’s amendment would make $90 million available for health screenings and long-term monitoring, and this funding is extremely important.
Clearly, our recovery did not end with the closing of the site. It is an ongoing process that requires attention to the medical and emotional well being of our members. Thank you for your past support. We ask for your continued support as our efforts continue. Of the many vivid images that remain in our memory from 9/11, the raising of the American flag by our three firefighters gave heart to a grieving nation. Let’s continue to support the firefighters and first responders who gave so much to our country.