What is the Purpose of this Medical Monitoring Program?

The World Trade Center Medical Monitoring Program provides for standardized periodic medical testing of workers and volunteers who participated in rescue, recovery, cleanup and related activities in the wake of the terrorist attacks on the World Trade Center (WTC).

For those of you who reported health problems in your first WTC screening examination, this examination will give us a chance to see how you are doing now and to evaluate the effectiveness of the care you have received.

You don’t need to have symptoms at this time for this exam to be useful. Many medical conditions don’t produce symptoms but are still detectable. What’s found at any exam can also be a useful comparison for future exams.

What Health Conditions Are We Monitoring?

This Program will screen for the most common health problems reported among September 11^th rescue, recovery and clean-up workers.  These problems include:

• Persistent or chronic sinusitis or rhinitis

• Reactive airways disease (asthma)

• Laryngitis/tracheitis/bronchitis

• Gastro-esophageal reflux

• Emotional distress

• Persistent problems related to injuries sustained at the WTC clean-up

What Possible Health Effects from September 11^th Cannot Be Tested at This Time?

There are some conditions and exposures that cannot be tested for in this monitoring program.

It is too late to test for some exposures or illnesses, such as

• Heavy metal exposure (for example, lead and mercury)
  It is not possible to check for heavy metals related to September 11^th exposure.  Heavy metals are flushed from the bloodstream rapidly (within 30-90 days).  Basic blood and urine tests can only detect recent exposures, so they would not be useful in detecting any overexposures related to WTC disaster clean-up work.

Similarly, it is too early to test for the following:

• Asbestos-related diseases (this only occurs 15-20 years after exposure)

• Cancer and other diseases which occur only after a long delay

How Long Will the World Trade Center Medical Monitoring Program Examination Take and What Will It Include?

The World Trade Center Medical Monitoring Program examination will take, on average, three hours to complete.  It may take longer or shorter, but three hours is the average. 

The examination will include the following components:

Medical Questionnaires

You will be asked a number of in-depth questions about the following:

• symptoms you’ve experienced since your last WTC examination, such as respiratory or breathing problems or emotional distress

• details about treatment you may have received since your last WTC examination

• general health matters (including smoking and exercise habits)

Exposure Assessment Questionnaire

Program staff will also ask in detail about the following:

• hazardous exposures you currently face or on jobs you have held since your last WTC examination

• exposures you have had off the job, including in your hobbies

Physical Examination

After reviewing your medical questionnaire, a physician will conduct a physical examination with special attention to the following:

• ear, nose and throat

• chest, including lungs

• heart

• abdomen

• musculo-skeletal and nervous systems  

Laboratory Tests

We will not perform drug or HIV testing. We will do:

• blood tests (Complete Blood Count and Blood Chemistries) to screen for

• anemia

• infection

• diabetes

• kidney problems

• liver problems

• high cholesterol and/or high triglycerides

• other health problems

• urine tests to screen for

• infection

• kidney dysfunction

• other urinary tract disorders

Pulmonary Function Test (PFT) – Breathing Test

During the PFT, you will be asked to breathe into a machine that measures breathing function.  The PFT measures:

• the rate of air flow in and out of your lungs

• the total amount of air you can inhale with a deep breath

You will be asked to breathe in and out vigorously several times.  Then you will be given an inhaled medication and re-tested to find out if your breathing improves.  (The medication is a standard medication given to people with airway diseases like asthma). The breathing tests will screen for:

• asthma and other conditions involving narrowed airways

• medical conditions associated with inability to fully inflate your lungs

Mental Health

In the initial Screening Program, we found that many people are still suffering from the emotional trauma of the 9/11 attacks.  Symptoms range from sleep disorders to depression to anxiety.  The Monitoring Program will include a mental health interview as part of the standard examination.

Results of Your Examination

At the end of your examination, you will be given a written report of the initial findings, and recommendations regarding follow-up, when warranted.

If there are abnormalities on your laboratory tests that require urgent follow-up, you will receive a letter or telephone call within several days. 

When all the information from your examination has been received and reviewed, you will receive a detailed letter from program doctors.  The letter will include an explanation of the results of your examination and recommendations for follow-up testing or treatment, when indicated.

If you need assistance obtaining any recommended follow-up care, program nurses will assist you.

Benefits

In addition to the physical and mental health consequences of the 9/11 attacks, many people suffered economic loss.  We will have benefits counselors available to help you identify any benefits programs you may be entitled to.