On the day itself, 412 aid workers were killed. In the years that followed, more than 3,400 more died.

This is evident from figures from the World Trade Center Health Program (WTCHP) that was set up shortly after the attacks. The program – which will run until 2090 – will provide medical assistance to 80,745 aid workers who responded to the attacks in New York and Washington and the plane crash in Shanksville. Think of firefighters, but also people who spent months recovering bodies and were involved in demolition work and clearing and cleaning the disaster area.

About the attacks
On September 11, 2001, two planes flew into the towers of the World Trade Center in New York. A third plane crashed into the Pentagon in Washington. And a fourth plane — suspected of having been intended to drill into the White House or Capitol — crashed near Shanksville, Pennsylvania. All occupants of the four aircraft were killed. In addition, more than 2,600 people were killed in the World Trade Center. 125 people were killed in the Pentagon. In total, the attacks – which could soon be linked to the terrorist organization Al Qaeda – claimed nearly 3,000 lives.

Dangerous Conditions

It soon became clear that the work of the rescuers was not without danger; 412 aid workers were killed on the day of the attacks. But the attacks took many more lives in the weeks, months and years that followed. Of the more than 80,000 first responders who reported to the WTCHP, 3,439 have died in the past 20 years, researchers say in the magazine. Prehospital and Disaster Medicine. And their deaths can (probably) be traced back to that fateful September 11th.

Causes of Death

The leading cause of death among the 3,439 first responders who died after September 11 are upper respiratory and digestive tract disorders. No less than 34 percent of the care providers who reported to the WTCHP and died some time later, have this cause of death on their death certificate. Cancer and mental health problems are also major causes of death, responsible for 30 and 15 percent, respectively, of the deaths recorded after 9/11.

health complaints

And then there are tens of thousands of aid workers who suffer from serious health problems. For example, about 45 percent of the first responders (or more than 36,000 people) who knocked on the door of the WTCHP, have to deal with respiratory diseases. Sixteen percent of healthcare workers suffer from cancer. And another sixteen percent have mental problems.

Increase in health complaints

Shortly after the attacks, some aid workers already had to deal with health problems. But for many, the first complaints only manifested themselves much later. This is apparent from, among other things, the fact that the number of care providers who call on the (free) medical help that the WTCHP offers has increased considerably in recent years. Of the more than 80,000 aid workers now relying on the WTCHP, more than 16,000 have applied in the last five years. “The study shows that the problem is growing – the number of first responders reporting to the WTCHP each year is increasing. And that indicates that their health and well-being is deteriorating, rather than improving,” study researcher Erin Smith said Scientias.nl.

Increase in the number of cancer cases

Researchers must also conclude that certain health complaints are being identified more and more frequently. For example, the number of health care providers diagnosed with cancer has increased by 185 percent in the past five years. “That’s not surprising,” Smith says. “Most of the time, cancer does not develop until years after people have been exposed to harmful substances.”

Until recently, colon and bladder cancer was the most common among health care providers, but now it is leukemia. The number of healthcare professionals diagnosed with leukemia has increased by 175 percent in five years. “Not surprisingly, there is a proven link between benzene exposure and acute myeloid leukemia,” Smith said. “And benzene is in jet fuel and was one of the toxic substances that aid workers at the WTC were exposed to.” Bladder and colorectal cancers are still common among health care providers. “It’s difficult to say for sure what caused this, but the dust and debris created by the attacks contained high concentrations of arsenic.” And that is a carcinogen that is associated with bladder cancer, among other things.

Mental health

In addition to physical ailments, many care providers also have to deal with mental problems. For example, PTSD (post-traumatic stress disorder) is about four times more common among care providers than in the general population. And almost half of the care providers still rely on psychological care.


In addition, brain scans show that the brains of many care providers show the first signs of dementia. “Many clinicians face an alarming cognitive decline,” Smith said. “Most are now in their early 50s and their numbers and other signs of cognitive decline are only increasing. Scientists and doctors are now wondering if that is due to 9/11.” Follow-up research should prove that.

In the meantime, doctors and scientists continue to closely monitor the health of these emergency workers. “We are only now beginning to understand the long-term effects of the 9/11 terror attacks,” Smith noted. “9/11 continues to affect both the physical and mental health of first responders and it is likely that the attacks are still causing the development of illnesses.” For example, it is feared that the number of care providers who develop cancer due to exposure to asbestos will increase in the coming years. After exposure to this carcinogen, several decades often pass before the disease manifests itself. “Those who ran into the burning buildings that day and climbed over, under, and through the smoldering rubble in the months after and exposed to toxins in the process continue to pay a heavy price for their bravery,” concludes Smith.