Wednesday September 12 5:29 PM ET

Health Effects of World Trade Dust May Linger

By E. J. Mundell

NEW YORK (Reuters Health) - To New Yorker Doug Macron, the scene near the World Trade Center Tuesday morning was like a ''terrible snowstorm,'' the sun a dim gray orb as the air ``filled with bits of dust and smoke that stung the eyes.''

The choking cloud covered downtown Manhattan, coating frantic passersby in a thick film of grime as they struggled to make their way to safety. Like many others who used anything at hand to help them breathe, Macron, a reporter with this agency, took off his shirt to ``cover my face and nose, protecting myself from the thickening smoke and dust.''

That dust--containing everything from melted plastics, pulverized concrete, burnt jet fuel and asbestos--may have health effects that could linger for days, weeks, even years, according to one expert.

``Anyone is potentially at risk depending on their exposure,'' said Dr. Mark Siegel, an expert in pulmonary medicine at Yale School of Medicine and director of the Medical Intensive Care Unit at Yale New Haven Hospital in Connecticut.

``A perfectly normal person close enough to the epicenter could have a profound injury to the lungs,'' he told Reuters Health. ``In contrast, as you get farther and farther away, people who have underlying diseases such as emphysema, heart disease or asthma could prove to be very sensitive to relatively lower levels of exposure.''

Those individuals should see a doctor if they begin to develop symptoms, Siegel said. But he cautioned that even healthy people can contract a delayed, sometimes dangerous condition called acute respiratory distress syndrome (ARDS) in the hours and days following intense exposure to choking fumes.

In ARDS, the lungs ``fill up with fluid until they become profoundly inflamed,'' the Yale expert said. This inflammation can turn dangerous as patients ``develop respiratory failure and require artificial ventilation,'' he explained.

``We don't really know how many people might develop (ARDS)--there may be people buried who are rescued that may have it,'' he added. ``For all I know there may be people in hospitals in New York that are on the verge of developing it. So the numbers are unknown, but that's something that I'm certainly concerned about.''

Many are concerned as well about the risk to individuals caught in the Trade Center disaster from inhaling asbestos, which was reportedly used in the construction of the two towers.

But Siegel said asbestos is actually low on his list of dust-related health concerns. Individuals suffering from asbestos-related illnesses such as mesothelioma or lung cancer typically ``have asbestos exposure not just in high amounts, but usually over long periods of time,'' he pointed out. ``So a single isolated asbestos exposure, even if it was large in quantity,would be unlikely to cause major lung damage.''

At especially high risk from respiratory distress are those brave individuals involved in the battle to save lives amidst the rubble.

``You've seen pictures on the news of firemen coughing and obviously that's related to their exposure,'' Siegel said. ``Mostpeople who are in that line of work are relatively healthy, and presumably are being as safe as they possibly can and try to maximize their protection with masks and filters and other things. But I have to believe that there are people who voluntarily put themselves there that are going to have some trouble.''

For the rest of New York's population, Siegel urges common sense. Individuals ``should call their doctor if they start to develop symptoms,'' he said. Manhattanites adversely affected by dust and smoke might also consider simply getting out of town, maybe ``take a trip to Connecticut and wait until the dust settles.''

For those who can't, however, ``one of the best things to do is probably stay indoors and put their air conditioner on,'' Siegel said. Most properly maintained air conditioners contain filters that minimize the amount of smoke and dust entering homes.

Whatever the precautions, the sheer scale of Tuesday's disaster may mean that area hospitals see an influx of patients suffering from breathing disorders. ``It's entirely possible that with so many people exposed to this that a lot of people will get sick from this,'' Siegel said.


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