Erika McGuire
COLUMBIA, Mo. (KMIZ)
The Health Toll of 9/11
25 years after the Sept. 11, 2001 terror attacks in New York, first responders who worked at Ground Zero continue to suffer health consequences linked to exposure of toxic and hazardous materials.
The World Trade Center Health Program reports more than 9,000 first responders have died from illnesses related to the attacks.
The program was established on Jan. 2 2011 after former President Barack Obama signed the James Zadroga 9/11 Health and Compensation Act of 2010, officially establishing the program that has been funded through 2090. The program provides eligible responders and survivors with no-cost medical monitoring and treatment for certified 9/11-related health conditions.
As of June 30, 2026, 144,000 people were enrolled in the program, including 56,299 first responders and 38,984 survivors in New York. Missouri currently has 117 first responders and survivors enrolled.
While 412 first responders died on the day of the attacks, the toll of 9/11 did not end that morning. In the years since, thousands of people have died from illnesses linked to exposure at the World Trade Center site, highlighting the lasting health consequences of the attacks.
Dr. Kate Grossman, a pulmonary and critical care physician at Boone Health was completing her fellowship and pulmonary medicine training at Mount Sinai, at the time of the attacks, in the upper East Side of New York which is the site for the World Trade Center Health Program. During her fellowship she was treating patients who were affected by the toxins even a decade later.
“That dust that was created there was really unique dust, it had of course big material in it that we don’t usually breathe into our lungs,” Grossman said. “Things from a collapse of a building, so concrete, glass, what makes up drywall mixed with smoke and burning fuel,”
First responders were also exposed to asbestos, heavy metals and different compounds that were created when the World Trade Centers collapsed which became carcinogenic or cancer causing to the body.
Exposure to toxic materials can have widespread effects on the body, including damage to the respiratory and digestive systems, respiratory and blood cancers, target-organ cancers, vascular damage, nervous system disorders, and brain toxicity.
“We see a lot of direct effects to the lungs of people who have a direct impact from the lungs. There is something, called World Trade Center cough which is very very prominent afterwards,” Grossman said. “In addition to that, new onset asthma, there’s something called rads or reactive airways dysfunction syndrome which is kind of like an immediate asthma,”
Immediate asthma can be difficult to treat as the chemicals and fine particles in smoke can act as strong irritants, smooth muscles surrounding the airways that can contract quickly and squeeze the passages shut.
“We also saw more lung disease like COPD and pulmonary fibrosis from things that got deeper down into the lungs, finder particles that get down there and then you have the health effects that affect the heart and blood vessels,” Grossman said. “A lol of the stuff that was breathed in and on the body where cancer causing increase in all different types of cancers,”
The World Trade Center Health Program has identified 68 types of cancer linked to 9/11, but doctors are now just seeing the different health effects since there is lag time when a person starts to see effects on the body.
The top 15 most common certified 9/11 cancers include:
Non-melanoma Skin
Prostate
Melanoma of Skin
Lymphoma
Thyroid
Kidney
Lung/Bronchus
Leukemia
Bladder
Colon
Breast – Female
Myeloma
Oropharynx
Rectum
Neuroendocrine
When the attacks happened, first responders rushed to Ground Zero to save lives. But being the first on the scene meant they were also exposed to some of the highest levels of dust, smoke and other hazardous materials, ultimately coming with a long-term cost.
In the years immediately after 9/11, lung cancer rates among first responders were not initially higher than expected according to Grossman. Grossman said this may have been because many responders were younger and had not yet reached the typical age when lung cancer develops.
But some cancers take decades to appear.
Lung cancer and mesothelioma, a cancer linked to asbestos exposure, can have a latency period of 20 years or more, Grossman said. That means some first responders are experiencing the health consequences of an event that happened 25 years ago.
Missouri Task Force 1 Answers the Call for Help
Missouri was connected to the long-term health consequences as 62 brave men and women of Missouri Task Force 1 were deployed to New York to help with the search and recovery efforts including Larry Ronald Duncan, a heavy rigging specialist.
Duncan died from Esophageal Gastric Junction Cancer. It has not been made clear when he was diagnosed.
The Boone County Fire Protection District said Doss was a part of the World Trade Center Health Program.
Eight members of Missouri Task Force 1 have passed away since 9/11, but Duncan is the only member whose death has been linked to his response at Ground Zero, according to Boone County Fire Assistant Chief Chuck Doss.
“He was a unique individual, he was a lot of fun to be around, quiet guy but again once you got to know him he was very outgoing,” Doss said.
Thousands of first responders from across the country answered the call to Ground Zero, a call that ultimately change the lives of many in from physical health, mental health to dealing with the loss of a team member .
“It was difficult seeing people that you knew become ill and then to learn that it was related to getting him volunteering and stepping up and saying I’ll help, that’s always difficult,” Doss said. It was a lot to take in, it took me a little bit to process all of it and still today it’s still a lot, so that was a big deal,”
When news began to spread that the first tower had collapsed, Doss says he knew there would be a call for help.
“I was home from class that day and I was sitting there and had the alphanumeric pages started getting information about the attacks on my pager, I turned on the T.V. and saw what was going on,” Doss said. “Seeing that first tower collapse, I kind of instinctively knew where things were headed and what was going to happen and just headed down here to get stuff packed and just to be ready when that call came,”
When Doss first arrived to Ground Zero, he says the image is “something you never forget.”
“We walked around the corner and just a magnitude and all we were seeing was just one corner of that giant scene, it was very overwhelming to see it and magnitude and you go okay let’s go to work,” he said.
25 Years Later: The Fight Continues
Doss was one of the 62 members deployed that day. Although he has not experienced any known physical health consequences from exposure to the toxic materials at Ground Zero, he continues to face the mental health effects of what he witnessed and experienced during the 10-day response.
During the response, MTF-1 conducted urban search-and-rescue operations. Teams used search-and-rescue canines, cameras, listening devices and ultrasonic equipment to locate people who may have been trapped beneath the debris.
When MTF-1 arrived at Ground Zero, protection and safety were a priority as responders worked through an environment filled with dust and debris.
“There was a lot of dust, you got to look at some of the pictures and you can the particulate that was in the air through some of the photos that you may not have seen at the time,” Doss said. “We were very fortunate that our hazmat folks told us we need to be sure that when we’re working we’re wearing respirators and we’re being careful so I think our team benefited from that extra layer of protection,”
But, some first responders didn’t have immediate access to an N-95 respirator, which could have limited exposure to toxic materials.
While mask were available, wearing one while doing physical labor and trying to communicate in a loud environment can present its own challenges, Grossman said, impacting how often a first responder was able to wear a mask.
Preventative measures and education, Doss says, is what the task force focuses to catch illnesses early on. He says they make sure those who responded after the attacks know what resources are available like the WTCHP that offers a yearly physical for first responders who are enrolled in the program.
“Every year go get lab work checks, X-rays, make sure that there’s baseline and track those things, so when there are issues, hopefully they’re caught early and that they’re addressed,” Doss said. “I’m still a member of the task force so I get an annual physical through the task force every year and then I see my own personal physician every year, so I get three annual physicals a year,”
Doss hopes with those three annual physicals that if an illness pops up that it will be caught early on.
The Boone County Fire Protection District invited members of MTF-1 who responded to the World Trade Center to participate in events marking the 25th anniversary of the attacks.
Several events will be held including a morning ceremony on the University of Missouri Campus and an evening ceremony at the Missouri State Capitol where BCFPD Fire Chief Dough Westhoff is set to speak.
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