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Respirators Protect Health in Emergency Response

Categories: Agency for Toxic Substances and Disease Registry (ATSDR), Sharing Our Stories

May 7-11 is National American Occupational Safety and Health Week. In recognition of this observance, we are featuring a study of respiratory protective equipment for emergency responders conducted by ATSDR scientists Dr. Vinicius Antao, Dr. Laszlo Pallos, Dr. Youn Shim, and Jay Sapp. They worked with colleagues from the New York City Department of Health and Mental Hygiene and Columbia University to study the health of responders to the 9/11 World Trade Center disaster.

New York, N.Y., September 17, 2001 -- FEMA Urban Search and Rescue teams work to clear rubble and search for survivors at the World Trade Center. Photo by Andrea Booher/ FEMA News Photo

New York, N.Y., September 17, 2001 — FEMA Urban Search and Rescue teams work to clear rubble and search for survivors at the World Trade Center. Photo by Andrea Booher/ FEMA News Photo

On September 11, 2001, people around the world watched as the two towers of the New York City World Trade Center (WTC) fell to the ground. Dense clouds of smoke and dust rose into the air. While the streets filled with people escaping the burning buildings, emergency responders charged into the darkness with little thought for their own safety.

In the following days, police, firefighters, and emergency medical technicians (EMTs) continued to search for survivors. Construction and sanitation workers joined them to clean up the six-story pile of debris that burned for more than 3 months.

Because the attack was unexpected, many rescue and recovery workers had no time to find respiratory protective equipment (RPE) needed to keep them from inhaling dust and smoke. RPE can range from dust masks to respirators that cover the face and help people breathe. Even in the months following the disaster, many workers did not protect themselves from toxic substances coming from the debris pile.

Dr. Antao and his colleagues wanted to see if using dust masks and respirators protected rescue and recovery workers from breathing problems, and, if so, how effectively. They used the World Trade Center Health Registry to study the health of these 9/11 workers.

Firefighter wearing respirator

Firefighter wearing respirator

Their study, published in the American Journal of Industrial Medicine, was the first to look at the use and fit of respiratory protective devices for workers on the WTC debris pile. The study shows that during the first day of response, half of the workers wore no respiratory protection at all, and about a third wore only disposable masks. Beginning in 2002, however, half of responders wore protective respirators most of the time.

In general, survey results showed that workers who used respirators had a lower chance of developing breathing problems and disease, and that workers who were trained were the most likely to use them. The study also showed that surgical or nuisance dust masks gave workers almost no protection at all.

The study has meaning beyond the WTC disaster. It advises all local, state, and national emergency programs to keep a supply of respirators on hand and to train responders to fit, use, and care for them. It also recommends that emergency managers require workers to use them in all disaster responses.

Antao says, “Being ready to protect the health of the emergency responders who risk their lives safeguarding the health and safety of others is an essential part of preparedness. Using well-fitted respirators is one of the best ways to do this.”

For more detailed information, please see the ATSDR feature Respirators Protect Health in WTC Emergency Response.

You can also view the study at

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