Factors Associated with Poor Control of 9/11-related Asthma

Posted on by Hannah Jordan, MD, MPH


Many people who were exposed to dust and fumes during the September 11, 2001 World Trade Center terrorist attacks developed asthma. Although asthma is a chronic illness, symptoms can be prevented with medications and avoidance of triggers. However, many factors, including co-existing medical conditions, can make it difficult to keep asthma symptoms under control.

The New York City Department of Health and Mental Hygiene’s World Trade Center Health Registry (the Registry) follows the health of over 71,000 people who were exposed following the September 11, 2001 (9/11) World Trade Center terrorist attacks and are enrolled in the Registry. The Registry conducted a study to see if enrollees who were diagnosed with asthma in the first few years following the 9/11 terrorist attacks continued to have symptoms a decade later. This is important because persistent asthma symptoms can cause substantial stress and make it difficult to do routine tasks. The study sought to identify groups of Registry enrollees who might benefit from special efforts to improve control of their asthma symptoms.

The study[i], published in the Journal of Asthma, included approximately 2,500 enrollees who were diagnosed with asthma between September 12, 2001 and December 31, 2003. The Registry found that, in 2011-2012, about two-thirds of the 2,500 study participants reported continued asthma symptoms that interfered with their usual activities. The factors that were most closely tied to severe, persistent asthma symptoms were co-existing mental health conditions, such as post-traumatic stress disorder (PTSD). Co-existing gastroesophageal reflux and obstructive sleep apnea were also associated with worse asthma symptoms.

These study results show that, approximately ten years after 9/11, many people who developed asthma after exposure to the 9/11 attacks continued to experience symptoms that could be treated or even prevented. People with both asthma and PTSD may benefit from targeted efforts to prevent or minimize asthma symptoms. Study findings also emphasize the importance of integrating care for both mental and physical health conditions.

This research was funded by NIOSH.   For more 9/11 research findings, visit http://www.nyc.gov/html/doh/wtc/html/studies/bibliography.shtml.


Hannah Jordan, MD, MPH

Dr. Jordan is the Deputy Medical Director of the World Trade Center Health Registry in the New York City Department of Health and Mental Hygiene


[i] Jordan H, Stellman S, Reibman J, Farfel M, Brackbill R, Friedman S, Li J, Cone J. Factors associated with poor control of 9/11-related asthma 10–11 years after the 2001 World Trade Center terrorist attacks. J Asthma 2015; 52:630-637.


Posted on by Hannah Jordan, MD, MPH

15 comments on “Factors Associated with Poor Control of 9/11-related Asthma”

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    Is COPD the same as having asthma? I have COPD, mental health conditions, post-traumatic stress disorder (PTSD), gastroesophageal reflux and obstructive sleep apnea.
    Is this another condition I should claim separate in addition to COPD with the VCF?

    Although Chronic Obstructive Pulmonary Disease (COPD) and asthma can have many of the same symptoms, COPD and asthma are different conditions.

    For questions about submitting a claim with the VCF, we recommend that you contact them directly at 1-855-885-1555, or via their website, http://www.vcf.gov.

    I lived just a few block blocks from ground zero during the 911 attack, and I am as healthy as can be. I had to evacuate my apartment on west side highway due to the dust and nasty quality of the air within the entire area. Within one month after the attack, I move down south the Marietta Georgia and never exhibited any asthmatic symptoms.

    Initially, I had coughing problems which eventually went away as I changed the quality of the air I breathed in on a daily basis. I found relevant help reading this article at huffingtonpost.com/2014/02/24/asthma-overmedicated-_n_4847071.html, and another one about the merits of using Himalayan rock salt lamps at atcemsce.org/best-himalayan-salt-lamp/. The key to controlling or eliminating asthmatic conditions if by changing the quality of both you indoor and outdoor air.

    You can medicate all you want, but unless you take the right steps to reduce the factors responsible for prolonging the asthma, your symptoms would get worst.

    In addition to my COPD I have just recently been officially diagnosed with asthma. One thing after another. Wish I had worn a respirator when they said it was okay to breath the air down at ground zero.

    I had childhood asthma and then for some reason it went away. Then after 911 I worked there as a police officer, it came back slowly with an attack here and there. However, just recently it has gotten to the point where I have an attack almost every day. This is 16 years after the fact. Not sure if it can be related or not. I really haven’t changed my lifestyle at all.

    I, too, had some coughing, wheezing, and difficulty with breathing after being a first responder at the WTC surrounding area. I was part of the perimeter security with the New York Air National Guard. As the years went by, I thought that the years were catching up to me, but my shortness of breath was constant. When I mentioned it to my PCP, I was sent to a pulmonologist, and also for a ultrasound of my neck area. The endocrinologist biopsies revealed a cancerous tumor on the thyroid, which was removed. I still had shortness of breath and was diagnosed with asthma. I remember Governor Christine Whitney stating that there was no worries about the air quality, as the air quality was completely safe. Perhaps she was trying to reassure the public, but I think that she was sadly mistaken. Here I am, eighteen years later, after a total thyroidectomy, still struggling to lead a healthy lifestyle due to my difficulty with exchanging air.

    Thank you for sharing your story and we are sorry to hear about your condition. Depending on the location, dates, and hours you worked as a responder, you may qualify for health benefits under the World Trade Center Health Program. If you have not already done so, please consider applying to the World Trade Center Health Program, https://www.cdc.gov/wtc/apply.html. You can also reach the program by phone at 888-982-4748.

    I was in the area of the 9/11 Site(Broadway and Fulton Streets) a few days after the occurrence as a spectator. After standing in the area and breathing in the toxic dust that was still lingering in the air, I starting to get a burning feeling in my chest. I left the area immediately after feeling it and have had breathing problems ever since. Do I qualify for any type of compensation from the VCF Fund?

    The WTC Health Program is administered by NIOSH and is separate from the September 11th Victim Compensation Fund (VCF), which is administered by the US Department of Justice. For questions about the VCF and financial compensation, we recommend visiting their website at http://www.vcf.gov. For more information about the WTC Health Program and WTC-related health care, including how to apply to become a member, please visit our site at http://www.cdc.gov/wtc.

    This asthma presentation is very interesting and educating, thanks. Hopefully, more people can use it selves, family and friends.

    The challenges in controlling 9/11-related asthma stem from a complex interplay of factors. Exposure to toxic substances during the attacks, delayed symptom onset, and the psychological impact of the event contribute to difficulties in managing the condition. Additionally, barriers to healthcare access hinder effective intervention. A comprehensive, multidimensional approach, including increased awareness, timely care, mental health support, and improved healthcare accessibility, is essential to address these challenges and improve the well-being of survivors and first responders.

    I was exposed to 3 of the deadliest asbestos for 3 years. After being told that the air quality was safe and we should return to our homes by the government we remained. It was EPA who came 3 years later with their machine to test the air in our residence and was told about my exposure to deadly asbestos. I was diagnosed with Syncope by a 9/11 physician who practices at gouverneur hospital. A very dangerous disease associated with COPD, I was told that I would not be compensated because it’s not 9/11 related. It is truly unfair, unethical and embarrassing for our government to disregard such claims and should be held accountable for Syncope and victims should be compensated accordingly.

    Thank you for your comment. Someone from the Program team will reach out to you to discuss your concerns.

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Page last reviewed: January 30, 2020
Page last updated: January 30, 2020