World Trade Center Health Program — More Than a Decade Providing Health Monitoring and Treatment

In 2022, over 14,000 members of the World Trade Center (WTC) Health Program self-identify as Hispanic. This blog is dedicated to our Spanish-speaking audience as a message of outreach and as an overview of the WTC Health Program and research over the last decade. This Hispanic Heritage Month, we honor the many survivors and responders of 9/11, who require care in the WTC Health Program.

This blog post is also available en español.

Origins of the World Trade Center (WTC) Health Program

As a result of the September 11, 2001, terrorist attacks (9/11) in New York City (NYC), at the Pentagon in Arlington, Virginia, and near Shanksville, Pennsylvania, nearly 3,000 people were killed, and thousands were injured. On that tragic day, many people rushed toward the WTC site to search for the missing, and later helped with rescue, response, recovery, and clean-up efforts. It is estimated that over 400,000 individuals between responders and NYC residents, students, and local area workers were exposed to numerous environmental toxins, hazardous contaminants, and other factors that increased their risk for certain physical and mental health conditions.

The James Zadroga 9/11 Health and Compensation Act of 2010 (Zadroga Act) established the WTC Health Program to provide medical monitoring and treatment of WTC-related health conditions for 9/11 responders and survivors. The Program is administered by the Centers for Disease Control and Prevention’s (CDC’s) National Institute for Occupational Safety and Health (NIOSH) and is funded until 2090.

Who Is Eligible for Health Care Services?

Almost two decades after the 9/11 attacks, more than 118,000 responders and survivors have enrolled in the WTC Health Program. The Program provides no-cost medical monitoring and treatment for certified WTC-related health conditions to those affected by the 9/11 attacks. For members enrolled as survivors, treatment costs are required to be coordinated with their personal health insurance benefits.

Health benefits are available only to enrolled responders and survivors regardless of where they currently reside in the United States. A responder refers to individuals involved in rescue, response, recovery, clean-up, and related support activities following the attacks. A survivor refers to a resident, building occupant, or worker who was impacted and adversely affected by the WTC attacks in NYC. To learn more about who is eligible for the WTC Health Program visit the eligible groups page.

The WTC Health Program serves four groups of people affected by the 9/11 attacks:

• Responders affiliated with the Fire Department, City of New York (FDNY);
• WTC General Responders;
• WTC Survivors (a person present in the New York City Disaster Area in the dust or dust cloud on September 11, 2001; or a person who worked, lived, or attended school, childcare, or adult daycare in New York City Disaster Area) within certain dates and timeframes[a]; and
• Pentagon/Shanksville Responders.

How to Enroll in the WTC Health Program?

If you are a 9/11 responder or survivor, but you are not currently enrolled in the WTC Health Program, please visit the WTC Health Program website or call 1-888-982-4748 for more information (Spanish operators available).

We urge those interested and eligible to complete the enrollment application. If you need help at any point in the process, you can contact us by phone at 888-982-4748 or get help from one of our outreach partners.

What Are the Health Conditions Covered by the WTC Health Program?

The Program provides medical monitoring and treatment to members who have certified 9/11-related health conditions. Certification is an official decision by the Program that a member’s condition is related to their specific 9/11 exposure and meets Program certification policies and criteria.

General covered condition categories include:

• Acute traumatic injuries;
• Cancers;
• Musculoskeletal disorders (for NYC responders only);
• Airway and digestive disorders; and
• Mental health conditions.

The most common WTC-related certified conditions are in the categories of aerodigestive, cancer, and mental health. Skin cancer, prostate, and breast cancer are the most common certified cancers.^* The average number of WTC-related certified conditions per certified member is 2.7.¹

For more information on covered conditions visit the covered conditions page.

Monitoring, Screening, and Treatment at the WTC Health Program

For survivors: The initial health evaluation for survivors is a no-cost, one-time only examination. Once approved, applicants are enrolled, and an initial health evaluation is scheduled at a designated Clinical Center of Excellence or with a clinical provider in the Nationwide Provider Network. If no WTC-related health condition is certified from this initial health evaluation, then the survivor member is not eligible for additional Program health benefits coverage, except for cancer screening of the lung, colon, breast and cervix. However, survivor members who later develop a WTC-related health condition can contact their designated Clinical Center of Excellence or Nationwide Provider Network to determine whether the condition could be certified, and, therefore, treatment costs would be covered by the WTC Health Program in coordination with personal insurance.

For responders: The initial health evaluation for responders is the baseline monitoring examination. Responders are eligible for yearly follow-up examinations, which are provided at no-cost to the responder. If no WTC-related health condition is certified from this initial health evaluation, then the responder member is still eligible for annual monitoring and cancer screening by the Program.

What Are the Plans for the Future?

In addition to providing medical monitoring and treatment of WTC-related health conditions, the WTC Health Program continues to fund 9/11-related research designed to help answer critical questions about the physical and mental health conditions of 9/11 responders and survivors. Since 2011, the WTC Health Program has awarded a total of $175 million in research funding. As of July 2022, a total of 465 peer-reviewed publications had been funded by the WTC Health Program.

The Program’s future research considerations include:

• Care factors affecting an aging population; and
• Holistic care approaches, such as member lifestyle and integrative health interventions.

The research areas of interest are based on the research agenda. See also World Trade Center Health Program: First Decade of Research.²

More Information About the WTC Health Program First Decade of Research

The Program has published two significant articles that summarize the first decade of programmatic and research findings of the program.

World Trade Center Health Program — United States, 2012−2020¹

World Trade Center Health Program: First Decade of Research²

Alejandro Azofeifa, DDS, MSc, MPH; is Health Scientist in  the World Trade Center Health Program

Max Lum, Ed.D, MPA, is a Senior Advisor for eCommunication and Research Translation in the NIOSH Office of the Director.

* Program statistics are available at: Program Statistics – World Trade Center Health Program (cdc.gov).

References

1) Azofeifa A, Martin GR, Santiago-Colón A, Reissman DB, Howard J. World Trade Center Health Program — United States, 2012−2020. MMWR Surveill Summ 2021; 70(No. SS-4):1–21. DOI: http://dx.doi.org/10.15585/mmwr.ss7004a1

2) Santiago-Colón A, Daniels R, Reissman D, et al. World Trade Center Health Program: first decade of research. Int J Environ Res Public Health 2020; 17:7290. https://doi.org/10.3390/ijerph17197290