Injuries and illnesses among New York City Fire Department rescue workers after responding to the World Trade Center attacks. (25/159)

Within minutes of the terrorist attacks on September 11, 2001, the Fire Department of New York City (FDNY) operated a continuous rescue/recovery effort at the World Trade Center (WTC) site. Medical officers of FDNY Bureau of Health Services (FDNY-BHS) responded to provide emergency medical services (see box). The collapse of the WTC towers and several adjacent structures resulted in a vast, physically dangerous disaster zone. The height of the WTC towers produced extraordinary forces during their collapse, pulverizing considerable portions of the buildings' structural components and exposing first responders and civilians to substantial amounts of airborne particulate matter. Fires burned continuously under the debris until mid-December 2001. Because of ongoing fire activity and the large numbers of civilians and rescue workers who were killed during the attacks, approximately 11,000 FDNY firefighters and many emergency medical service (EMS) personnel worked on or directly adjacent to the rubble and incurred substantial exposures (Figure). This report describes morbidity and mortality in FDNY rescue workers during the 11-month period after the WTC attacks and documents a substantial increase in respiratory and stress-related illness compared with the time period before the WTC attacks. These findings demonstrate the need to provide acute and long-term medical monitoring, treatment, and counseling to FDNY rescue workers exposed to this disaster and to solve supply, compliance, and supervision problems so that respiratory protection can be rapidly provided at future disasters.  (+info)

Community needs assessment of lower Manhattan residents following the World Trade Center attacks--Manhattan, New York City, 2001. (26/159)

On September 11, 2001, terrorists attacked and destroyed the World Trade Center (WTC) in New York City (NYC). An estimated 2,819 persons were reported killed in the attacks; many others were injured (Office of the Chief Medical Examiner, New York City Department of Health and Mental Hygiene [NYCDOHMH], unpublished data, 2002). An estimated 25,000 persons living nearby in lower Manhattan were affected both physically and emotionally. Many persons witnessed the attacks; lost family and friends; were exposed to smoke, dust, and debris; and evacuated their homes. To identify the health-related needs and concerns of persons residing near the attack site, NYCDOHMH, in collaboration with CDC, surveyed persons residing in areas immediately surrounding the WTC site. The primary purpose of the survey was to gather information to set priorities and direct public health interventions. This report summarizes findings from the assessment, which indicate that a large proportion of respondents had physical and psychological symptoms potentially associated with the exposure and needed information to address their health and safety concerns. On the basis of the results of the survey, NYCDOHMH responded to resident concerns, helped reduce exposure to dust and debris, and provided information about mental health resources.  (+info)

Deaths in World Trade Center terrorist attacks--New York City, 2001. (27/159)

On September 11, 2001, terrorists flew two hijacked airplanes into the World Trade Center (WTC) in lower Manhattan in New York City (NYC), destroying both towers of the WTC. This report presents preliminary vital statistics on the deaths caused by the terrorist attacks and describes the procedures developed by the New York City Department of Health and Mental Hygiene (NYCDOHMH) to issue death certificates in response to the attacks. These data underscore the need for legal mechanisms to expedite the issuance of death certificates in the absence of human remains and the need for vital registration systems that can be relocated in case of emergency.  (+info)

Use of respiratory protection among responders at the World Trade Center site--New York City, September 2001. (28/159)

The terrorist attacks on the World Trade Center (WTC) on September 11,2001, created an occupational health and safety challenge for New York City (NYC) firefighters and rescue workers responding to the disaster. Immediate respiratory hazards included explosions, fire, falling debris, and dust clouds containing particulate matter comprised of pulverized building materials. Ongoing risks included lingering particulate matter in the air and intermittent combustion products from initial and persistent fires beneath the rubble pile. Because the nature and extent of exposures in disaster situations are complex and difficult to characterize, the use of adequate personal protective equipment (PPE), including respiratory protection, is essential in protecting the health of firefighters and other rescue workers. During the weeks after September 11, the NYC Fire Department's Bureau of Health Services (FDNY-BHS) and CDC's National Institute for Occupational Safety and Health (NIOSH) organized a collaborative study to evaluate occupational hazards and exposures for these workers, including their use of respiratory protection. This report summarizes the results of that study, which indicate that the majority of firefighters did not use adequate respiratory protection during the first week of the rescue/recovery operation.  (+info)

Impact of September 11 attacks on workers in the vicinity of the World Trade Center--New York City. (29/159)

In January 2002, CDC's National Institute for Occupational Safety and Health received requests for Health Hazard Evaluations from labor unions representing workers employed in buildings in the vicinity of the World Trade Center (WTC). Workers reported persistent physical and mental health symptoms that they associated with exposures from the WTC collapse and ensuing fires. To address these concerns, CDC conducted surveys of workers at four workplaces in New York City (NYC), a high school (high school A) and college (college A) near the WTC site, and a high school (comparison high school B) and college (comparison college B) > or = 5 miles from the WTC site to determine rates of physical and mental health symptoms. This report summarizes the preliminary results of the employee surveys, which indicated that workers employed near the WTC site had significantly higher rates of physical and mental health symptoms than workers employed > or = 5 miles from the site. Intervention programs should be tailored to address the needs of these workers, and the effectiveness of these programs should be evaluated. Further assessment is warranted to describe the nature and extent of illness in specific working groups and individual medical follow-up in those with persistent symptoms.  (+info)

Lessons learned from non-medical industries: root cause analysis as culture change at a chemical plant. (30/159)

Root cause analysis was introduced to a chemical plant as a way of enhancing performance and safety, exemplified by the investigation of an explosion. The cultural legacy of the root cause learning intervention was embodied in managers' increased openness to new ideas, individuals' questioning attitude and disciplined thinking, and a root cause analysis process that provided continual opportunities to learn and improve. Lessons for health care are discussed, taking account of differences between the chemical and healthcare industries.  (+info)

Implications of the World Trade Center attack for the public health and health care infrastructures. (31/159)

The September 11, 2001, attack on the World Trade Center had profound effects on the well-being of New York City. The authors describe and assess the strengths and weaknesses of the city's response to the public health, environmental/ occupational health, and mental health dimensions of the attack in the first 6 months after the event. They also examine the impact on the city's health care and social service system. The authors suggest lessons that can inform the development of a post-September 11th agenda for strengthening urban health infrastructures.  (+info)

Letter: Laparoscopy explosion hazards with nitrous oxide.(32/159)

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