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Zero for Heroes

Many of the people who spent months in the pit at ground zero have respiratory ailments. And no health insurance. And no aid from the government. Why?

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Pit Crew: Breathing the air at ground zero was hazardous to many workers' health.  

David Rapp used to pride himself on being an active guy. A 250-pound construction worker, he drove piles on the Williamsburg Bridge and on projects all over the city. He could carry a sack of cement on his shoulder as easily as you carry an order of takeout sushi back to your desk. He liked fixing cars. He went crabbing in Jamaica Bay.

Then came September 11. Rapp spent several months at ground zero, drilling steel reinforcements into the “bathtub wall”—the slurry wall between the pit and the Hudson River that prevented the water from flooding the area.

Rapp’s illness began with a faint dizziness and shortness of breath, but it steadily got worse. Before long, he was useless to his former employers. They laid him off. Now Rapp is very, very sick. He’s suffering from severe pulmonary disease—meaning he never gets enough air. He has frequent respiratory infections. He’s on twelve medicines. He carries an oxygen tank wherever he goes. “I just went straight down,” Rapp says, his voice somewhere between a whisper and a rasp. “It’s real depressing.”

He’s learning to accept the fact that he may never work again. But with that comes a question: How is Rapp, whose medical costs are now covered by temporary state workers’ comp, going to pay for his treatment in the future?

“I’m a scared guy right now,” says Rapp, who clearly isn’t accustomed to making such an admission. “I’m in real bad trouble. There are a lot of claims coming in right now. I’m afraid my pharmacy will tell me I’m cut off. I rely on my medicine to breathe.”

Rapp is one of perhaps thousands of people who are not cops or firefighters but who toiled at ground zero and are now sick, even disabled, from asthma, chronic infections, and other respiratory illnesses. These conditions, some experts maintain, were caused by the “crud”—the mixture of dust, ash, fumes from burning plastic, pulverized concrete, and vaporized human remains around ground zero.

Unlike the cops and firefighters whose heroism—and subsequent illnesses—have gotten huge amounts of attention, these other workers lack the medical safety net and pension enjoyed by the guys in uniforms. So they are scrambling for treatment in all kinds of ways. Some are on waiting lists for financially strapped private programs. Others are still battling for workers’ comp. Still others are defying doctors’ orders and working—because with a job comes health insurance. While some have found temporary treatment, they all share an uncertain future, with no guarantee that they’ll get the long-term care they’ll need.

“Thousands of people are facing lives turned upside down by illness—without access to care.”

The reason for this is not hard to divine. Two years have passed since the attacks, and there has been no comprehensive effort by the federal government to treat people who got sick helping out at ground zero. Incredibly, thousands of people are ill from a national disaster, and the federal government is AWOL.

“From a public-health standpoint, this is an intolerable outrage,” says Dr. Stephen Levin, who oversees a program at Mount Sinai Hospital that screens thousands of patients with ground-zero-related illnesses. “There is a patchwork, at best, of treatment resources for a limited number of people. But this requires a serious federal response. Hundreds and hundreds of people are facing lives turned totally upside down by illness—without access to care.”

They include volunteers with no insurance; people whose workers’-comp claims have been stymied by insurance companies; and others who were laid off after 9/11 because they were too sick to work—and lost their insurance. These are the same people, you may recall, who were hailed as heroes after 9/11, with adulatory bumper stickers and THANK YOU signs along the West Side Highway.

What made them ill? There was the hydrochloric-acid mist released by plastics smoldering in the wreckage. Also, the falling towers ground a huge amount of concrete into powder so fine that it could be inhaled deep into the lungs. These irritants caused swelling that led to sinusitis, laryngitis, bronchitis, asthma.

Marvin Bethea developed bad asthma. When the towers fell, Bethea, a paramedic, was tending to people in a nearby bank. He found himself inhaling air so dense, he recalls, that “it felt like someone was dumping dirt down my throat.” Two years later, his doctor has told him his condition is so bad that he should quit his job, which entails running up stairs with heavy equipment. But he’s still working—because without the job, he’d lose the health insurance.

The plight of these workers has been taken up by politicians here and there, notably Hillary Clinton and Representative Carolyn Maloney. Maloney is drafting legislation that would require the government to pay the medical costs of all responders without coverage who were injured or sickened at ground zero. “Three thousand rescue workers, and probably thousands more, are still suffering from health problems that are a direct result of their work at ground zero,” she says.

In recent weeks, Levin has done an extensive assessment of his program, which has screened nearly 8,000 victims. And he made two striking discoveries. The first: Ground-zero workers who are being examined now are showing roughly the same rates of illness as they did last year. “We’re finding that these problems are not going away,” Levin says.

The second revelation is no less surprising. Mount Sinai also runs a treatment outfit that has cared for around 400 people. And of those patients, Levin says, 40 percent have no insurance whatsoever. “This disturbing new finding further illustrates how our fragmented system fails people every day,” says Clinton.

The environmental fallout of 9/11 has finally enabled Democrats to stake out a ground-zero-related issue of their own. Clinton has already made headlines with her criticism of the EPA and its mishandling of the downtown-air-quality issue.

In fairness, the Feds have done a few things. Last February, under heavy pressure, they allotted $90 million to pay for the long-term monitoring of ground-zero workers. But the program covers only screening—not treatment. There’s a federal Victims Compensation Fund, but it only applies to people who were at ground zero between September 11 and 15.

In the weeks ahead, the government will have a harder time sidestepping the issue. Representative Chris Shays, a Connecticut Republican, is chairing a congressional hearing at Mount Sinai on October 28 on ground-zero-related health issues. It promises to be a lively show, at which Rapp will be a star witness. “We’d like to see the administration come to grips with this problem,” says Levin. “They surely haven’t done so thus far.”


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