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Q&A: Dr. Jackie Moline, Mt. Sinai World Trade Center Monitoring Program

By Michael Clancy | amNewYork City Editor

2:04 PM EDT, September 5, 2006

Dr. Jackie Moline of the Mt. Sinai World Trade Center Monitoring Program, which is studying the health of 16,000 people exposed to the air at Ground Zero after Sept. 11, 2001, spoke with amNewYork.

Q. What type of ailments are you seeing?

A. We certainly have seen that people have persistent upper- and lower-respiratory problems, including asthma, reactive airwaves, rhinitis, chronic sinusitis and other throat-related problems. A lot of people have persistent reflux. There are people who have posttraumatic stress disorder, generalized anxiety, depression, and other psychological conditions as a result of their exposures. People are also complaining of decreased exercise tolerance. And I think that bears out well with some of the studies that have been recently published by the Fire Department, where people's lung capacity has gone down much more dramatically.

Q. Are there any hard numbers as to how many people were affected?

A. Initially about 60 or 70% of people (of the 16,000 interviewed at Mount Sinai). Of that, about 40 to 50 % have had persistent symptoms.

Q. Who has Mt. Sinai interviewed for this project?

A. We have the gamut of everyone who went down there -- law enforcement, construction workers, people who restored basic services transportation, sanitation, communication workers, for example. Other municipal workers, medical examiners, volunteers. Anyone who was down there who wasn't a firefighter or EMT is eligible for our program. We've had cameramen, reporters.

Q. What do you worry about looking forward?

A. There is a lot of concern about lung scarring. Some individuals have been diagnosed with pulmonary fibrosis or other scarring-lung diseases. Normally it takes about five to 20 years for these things to show up, sometimes longer. We don't know how the World Trade Center dust is going to behave in individuals. It was a really complex mixture. Something that we are all concerned about is whether there are going to be increased rates of cancer, given that there were definite carcinogens down there.

Q. Do you think the death toll of 9/11, which now stands at 2,749, will ever be amended upward?

A. I think we already have some reports of people who have died of lung diseases and I think there will be a second wave. I think it is incumbent upon us to be vigilant in identifying these problems because what we want to be in a position to do is to make sure that we should know what we should be looking for. Not just our monitoring program but that the medical community in general is on the lookout for unusual diseases that may be hallmark diseases.

Q. Do you think there ever will be a link established between certain illnesses and 9/11 exposure?

A. I think that what we are going to see is disease patterns emerging and over time we will see these patterns emerging and say 'Look at all of these people that were down there, they all have the same unusual disease, that is what we call a cluster.' And that's how we identify things in occupational medicine. I think that we need to work with individuals who are sick and their families. And in the unfortunate circumstance that someone may pass away, make sure that we do autopsies, and take a look at the lungs, and take a look at the dust within the lungs and see if it is World Trade Center dust. And all those things will go to establishing whether you can say with absolute certainty that this is a World Trade Center-related disease.

Q. That seems to be the big question right now.

A. We are all cautiouswhat we have classically learned is that it takes many years for cancers to develop. This is an unusual circumstance so we have to keep our eyes and minds open and also be scientific about it to make sure we reach conclusions in a well though-out process.

Q. What will be the most important task ahead?

A. The most important task ahead is to secure funding to make sure that these programs stay alive. Our funding runs to 2009. It would be inhuman and a disservice to those who selflessly volunteered or worked down there in this situation to abandon them and to not have continued monitoring of their health status in years to come.