‘Absolutely Horrifying’

It's still not even clear how many may be suffering from related health problems since thousands have not yet been screened. Worse, some of the most serious health problems may not yet have emerged. “We have never done an adequate characterization of the nature and scope of the contamination, so we can’t quantify what kinds of problems people are going to face,” says David Newman, an industrial hygienist at the New York Committee for Occupational Safety and Health (NYCOSH). “There may be a whole group of people out there who may still become seriously ill.”

Dr. Levin at Mount Sinai, where more than 16,000 people have been screened, says, “We are seeing people for the first time now, more than four years later, who have been persistently symptomatic for all that time and haven’t been screened or gotten care.” He suspects there may be many more.

Unions have had a tough time persuading members to get medical checks, partly because of fears they’ll be told they can no longer work. Construction workers or emergency medical technicians can make $80,000 to more than $100,000 a year with overtime; New York Worker Compensation only pays about $400 a week. Dominick Marrocco, business agent for Local 282, which represents workers in building materials and construction, says 840 members worked at the site in the weeks following the September 11 attacks. Only 270 of them have been screened. “I wouldn’t doubt that there are people out there working still who have health problems,” he says.

Marianne Pizzitola, a pension and benefits coordinator for the uniformed Emergency Medical Services union says she’s also spoken with members who refuse to quit despite respiratory problems. “They’ve got mortgages and kids, and they can’t afford to stop working,” she says.

More than 10,700 Worker Compensation claims have been filed in New York, and nearly 94 percent have been “fully resolved,” according to Jon A. Sullivan, spokesman for the New York State Workers' Compensation Board.

But some ailing workers complain that their claims have been disputed or delayed for months—or even years. Industrial cleaner Alex Sanchez, 38, spent several days at Ground Zero clearing dust from the airshafts and indoor surfaces of the buildings around the World Trade Center site with just a washcloth or paper mask over his face. (Newman, from NYCOSH, says no more than 60 percent of workers at Ground Zero wore respirators on any given day and, on some days, just 20 percent wore them—in part, perhaps, because the Environmental Protection Agency issued a statement that the air was safe to breathe a week after the attacks, an assurance that later proved to have been dangerously premature.)