When Dan Kochensparger was on his hands and knees sifting through cement, metal and other debris at the World Trade Center site in New York, specks were floating in the thick air. He didn't think about what they were.
He was doing his job as a hazardous materials specialist, monitoring the wreckage as he and other members of Ohio's emergency response team searched for survivors of the Sept. 11, 2001 terrorist attacks. The breathing problems came later.
"The air was pretty much filled with (particulate matter) the whole time. We didn't realize it, but a lot of the photo documentation we had done, there were particles on the pictures," said Kochensparger, a 21-year veteran of the Upper Arlington Fire Department in central Ohio.
A federal program created to monitor the health effects of work at the site has found thousands still suffering from asthma, pneumonia, bronchitis and depression.
It's the first time the health of rescue and recovery workers has been followed so closely after a major disaster. As the second anniversary of the attacks nears, new information coming out on long-term health implications of rescue work is getting the attention of emergency officials and prompting Congress to consider creating federal screening for future disasters.
"A lot of us in the rescue business don't think about the long-term effects of our work," said Kettering Fire Chief Robert Zickler, captain of Ohio Task Force One, a 72-member team dispatched to the Trade Center wreckage for 10 days.
Doctors monitoring the health of people who dug through the rubble at Ground Zero now say the airborne particles likely were pulverized concrete. When inhaled, it can burn the lungs. When swallowed, it can inflame the stomach lining, causing heartburn.
Kochensparger came home with a cold and a persistent cough. His doctor diagnosed walking pneumonia and bronchitis. He wasn't alone.
"Some may never recover. They may be walking through a street and get a sudden blast of exhaust and their chest will tighten," said Dr. Stephen Levin, co-director of the federal screening program for World Trade Center workers, which is being administered by New York's Mount Sinai Medical Center.
To date, about 7,500 of the estimated 30,000 workers who toiled at the ruins have been examined under the $12 million program created in July 2002. With $4 million in extra funding this year, doctors expect to examine 4,500 more by March 2004.
Preliminary results show 48 percent of workers with ear, nose and throat problems such as nasal congestion, hoarseness, headaches and throat irritation. Thirty percent have pulmonary problems, including shortness of breath, persistent cough and wheezing.
About 19 percent of workers have been diagnosed with post-traumatic stress disorder - at least double the rate seen in the general population.
The data reflect 1,100 patients screened between July 2002 and April 2003. But program directors say patients have continued to report symptoms at about the same rate since then.
"We are seeing people now in our screening program - two years later - who are still suffering these symptoms," Levin said in a recent interview.
It's too early to determine whether any of the workers will one day suffer from lung or other types of cancer as a result of their assistance, he said. A final report on the workers' health is expected next spring.
Meantime, senators from Ohio and New York are working to create a federal medical screening program for emergency personnel and others who respond to future disasters.
The Federal Emergency Management Agency, which funds the existing program, lacks authority to conduct such long-term monitoring.
"If a horrific event occurs, those who risk their lives to respond must know that their health needs will be met," said Sen. George Voinovich, R-Ohio, who chairs the Senate Environment and Public Works subcommittee that oversees FEMA.
His bill passed the committee in July and is pending before the Senate, where no opposition is expected. It wouldn't cost anything to create the program, and funding to operate it would be appropriated as needed.
Workers whose job it is to rush straight into one disaster after another can't believe they have gone so long without the health tracking, which wasn't in place for emergency crews who responded to the Oklahoma City bombing or to California's earthquakes.
"We go in and answer calls for the safety of other people, that's what we are paid to do," said Robert Hessinger, a paramedic on the Ohio team who had trouble taking deep breaths after the Sept. 11 mission.
"There also needs to be things in place to look out for our safety," Hessinger said.
By Malia Rulon