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Suffering the Dust of Destruction

Dr. David Prezant, the deputy chief medical officer of the New York Fire Department, talked with the Early Show about the cough and other respiratory problems that firefighters have developed from working long hours at Ground Zero.

Dr. Prezant is also a professor of medicine at Albert Einstein College/Montefiore Medical Center. Since the terrorist attacks of September 11 and the destruction of the World Trade Center towers, nearly 11,000 New York firefighters have worked at Ground Zero. Of those, about 4,000 reportedly are suffering a "chronic, annoying cough."

A random sampling of 100 sick firefighters found 25 with breathing problems that could indicate they could develop asthma. At this point, no one is saying if any of these problems may be permanent. But all firefighters who worked at Ground Zero will now be examined.

Dr. Prezant describes the couch as a response to an overly irritating exposure. In most people, it is a dry, nonproductive cough. For some, it also has resulted in sore throats, wheezing, shortness of breath, and gastrointestinal reflux--better known as heartburn.

Most of those suffering from the cough are still on full duty, according to Dr. Prezant. They are functioning well.

And while 25 of 100 members of a sample group showed signs that asthma may develop, he says it's no guarantee that it will. From his perspective, this discovery was helpful in that it helps doctors treating the firefighters know what they are up against. They now can intervene appropriately, mainly with inhaled steroids.

The worst-case scenario is that someone would develop a chronic cough, chronic obstructive pulmonary disease, or asthma. The best case--and what Dr. Prezant thinks will occur in most cases--is full recovery.

At this point, the bottom line is that treatment is being given and doctors have to monitor patients' progress. It's impossible to accurately predict what the long-term prognosis is at this point.

The cough is the result of massive exposure to pulverized concrete and glass. There also may be asbestos and other carcinogens involved, but most people are reacting to the concrete and glass, which acts like sandpaper against the airway.

Respirators have been distributed to all those working at Ground Zero and Dr. Prezant says it's imperative that the firefighters actually wear them.

According to Dr. Prezant, anyone who was in the area of the World Trade Center on September 11 or has spent significant time at Ground Zero since then may have these symptoms. If so, they should see their doctor. However, Dr. Prezant emphasizes that simply being on-site does not mean you will develop long-term health problems. In fact, he says that more than 10,000 firefighters have been at Ground Zero and only 4,000 of them chose to take inhaled steroid treatment for any period. That means that 6,000 of them apparently are breathing fine.

This experience has taught Dr. Prezant and others about thimportance of having a baseline report on the health of all emergency workers so that they can compare it to the effect of a disaster on their health. In addition, he believes it shows that all immunizations should be kept up to date--to protect workers against any bioterrorism. It also has demonstrated the effectiveness of early use of a respirator and inhaled steroids in treating those who may develop respiratory problems.
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