Lessons learned: Worker health and safety since September 11, 2001

The attack on the World Trade Center on September 11, 2001 was the worst assault on the American homeland in the 225-year history of the United States. It was also the most massive acute environmental disaster that ever has befallen New York City. The destruction of the twin towers released thousands of tons of toxic materials into the air of lower Manhattan—asbestos, particulate matter, lead, soot, PCBs, and dioxins. Workers and children were the groups at greatest risk of exposure. The threat to human health was compounded in the months after September 11 by the bioterrorist attacks involving anthrax. Responses to the attacks on the World Trade Center involved extraordinary heroism. They demonstrated the ability of the American health care system and of individual health workers to respond magnificently to an unprecedented crisis. But, the he response also underscored deep problems in the nation’s public health infrastructure. These problems must be addressed and the necessary improvements to the system must be made, if mistakes are not to be repeated in future disasters. The following were the most important lessons learned for public health: