World Trade Center rescue worker injury and illness surveillance, New York, 2001

The September 11, 2001, terrorist attacks on the World Trade Center in New York City, New York, prompted an unprecedented rescue and recovery response. Operations were conducted around the clock, involved over 5000 workers per day, and extended into months following the attacks. The City of New York Department of Health and Mental Hygiene and the Centers for Disease Control and Prevention implemented prospective surveillance to characterize rescue worker-related injury and illness and to help guide public health interventions.

From September 11 to October 11, 2001, personnel reviewed medical records at four Manhattan hospital emergency departments (EDs), and healthcare providers completed data collection forms at five temporary Disaster Medical Assistance Team (DMAT) facilities located at the site. Rescue workers included construction workers, police officers, firefighters, emergency medical service technicians, or Urban Search and Rescue workers. Data collected included demographic characteristics, injury type, illness, and disposition.

Of 5222 rescue worker visits, 89% were to DMAT facilities and 12% to EDs. Musculoskeletal conditions were the leading cause of visits (19%), followed by respiratory (16%) and eye (13%) disorders. Incidence rates were estimated based on total injuries and/or illnesses reported times 200,000 (100 equivalent full-time workers in 1 year at 40 hours per week x 50 weeks per year), then divided by the total number of hours worked. Eye disorders (59.7) accounted for the highest estimated injury and illness rate, followed by headache (46.8). One death, 52 hospital admissions, and 55 transports were reported. Findings underscored the need to coordinate distribution and enforcement of personal protective equipment use, purchase of diagnostic equipment to diagnose corneal abrasions, and distribution of health advisories.

This system provided objective, timely information that helped guide public health interventions in the immediate aftermath of the attacks and during the prolonged rescue and recovery operations. Lessons learned can be used to guide future surveillance efforts.