The 9/11 Casualties Still to Come

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REUTERS/Tom Sperduto

Last January — more than nine years after the Sept. 11 attacks — Osama bin Laden killed Roy Chelsen. Bin Laden never met Chelsen; that’s not the way it is when you do your killing en masse. And he certainly didn’t kill him quickly.

Chelsen was a fireman, working for the 28th Engine Company on Second St. in Manhattan on the morning of Sept. 11. Like so many other first responders, he was called to the Towers that morning and found himself climbing the stairs as the office workers flowed down them. Like too-few first responders, he made it out alive, standing just half a block away when the second tower fell. He then joined thousands of other people working in search and rescue — and later search and recover — operations for weeks afterward. In 2005, he developed multiple myeloma, a cancer of the blood, and on Jan. 9 of this year, he died.

(More on TIME.com: See stunning aerial photos of the Sept. 11 destruction)

“Roy had had two marrow transplants but kept relapsing,” says his sister Kathy, who was with him at the end. “When we brought him home from the hospital two days before he died, there were trucks from his engine company out front with their lights flashing. His friends had come to help him inside.”

At least 1,000 other first responders have died in similar ways since the morning of Sept. 11, 2001, and thousands more have gotten sick. And if there’s any real surprise about all that, it’s that even more haven’t been claimed.

In addition to the 40,000 people who labored sifting through the rubble and later clearing it away, 60,000 more worked in the vicinity. The debris cloud that engulfed all of them on the morning of the attacks and long afterward contained an estimated 2,500 different toxins, including such known nasties as lead, mercury, asbestos and dioxin, as well as such less notorious contaminants as silica, cadmium and polycyclic hydrocarbons. All of them are carcinogenic; combined in a single aerosolized mix they are believed to lead not just to cancer but to heart, liver, lung, kidney and central nervous system diseases.

(More on TIME.com: See a portrait of a heroic 9/11 firefighter)

The government acted fast — in its fashion — to provide assistance to the first-responders or at least to track their health. In 2002, the Centers for Disease Control and Prevention (CDC) established the World Trade Center Health Program, a monitoring body that would recruit anyone in the New York City or surrounding area who had worked with toxic debris from Ground Zero, asking them to come in for periodic checkups and to report immediately if they had suspicious symptoms. Originally, only 2,579 people signed on, a number that has soared to more than 57,000 since then.

At first, there were only three categories of diseases that qualified for federal first-responder coverage: respiratory ills, gastrointestinal problems and depression or PTSD. Those are still the only ones that make the official cut simply because those were the conditions that were showing up the most.

“The challenge from the beginning was to identify which conditions would be linked to working at Ground Zero” says Fred Blosser, a spokesman for the National Institute for Occupational Safety and Health (NIOSH). “The ones that would get covered were the ones that were being diagnosed.”

(More on TIME.com: See TIME’s 2001 cover story on the 9/11 attacks)

But such a treat-what-you-see (as opposed to anticipate-what-may-come) policy is not the only thing that’s gotten in the way. So too has a lack of funding. About $475 million has been spent monitoring and treating 9/11-related ills since the attacks, or less than $50 million per year to follow at least 100,000 potential victims. Things looked worse still late last year when a $7.4 billion proposal for long-term funding came before Congress and was blocked by Republicans in the Senate who threatened a filibuster if a tax-cut deal wasn’t struck first.

The official GOP position was that the bill created a “massive new entitlement program,” though if our gridlocked political system can agree on one thing, it ought to be that if anyone can be said to be “entitled” to government help it’s the people who rushed into the fires of Ground Zero that day while any other sane person was rushing away. Ultimately, the GOP gave in, but only after slashing the allocation to $4.2 billion.

Still, any funding helps, and the law has some smart ways to spend the money that’s been made available. Most notably, it establishes a board of medical advisers who will study all of the diseases among the sample population more closely, looking for any hidden — or not so hidden — 9/11 link that may exist. Of the 57,000 people participating in the CDC program so far, nearly 16,000 have sought treatment just in the past year for problems they think or fear are connected to their time on the pile. Not all of those ills will indeed be connected, but 16,000 is a big enough share of the sample group that the scrutiny is warranted.

(More on TIME.com: See pictures of the devastation on Sept. 11, 2001)

“Making this connection has been a challenge since the beginning,” says Blosser. “One of the biggest goals of this program is to help people figure out why they’re not well and get them treated if we can.”

Roy Chelsen’s family never doubted why he died, and multiple myeloma is indeed one of the diseases that’s getting close attention from the new panel — even if it’s attention that comes too late for many. “When I heard that bin Laden was dead, I was glad that justice had been served,” says Kathy, “but it’s just too bad Roy wasn’t around to see it.”

It’s a hard truth that many more people are likely to die over many more years as a result of the service they gave on 9/11. But it’s some small consolation, perhaps, that at least they will be among the ones who outlived their killer.

(More on TIME.com: See pictures of the evolution of Ground Zero)

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