More than 14 years later, the aftermath of the 9/11 attacks on the World Trade Center continues to have devastating effects on the lives of survivors, family members, friends, and first responders (firefighters, construction workers, and sanitation workers) involved in the disaster. And yet, the tragedy’s full impact on both the environment and the health of those affected still remains unclear. This is largely because many health conditions — such as cancer caused by exposure to asbestos, toxins, pollution, or environmental elements — often take many years to develop.

How Long Does it Take for Mesothelioma and Other Cancers to Develop?

According to Dr. Raja Flores, a world-renowned expert in thoracic surgery and mesothelioma, Chairman of the Department of Thoracic Surgery and Professor at Mount Sinai Medical Center in New York City, “The cancers we’re expecting like — esophageal and lung cancer — normally have a longer latency period. This means it can take longer for [the signs and symptoms of these cancers to appear],” he explains. The same holds true for mesothelioma, a deadly cancer caused by exposure to asbestos. “Normally mesothelioma takes 20-30 years to develop,” he says. “In general, it’s unusual for cancer to develop for 7 -10 years [after exposure to something]. It usually takes 20-30 years for a carcinogen [or cancer-causing agent] to cause cancer in your body.”

This means that it might be another decade before the world truly begins to see the full extent of health concerns associated with 9/11. Dr. Flores went on to say:

Yes, it was tragedy that people died from the attack, but there are also many more people who are still continuing to die prematurely as a result of 9/11. I think you’re going to see a huge increase in cancer 20 – 25 years later in the people [who were exposed to the elements from the World Trade Center attack]…. The biggest thing people are expecting is an increase in mesothelioma and lung cancer.”

9/11 and the Associated Cancer Risk

Dr. Flores’ sentiments aren’t far off base. In fact, this might also explain the lack of available information and published research that could shed more light on whether exposure to the chemicals from the World Trade Center (WTC) attack might increase the risk for cancer. To date, only a limited number of studies have been published on the topic, one of which was a study assessing the health conditions of 9,853 male firefighters, 8,927 of whom were labeled as being “WTC-exposed”. The study found a slight increase in cancer risk in the male firefighters who were exposed to the pollution and environmental contamination from 9/11. However, researchers point out that since the study was done only 7 years after the attack, not enough time had passed to fully evaluate the potential impact of the pollution from the WTC on cancer.

Another study evaluating the long-term health effects of 9/11 published in the Journal of the American Medical Association in 2012 also showed a slight risk of cancer in people exposed to the elements of the World Trade Center. Researchers found that 9/11 survivors were at an increased risk for prostate cancer, thyroid cancer, and myeloma when compared to the overall population living in New York in 2007-2008. As with the firefighter study, the collected data in the report also showed that the time lapse between the 9/11 attack and when cancer first developed was quite short in comparison to the time it typically takes cancer to occur.

The research further suggests that the people most likely to develop cancer tended to be older in age, more likely to smoke, and less likely to be Latino — whether or not they had been exposed to post-9/11 pollution. This also supports the theory that only time will tell just how much 9/11 has affected the health of area residents, survivors, and other people who have come into contact with the environmental contamination.

According to Dr. Flores, another study published by Mount Sinai Medical Center found that in people affected by 9/11, 40% had reflux (a precursor to esophageal cancer), 40% had asthma, 30% had sinusitis, and many people had multiple conditions — all of which he says are precursors to cancers. Some survivors have developed more than one of these cancers.

What Makes Exposure to Chemicals from 9/11 Different from Other Carcinogens?

Part of what makes the exposure to 9/11 carcinogens unique is the fact the attack released many toxic chemicals used in the buildings’ infrastructure into the air. This includes many known environmental pollutants and cancer-causing agents like asbestos, silica, benzene, polychlorinated biphenyls, polycyclic aromatic hydrocarbons, volatile organic compounds, and building materials that were crushed like pulverized steel, along with numerous other metals.

Unfortunately, it doesn’t stop there. “There is also a substance called vermiculite that [experts] think was used on about 40 floors of the World Trade Center,” Dr. Flores reveals. And like asbestos, not only is vermiculite a naturally occurring mineral, but it can also withstand high temperatures and be used in insulation. Dr. Flores explains that the vermiculite used to build the World Trade Center came from a mine in Libby, Montana. According the to the Environmental Protection Agency (EPA) website, 70% of the vermiculite used in the U.S. came from this mine from 1919 until 1990. What’s important to note about this mine is that it was contaminated with asbestos.

Dr. Flores and his researchers have also considered how the Libby mine asbestos contamination might affect miners and their families. “We studied this disease in Libby, Montana and the effects on teenagers, adults, people who work in the mine. Their rates of mesothelioma have been astronomical compared to other people [who were not exposed]…. They had twice the amount of cancer as smoking patients.”

The other challenge is that it’s hard to know what effect other environmental factors may have in increasing the cancer risk in the people in Libby, Montana or those affected by 9/11.

And even though it’s still a little too soon to tell what kind of impact the World Trade Center aftermath will have on long-term health, Dr. Flores believes that we can look to history for clues. “Historical evidence that shows that miners and insulators as well as their families would be exposed to pollutants, so why should it be any different with the victims of 9/11?” he questions.

Other Factors Contributing to Cancer

Donna Summers - Dr. Raja Flores Explores Esophageal, Lung & Mesothelioma Cancers in Wake of 09/11

In looking over some of the numbers, people have questioned what effect the exposure to 9/11 carcinogens had and may have on health conditions — especially in smokers. The unexpected death of the popular disco singer and New York City resident Donna Summer from lung cancer brought some attention to the potential long-term consequences of 9/11 exposure. It also might forecast what’s in store for other survivors in the long term. After Summer’s passing, rumors swirled about whether asbestos exposure caused the vocalist to get lung cancer – as the toxic dust of the World Trade Center towers hovered over lower Manhattan for days after the attacks. While many people may associate Summer’s lung cancer to either smoking or exposure to cigarette smoke in nightclubs, Dr. Flores states that when added to the chemical exposure from 9/11, cigarette smoke may have increased Summer’s risk.

“When you combine smoke and asbestos exposure, it’s not just an additive effect, it’s a synergistic effect: 1+1 doesn’t equal 2 — it equals 5 when you add the effects of smoking and the asbestos together. I don’t know if [Donna Summer] smoked or not, but she was down there and lived down there in Park City, so her speculations may not have been off.”

In other words, smoking and exposure to secondhand smoke only heightens the risk for people who came into contact with 9/11 pollutants.

What Can You Do if You’ve Been Exposed to Chemicals from 9/11?

When it comes to lung cancer, including mesothelioma, the earlier you can get diagnosed and the sooner you can begin treatment, the better your chances for survival. Dr. Flores says that 80% of patients with lung cancer will still be alive five years later if it’s caught early.

“Lung cancer is very curable when it’s caught early. Mesothelioma frequently presents at a very early stage. There are certain mesothelioma patients, who, when diagnosed early, live 8-9 years longer. As surgeons, we see people who arrive 3, 5, 10 years later. We believe that we can help patients achieve long-term survival through screening and early diagnosis.”

His advice? “Get a low-dose screening CAT scan once a year if you’ve been exposed. There’s evidence that this has helped patients who’ve been exposed.” And people shouldn’t worry about the radiation from CAT scans at low doses, he explains. “A low-dose CAT scan gives you the same amount of radiation that you get from mammograms.”

9/11 is a day that changed America forever, claiming many lives while compromising many others. And yet, only time will tell what truly lies in store for the health of its survivors and first-responders.