question: Why are 9/11 first responders getting cancer so reliably?
comment: Many things used in construction can be toxic to humans but have very limited contact with humans. For example, old insulation with asbestos is between walls and only comes in contact with the person installing or removing it. When 9/11 happened, the buildings were burning to convert these solid materials into toxic fumes. Furthermore, the collapse of the buildings pulverized these toxic materials into breathable powder. This made these toxic materials contact the people at the site for long periods of time. The first-responders had high exposures of these toxic materials known to cause cancer.
passages: , medical authorities concluded that 1,140 people who worked, lived, or studied in Lower Manhattan at the time of the attack have been diagnosed with cancer as a result of "exposure to toxins at Ground Zero". It has been reported that over 1,400 9/11 rescue workers who responded to the scene in the days and months after the attacks have since died. At least 11 pregnancies were lost as a result of 9/11.
  
  Section::::Evacuation.
   A study published in December 2012 in "The Journal of the American Medical Association" observed the possible association between exposure to the World Trade Center debris and excess cancer risk. Over 55,000 individuals enrolled in the World Trade Center Health Registry, separated by rescue and/or recovery workers and non-rescue and/or recovery workers, were observed from 2003 or 2004 to December 31, 2008. The findings showed the overall incidence of all cancers among rescue and/or recovery workers was not significantly elevated, compared to non-rescue and/or recovery workers. Despite this, the incidences for prostate cancer, thyroid cancer, and multiple myeloma were significantly elevated among the rescue and/or recovery workers, in the final year of observation.
   On November 28, 2006, the "Village Voice" reported that several dozen recovery personnel have developed cancer – as opposed to having contracted respiratory ailments, and that doctors have argued that some of these cancers developed as a result of the exposure to toxins at the Ground Zero site:
  
  "To date, 75 recovery workers at ground zero have been diagnosed with blood cell cancers that a half-dozen top doctors and epidemiologists have confirmed as having been likely caused by that exposure."
   It was reported in 2018 that at least 15 FBI agents had died from cancer due to their roles in the aftermath and investigation of the attack. Further, a medical director of the World Trade Center Health Program at Mount Sinai Hospital reported in 2018 that out of the approximately 10,000 first responders and others who were at Ground Zero and have developed cancer as a result, more than 2,000 have died due to 9/11 related illnesses. The Uniformed Firefighters Association of Greater New York also reported over 170 deaths of firefighters due to 9/11-related illnesses, and that roughly 1 in 8 firefighters who were at Ground Zero have developed cancer.
   Section::::Exposures and conditions.:Cancer risk.
   In 2008, the lead researcher of a New York State Department of Health study informed "The New York Post" of a study documenting at least 204 deaths of rescue and recovery workers since September 11, 2001. The researchers for the study confirmed 98 deaths with death certificates. The researchers showed that 77 persons died of illnesses, including 55 from lung and various other cancers. Kitty Gelberg, New York state Bureau of Occupational Health's chief epidemiologist said, "We're not saying they are all World Trade Center related; we're just saying this is what people are dying from." Many of the 55 responders who died from cancer had cancer before September 11, 2001, but most of the cancer patients developed the disease afterward.
   Dr. John Howard was appointed the medical administrator of the federal World Trade Center Health Program funded through the James Zadroga Act. On July 22, 2011, Howard's report on a study of a link between particulate exposure in the aftermath and cancer was released. The report said that there was insufficient evidence of a link between particulate exposure and cancer. The report's findings meant that many first responders to the attacks would be limited in their access to funds for medical treatment. Three New York Congressional delegation Representatives, Peter T. King, Carolyn B. Maloney and Jerrold Nadler, said that they believed that further studies would indicate a link between exposures and cancer.
   Increasing numbers of Ground Zero workers are getting illnesses, such as cancer. Between September 11, 2001, through 2008, there were 263 new cases of cancer found in 8,927 male firefighters who responded to 9/11 attacks. This number is 25 more than what is expected from men from a similar age group and race. There is a 19% increase in cancer overall, between firefighters who responded to the attacks and those who were not exposed to toxins from responding to the attacks on September 11.
   As of December 2017, the most common conditions certified by the World Trade Center Health Program were rhinosinusitis, gastroesophageal reflux disease (GERD), asthma, sleep apnea, cancer, posttraumatic stress disorder, respiratory disease, chronic obstructive pulmonary disease, depression, and anxiety disorder. The most common cancers were skin cancer and prostate cancer. The World Trade Center Health Program regularly publishes the most commonly certified condition on its website.
  
  Section::::Exposures and conditions.:Toxic dust.
   The thousands of tons of toxic debris resulting from the collapse of the Twin Towers contained more than 2,500 contaminants, including known carcinogens. Subsequent debilitating illnesses among rescue and recovery workers are said to be linked to exposure to these carcinogens. The Bush administration ordered the Environmental Protection Agency (EPA) to issue reassuring statements regarding air quality in the aftermath of the attacks, citing national security; however, the EPA did not determine that air quality had returned to pre-September 11 levels until June 2002.
   During the attacks and afterwards there was a large amount of toxic dust, debris and ash that was centralized around Ground Zero and created long term health problems. Toxic materials such as asbestos, lead, and mercury were in the air and the debris and many victims and first responders did not wear respirators.
   There is also scientific speculation that exposure to various toxic products in the air may have negative effects on fetal development. A notable children's environmental health center is currently analyzing the children whose mothers were pregnant during the WTC collapse, and were living or working nearby. A study of rescue workers released in April 2010 found that all those studied had impaired lung functions, and that 30–40% were reporting little or no improvement in persistent symptoms that started within the first year of the attack.
  
  Section::::Long-term effects.:Health effects.:Legal.
   Health effects extended to residents, students, and office workers of Lower Manhattan and nearby Chinatown. Several deaths have been linked to the toxic dust, and the victims' names were included in the World Trade Center memorial. Approximately 18,000 people have been estimated to have developed illnesses as a result of the toxic dust. There is also scientific speculation that exposure to various toxic products in the air may have negative effects on fetal development. A notable children's environmental health center is currently analyzing the children whose mothers were pregnant during the WTC collapse, and were living or working nearby. A study of rescue workers released in April 2010 found that all those studied had impaired lung functions, and that 30–40% were reporting little or no improvement in persistent symptoms that started within the first year of the attack.
   Richard Clapp and David Ozonoff, professors of environmental health at Boston University School of Public Health; Michael Thun, director of epidemiological research at the American Cancer Society; Francine Laden, assistant professor of environmental epidemiology at Harvard School of Public Health; Jonathan Samet, chairman of the epidemiology department at Johns Hopkins Bloomberg School of Public Health; and Charles Hesdorffer, associate professor of oncology at Johns Hopkins School of Medicine argue that the cancer incidence among monitored individuals cannot be called a coincidence. They assert that the Ground Zero cloud was likely the cause of the illnesses. The American College of Preventative Medicine is concerned that malignant mesothelioma will develop among persons exposed to Ground Zero air.
   On September 11, 2018, 17 years after the attacks, a New York City law firm reported that at least 15 men were diagnosed with male breast cancer in the intervening years due to the attacks.
  
  Section::::Exposures and conditions.:Psychological effects.
  
  A study published two months after 9/11 found that Americans across the country experienced substantial symptoms of stress after the attacks. Two subsequent studies found that exposure to the attacks was a predictor of the development of PTSD.
  
  Section::::Exposures and conditions.:Reactions.
   Hundreds of thousands of tons of toxic debris containing more than 2,500 contaminants, including known carcinogens, were spread across Lower Manhattan due to the collapse of the Twin Towers. Exposure to the toxins in the debris is alleged to have contributed to fatal or debilitating illnesses among people who were at Ground Zero. The Bush administration ordered the Environmental Protection Agency (EPA) to issue reassuring statements regarding air quality in the aftermath of the attacks, citing national security, but the EPA did not determine that air quality had returned to pre-September 11 levels until June 2002.
   On September 11, 2001, 19 terrorists associated with the Islamist militant group al-Qaeda hijacked four passenger jets in a series of suicide attacks on the United States, killing 2,996 people and injuring more than 6,000 others. Hijackers flew planes into two main towers of the World Trade Center, resulting in the collapse of three buildings of the World Trade Center complex, and the Pentagon, resulting in the partial destruction of the western side in the building. The resulting dust cloud due to the collapse of the World Trade Center covered Manhattan for days and contained thousands of tons of toxic debris, including asbestos and other known carcinogens. Another hijacked plane crashed into a field in Shanksville, Pennsylvania following an attempt by the passengers to retake control of the plane. No one in the airliners survived.
   Apparently, out of at least 100,000 eligible, fewer than 14,000 have registered, as reported by the National Council for Occupational Safety and Health. The final registration deadline for September 11-related workers' compensation was August 14, 2007.
   Communications recovery worker Mark DeBiase, aged 41, died on April 9, 2006, from a Ground Zero illness. He worked without protective gear for restoring communications at the site. "DeBiase's work was so crucial in emergency workers to communicate that he was shuttled between locations in a military helicopter," according to his father, Angelo DeBiase.
  
  Section::::Vulnerable individuals.:Janitorial workers.
  
  Manuel Checo is one of many janitors that performed cleanup work who now suffer from "World Trade Center cough." He spent six months at the site. Compounding janitorial workers' troubles, three-quarters of them lack health insurance.
  
  Section::::Vulnerable individuals.:Financial district personnel.
   According to a report in "New York Magazine" some doctors believe that and have said that the carcinogens in the WTC dust accelerated cancers that were already under way in some rescue workers, either by promoting further mutations in genes whose cancerous transformations were nearly complete, or by tampering with genes that suppress these deadly mutations. Exposure to the unprecedented combination of carcinogens and immune suppressants in the dust caused shortened latency periods for cancers that would generally take far longer to develop.
  
  Section::::Personal life.
   As of 2008, the New York State Department of Health had documented at least 204 deaths of rescue and recovery workers since September 11, 2001. 77 of these individuals died of illnesses, including 55 from lung and various other cancers. Kitty Gelberg, New York state Bureau of Occupational Health's chief epidemiologist said, "We're not saying they are all World Trade Center related; we're just saying this is what people are dying from." Many of the 55 responders who died from cancer had cancer before September 11, 2001, but most of the cancer patients developed the disease afterward.
   Various health programs have arisen to deal with the ongoing health effects of the September 11 attacks. The World Trade Center Health Program, which provides testing and treatment to 9/11 responders and survivors, consolidated many of these after the James Zadroga 9/11 Health and Compensation Act became law in January 2011.
  
  Section::::Exposures and conditions.
   In particular, "first responders," New York Police Department and Fire Department of New York members that reported to Ground Zero, have asserted that they are victims of diseases associated with the toxic cloud from the pulverized buildings and equipment.
  
  NYPD Detective James Zadroga, 34, was the first 9/11 responder whose 2006 death was directly linked with toxic Ground Zero substances.
   These toxic exposures have led to debilitating illnesses among rescue, recovery, and cleanup workers, and the pulmonary fibrosis death of NYPD member Cesar Borja. Increasing numbers of cases are appearing in which first responders are developing serious respiratory ailments. Health effects also extended to some residents, students, and office workers of Lower Manhattan and nearby Chinatown.
  
  Dr. Edwin M. Kilbourne, a high level federal scientist, issued a memo on September 12, 2001, to the Centers for Disease Control and Prevention advising against the speedy return to buildings in the area because of possible hazards from various toxic materials.
   An ongoing Pennsylvania State University/Monmouth University study reported that respiratory illnesses grew by more than two hundred percent in the year and a half after the September 11 attacks. (This was the first study that monitored police officers at the Ground Zero site. It was published in the "Journal of Occupational and Environmental Medicine.") In this study of 471 police officers, 19 percent of the officers in October 2001 experienced shortness of breath; 44 percent of the officers experienced shortness of breath in April 2003. The percentage of the 471 officers coughing up phlegm increased from 14 percent in October 2001 to 31 percent in 2003.
  