Not all the victims of 9/11 died on 9/11/2001.

I read an article about how three FDNY firefighters died in one day last week, of illnesses linked to their work at Ground Zero. It was a timely piece of news while reading this account of the health effects (known and/or suspected) of the dust people were exposed to as a result of the 9/11 attack on the World Trade Center.

The Twin Towers collapsed with such force that building materials, office contents, and victims were largely pulverized into a massive cloud of dust that blotted out the sun and choked all the people in its path -- emergency responders and civilians -- as it plumed outward from Ground Zero. As the dust settled, it penetrated nearby office and residential buildings. The dust was caustic, and contained toxins such as asbestos (from fireproofing) and lead (from thousands of pulverized computer monitors). Those working on "the pile" at Ground Zero, first in desperate rescue attempts and then in the recovery/cleanup process that followed, were exposed in large doses for long periods of time. People who lived and worked in the area were exposed, too, finding bits of Ground Zero dust in their residences and offices for years as furniture was moved or ductwork was renovated.

Anthony DePalma explores the messages put out by city and federal officials about the safety of the air near Ground Zero, the issue of safety precautions (or lack thereof) for those working the rescue/recovery effort, and the health issues which soon began to crop up among those exposed to the dust. It is a complex book because it is a complex subject. I think he did a fairly even-handed job, on the one hand arguing that the message given out regarding the safety of the air was deceptive, but also that workers often shirked safety equipment when such equipment was offered (and explains the complex reasons why).

He shows that, clearly, many workers suffered serious health issues as a result of the dust, while pointing out that not every Ground Zero worker who got sick was necessarily sick as a result of work at Ground Zero. He reminds us that that many of the illnesses caused by environmental exposures don't show up until many years later, which creates ongoing fear for those at risk. He explores the difficulty of linking cause and effect in diseases like cancer. He introduces us to the doctors who struggled to provide appropriate screening and care to those who needed it. He unravels the bureaucratic wrangling which had the government talking out of both sides of its mouth, so to speak, as they dealt with the environmental impact of 9/11; and the legal wrangling that stretched on for a decade and probably is still going on. It's a thought-provoking, frustrating piece of journalism. ( )