Twenty-five years after the September 11 attacks, the health crisis facing first responders and survivors continues to evolve, marked by thousands of deaths and ongoing medical struggles. New data from the World Trade Center (WTC) Health Program reveals that more than 9,400 individuals have died from illnesses linked to the terrorist attacks—triple the number of the 2,977 lives lost on the day itself.
Michael O’Connell, a New York City Fire Department (FDNY) firefighter, was sworn in just four months before being deployed to lower Manhattan. He spent weeks at ground zero fighting fires and conducting search-and-rescue operations amid the rubble. For years, O’Connell remained healthy, but on New Year’s Day 2007, he awoke in severe pain with his body inflamed and covered in bruises and blisters. He was eventually diagnosed with sarcoidosis, a multi-system inflammatory disease affecting the lungs, skin, and lymph nodes, which doctors attribute to his exposure to toxins at the site.
O’Connell is one of many affected by what experts call a “toxic cocktail” of asbestos, benzene, glass, metal, and other hazardous particles released when the Twin Towers collapsed. Fires within the debris pile burned through late 2001, with flare-ups continuing into 2002. The Environmental Protection Agency (EPA) had declared the air safe to breathe at the time, a stance that has faced significant scrutiny.
A Legacy of Illness and Loss
The CDC reports that an estimated 400,000 people were exposed to toxic dust, smoke, and debris, as well as physically and emotionally stressful conditions. To date, the WTC Health Program has certified at least 69 types of cancer—including breast, prostate, skin, and head and neck cancers—as linked to 9/11. Approximately 50,000 cancer diagnoses have been certified, alongside airway, digestive, musculoskeletal, and mental health conditions.
Michael Barasch, a managing partner at Barasch & McGarry, a firm specializing in compensation for responders, emphasized the longevity of the crisis. “The truth is, 9/11 didn’t end on 9/11,” Barasch told ABC News. “I personally lost dozens of clients… but I have lost thousands of clients since.”
Morning of the Attacks
For NYPD Sergeant Thomas Wilson, the day began with a routine burglary investigation in Brooklyn. When reports came in that a plane had hit the World Trade Center, Wilson headed toward the Williamsburg Bridge. He recalls helping to secure the bridge as thousands of people fled Manhattan on foot. “I’m still haunted. Covered in dust… That mass exodus out of Manhattan still sticks with me,” Wilson said.
Wilson later contributed to recovery efforts at ground zero, logging approximately 350 hours, and worked as a sifter at the Fresh Kills Landfill on Staten Island. He was issued disposable suits and respirators, but noted that 12-hour shifts exceeded the eight-hour filter limits of some respirators. Wilson was later diagnosed with aggressive neck cancer that spread to his tongue and skeletal muscle, a condition linked to inhaling dangerous toxins.
FDNY Emergency Medical Technician Ivonne Sanchez arrived at the site after the towers fell and worked for about 20 straight hours. She described the dust as so thick she could not see. Sanchez did not receive a proper mask until October, when OSHA inspectors conducted mandatory fittings. For months prior, she endured coughing, nosebleeds, and vomiting after shifts. She ultimately retired in 2002 due to injury.
Debate Over Air Safety
Recent document releases by New York City Mayor Zohran Mamdani include over 170,000 pages related to the attacks, including the “Harding Memo.” Dated October 2001, the memo from then-Deputy Mayor Robert Harding indicated the city was aware of air quality dangers and legal liability, despite public assurances that the air was safe.
Christine Todd Whitman, the EPA administrator during 9/11, apologized in a 2016 interview for “whatever we got wrong” but denied knowingly lying about air quality. The city has not yet responded to requests regarding potential toxins or allegations of unsafe air declarations.
As research continues into the cumulative effects of toxic exposure, the human toll remains stark. FDNY demolition supervisor John Feal, who arrived on September 12, recalled the haunting sound of PASS alarms—devices that beep when firefighters remain motionless. “That’s all you heard were those alarms when we first got there,” O’Connell remembered. “You couldn’t [get to them]. They were underneath that pile.”
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