Leukemia in 9/11 First Responders and Survivors
Leukemia is one of the most common types of cancer diagnosed among 9/11 responders and survivors. Leukemia – like lymphoma and multiple myeloma – is a cancer of the blood and bone marrow.
The Zadroga Act lawyers at Hansen & Rosasco, LLP represent many first responders and Downtown Manhattan residents and workers diagnosed with leukemia, as well as many other types of 9/11-related cancers.
A recent study found that first responders at the World Trade Center on September 11, 2001, have significantly greater rates of genetic mutations that increase the risk for blood cancers and cardiovascular disease. This study supports the presumptive known link recognized by the WTC Health Program between exposure to 9/11 toxins by responders and downtown workers and residents and blood/lymphoid tissue (including lymphoma, myeloma, and leukemia).
The study began after the FDNY chief medical examiner noticed that firefighters were being diagnosed with cancer at their annual physicals much younger than anticipated.
The study results are a strong argument for annual cancer screenings for first responders exposed to the toxins at Ground Zero. The findings have prompted one of the researchers who authored the study to suggest that the World Trade Center Health Program (WTCHP) should offer genetic testing—which is costly and not always covered by health insurance—for those at the highest risk.
About the Study
The study, published in the March 7, 2022, issue of Nature Medicine, was conducted by scientists from Vanderbilt-Ingram Cancer Center and researchers from New York. The Vanderbilt-Ingram team accessed the DNA of 203 Nashville firefighters extracted from blood collected during routine physical testing.
The de-identified DNA from the Nashville firefighters, combined with DNA from 52 firefighters who gave samples at the annual convention of the International Association of Firefighters, created a 255-person control group to compare to DNA from 481 WTC-exposed first responders. In particular, the team studied 237 genes that often mutate in blood cancers such as leukemia.
The researchers found that 10 percent of the World Trade Center firefighters showed evidence of clonal hematopoiesis, compared to 6.7 percent of the control group. Clonal hematopoiesis is a common age-related genetic mutation within a person’s blood cells.
While the mutations provide the cells with a competitive advantage, they also increase the risk of blood cancers and cardiovascular disease. After controlling for gender, age, and ethnicity, researchers found that developing blood cancer or cardiovascular disease was two to three times higher for the firefighters exposed to the toxins at Ground Zero than for those in the control group.
In addition to studying the firefighters’ DNA, researchers also exposed mice to particulate matter found at Ground Zero in a similar dosage to what first responders absorbed.
Thirty days after exposure, the mice exhibited a significant increase in hematopoietic stem cells. This offered additional support for the researchers’ conclusion that the World Trade Center first responders’ increased mutational burden places them at a heightened risk of blood cancers. Additional studies on particulate matter and how it relates to blood cancer continue.
The Types of Blood Cancer Covered by the WTCHP
According to the WTCHP, three types of blood cancers—leukemia, lymphoma, and myeloma—commonly occur in first responders exposed to the 9/11 dust plume and covered by the WTCHP. These are also types of cancer identified as apparent risks by the recent Vanderbilt-Ingram study. Here is an overview of each.
About 500 first responders and 423 survivors who participate in the WTCHP have been diagnosed with leukemia. This type of cancer occurs in the body’s blood-forming tissues, including bone marrow and the lymphatic system. There are many types of leukemia, with some forms being more aggressive than others.
Symptoms vary but can include:
- Bruising or bleeding easily
- Recurring nosebleeds
- Tiny red spots on the skin
- Fatigue or weakness
- Bone pain or tenderness
- Frequent or severe infections
- Unexplained weight loss
- Excessive sweating, particularly at night
- Swollen lymph nodes
- Enlargement of the liver or spleen
708 WTC responders and 737 survivors had been diagnosed with lymphoma in late 2021, making it the fifth most commonly diagnosed cancer in the 9/11 community. Non-Hodgkin lymphoma is a type of cancer that originates in the body’s lymph system, which is part of the body’s immune system. This condition causes tumors to develop in the lymphocytes, a type of white blood cell.
Some common symptoms of Non-Hodgkin lymphoma include:
- Swelling of one or more of the lymph nodes in the neck, armpit, or groin
- Fever and night sweats
- Unexplained weight loss
As explained by the NYC Department of Health, individuals exposed to the dust at Ground Zero are more likely to acquire non-Hodgkin lymphoma than the general population.
Doctors diagnosed multiple myeloma in 232 responders and 274 survivors in the WTCHP. It is cancer that forms plasma, another type of white blood cell. The condition causes cancerous plasma cells to accumulate and crowd out healthy cells in the bone marrow. While healthy plasma cells make antibodies that help the body fight off infections, plasma cells in a person with multiple myeloma produce abnormal proteins.
Some common symptoms of multiple myeloma include:
- Bone pain, most commonly located in the spine or chest
- Loss of appetite
- Mental fogginess
- Weight loss
- Frequent infections
- Excessive thirst
- Weakness or numbness in the legs
How Do Doctors Determine if a Blood Cancer Diagnosis is the Result of 9/11?
Research like the recent Vanderbilt-Ingram study indicates that responders and survivors who were in the NYC exposure area on 9/11 or in the months that followed have an increased risk of blood cancers, including leukemia, lymphoma, and myeloma. One commonly asked question is: How do I know if 9/11
caused my cancer?
If you were exposed to the 9/11 toxins between 9/11 and July 31, 2002 and you meet the WTC Health Program requirements in the Administrative Manual, then there is a presumption that the 9/11 exposure caused your cancer.
One of the WTCHP requirements is that a 9/11 patient meet the “latency period” requirement. The latency period is the time that passes between exposure to a cancer-causing material and cancer diagnosis. Blood cancers have a minimum latency period of around 146 days. This means that if the individual meets the guidelines for exposure to the WTC dust in Lower Manhattan and at least 146 days passed between the exposure and diagnosis.
What Are the Exposure Guidelines for WTCHP Eligibility?
The exposure guidelines for WTCHP eligibility for each of the member groups include:
- FDNY firefighters who worked on the rescue and recovery effort for a minimum of four hours spent between September 11, 2001 – July 31, 2002, at Ground Zero, the Staten Island Landfill, or the NYC Chief Medical Examiner’s Office.
- WTC General Responders who worked or volunteered in the rescue, recovery, or cleanup operations or support services related to those operations for a minimum of four hours from September 11 to September 14, 2001; 24 hours between September 11 and September 30, 2001; or a minimum of 80 hours between September 11, 2001, and July 31, 2002, in Lower Manhattan (south of Canal Street), at the Staten Island Landfill, or certain barge loading piers.
- Active or retired members of NYPD or the Port Authority Police of the Port Authority of New York and New Jersey who participated in rescue, recovery, or debris cleanup operations for a minimum of four hours in Lower Manhattan, at Ground Zero, at the Staten Island Landfill, or certain barge loading piers between September 11 and September 14, 2001; or a minimum of four hours on-site at Ground Zero, the Staten Island Landfill, or certain barge loading piers between September 11, 2001, and July 31, 2002; or a minimum of 24 hours in Lower Manhattan between September 11 and September 30, 2001; or a minimum of 80 hours in Lower Manhattan between September 11, 2001, and July 31, 2002.
- Employees of the NYC Office of the Chief Medical Examiner and other morgue workers who performed similar functions spent a minimum of 4 hours at the Office of the Chief Medical Examiner or at the morgue at Bellevue Hospital between September 11, 2001, and July 31, 2002.
- Port Authority Trans-Hudson Corporation Tunnel Worker who spent a minimum of 24 hours in the Port Authority Trans-Hudson Tunnel between February 1 and July 31, 2002.
- Vehicle maintenance workers who were exposed to debris from the former WTC site while retrieving, driving, cleaning, repairing, and maintaining vehicles that had been contaminated by WTC toxins for a minimum of four hours between September 11, 2001, and July 31, 2002.
- WTC survivors (those who worked, lived, or attended school or daycare in the area) who were present in the dust cloud on September 11, 2001; or who were present for a minimum of four days in the NYC exposure area between September 11, 2001, and January 10, 2002; or for at least four hours a day for a minimum of 30 days between September 11, 2001, and July 31, 2002.
- WTC survivors who worked as cleanup workers or performed maintenance with significant exposure to the 9/11 dust in the exposure area for a minimum of four hours between September 11, 2001, and July 31, 2002.
- Individuals who lived or worked within the exposure area who could receive a grant from the Lower Manhattan Development Corporation between September 11, 2001, and May 31, 2003.
- Shanksville responders who spent at least four hours at the terror site in Shanksville, PA, between September 11 and October 3, 2001.
- Pentagon responders who spent at least 4 hours working at the terror site at the Pentagon between September 11 and November 19, 2001.
What Happens if You’re Diagnosed With Blood Cancer and You’re a WTCHP Member?
Individuals who enroll with the WTCHP are eligible to receive a free annual health screening. If that screening gives your medical team reason to suspect blood cancer, tests will determine which type of cancer you may have.
After doctors diagnose you, further tests will determine the progression of the disease. After determining that, doctors will certify your condition as 9/11-related and begin discussing your treatment options with you.
WTCHP members may receive free treatment for certified 9/11-related conditions, including surgical procedures, hospitalization, outpatient treatments, and prescription medications, as long as they seek these services from one of the programs, Clinical Centers of Excellence in New York City, or from partner physicians and pharmacies in the program’s Nationwide Provider Network.
The certification of the condition also satisfies one of the criteria to be eligible to file a claim for financial compensation from the September 11 Victim Compensation Fund (VCF).
To reserve your right to file a VCF claim and obtain compensation for your 9/11-related condition, you must register with the VCF within two years of the WTCHP’s certification of your condition. If the cancer was never certified by the WTCHP, you likely still have time to register and file a claim – even if many years have passed since you were first diagnosed.
Once you have registered, you can file a claim at any time between now and October 2090. In addition to compensating for wage loss and other out-of-pocket expenses you incurred due to the diagnosis, the VCF also provides compensation for pain and suffering of up to $250,000 for a certified 9/11-related cancer.
Obtaining WTCHP benefits and compensation through the VCF is hard. An experienced 9/11 lawyer can gather the evidence needed to prove your exposure to the toxins at Ground Zero or one of the other terror attack sites and can represent you in applying for, proving, and appealing decisions about benefits. For a free case evaluation, contact an experienced WTCHP/VCF benefits lawyer today.
We Represent 9/11 Victims Exclusively
Our Zadroga Act lawyers know the pain and fear of hearing a cancer diagnosis. It is our goal to minimize your stress concerning the 9/11 Victim Compensation Fund (VCF) process, so that you can focus the needed time and energy on yourself.
Leukemia begins in cells in the bone marrow. Over time, Leukemia cancer cells suppress the development of normal cells. There are different types of leukemia. The rate at which this cancer develops and how the cells replace the normal blood and marrow cells differs with each type of leukemia.
As a result, VCF cancer payouts differ between cases and conditions. The WTC Health Program provides benefits and coverage for the medical care and treatment for every eligible 9/11 victim, including for leukemia.
Types of Leukemia include:
- Acute Lymphoblastic Leukemia (ALL)
- Acute Myeloid Leukemia (AML)
- Chronic Lymphocytic Leukemia (CLL)
- Hairy Cell Leukemia (HCL)
- Large Granular Lymphocytic Leukemia (LGL)
Ask Our Zadroga Act Lawyers
Do you have questions about a 9/11-related cancer, VCF cancer payouts, or the WTC Health Program? The Zadroga Act lawyers at Hansen & Rosasco, LLP are ready to answer any of your questions. If you are seeking medical care or compensation for leukemia, please call us at 800-887-7299 or fill out a contact form here.
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