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Information for Rescue Workers

Assessing Your Risk
Specific Safety Precautions:

1. Obtain and use proper safety equipment
    Safety Equipment Needs
    Correct Use of Safety Equipment
2. Reduce contamination
3. Cleanse your body
4. Reduce your toxic load
5. Asbestos Safety Information from the White Lung Association
6. World Trade Center Catastrophe Worker Health Fact Sheet

Where to Get More Information

Rescue Workers Stay Well!
Protect Yourselves!

Assessing Your Risk

You are at risk

There are many news reports saying rescue workers, residents, and others in the area of the crashes are "safe" from toxic exposures. This is not true. If you read the reports carefully you'll see that they aren't really saying this at all. They are saying risks are minimal for healthy people wearing protective equipment. And that the risks are larger for those with immune problems, asthma, heart conditions, or chemical sensitivities. Asbestos risks are also much greater for smokers.

The reports often say no or low-levels of toxins were found in air samples. Read between the lines. The mayor of New York, other government officials, and the media are focused (quite rightly) on rescue attempts and immediate threats to human life. When they say the risks are low, they mean the risk of immediate reactions.

Most of them do not accept the idea of long-term, low-level exposures causing chemical sensitivities (or the other problems those of us connected with Immune Web have), asthma, cancer, and so on. They are not going to suddenly gain a new awareness of these risks for people working or living in or near the crash sites. The politics of asbestos are equality complicated. Even today you have powerful asbestos companies claiming their (former) products do not cause serious illness. It is similar to what is happening in the tobacco industry. Unfortunately, future liability is often a larger consideration than human health. The officials in New York care about your safety, as do us citizens watching on the sidelines. But sometimes it's harder to see the long-term picture.

Assume the air, dust, and smoke are toxic and proceed accordingly

Be a bit overcautious now. If you are near the crash sites, wear protective equipment, even if others around you are not. If you are a rescue worker, insist on complete protection (suits, eyes, nose/mouth, etc) and use it! Respirators are useless if they are hanging around your neck. Take precautions with your indoor air quality. If you were exposed to the dust from the World Trade Center buildings coming down, assume it is loaded with asbestos. Take appropriate cleanup measures in your home, car, workplace, and anywhere else you may have tracked the dust.

If it turns out there was no asbestos or other toxins to worry about, you will have only inconvenienced yourself. If it turns out there is asbestos and other toxins, you may have saved your life or your health. Don't take chances! Prepare for the worst case scenario.

If you are a rescue worker, you are taking grave risks just by working under the shadow of crumbling buildings. All of us in America and around the world salute you for your courage and dedication. It would break my heart though to hear that, twenty years from now, large numbers of you ended up with lung cancer or other asbestos-related illnesses. Or that a month from now many of you ended up with occupational asthma or chemical sensitivities. Please protect yourselves so that your work can continue.

Those of you living in New York City or areas surrounding any of the crash sites should also be careful. Smoke can aggravate many medical conditions, even if the only damage is from particles in the air, and it's certain that is not all that is in the smoke. If you were exposed to WTC dust, assume it has asbestos and proceed accordingly. If you need to go out, wear a respirator. Those paper and cloth filters are basically useless. They filter out a few particles, nothing more (and definitely not asbestos). At least get a mask with a carbon lining. Better, use a canister mask with the type of filters that screw in. And wear it on your face; it does no good in your hand, around your neck, or on the top of your head.

Is there asbestos in the World Trade Center dust? Yes

We don't know how bad it is, but we know it is there. Most of the official reports say there are "low levels" of asbestos present. Anything under 1% is considered "low," even though that is more than enough to cause serious illness. You are at risk even with low level exposures. If the reports turn out to be correct, there may be few health concerns, but why take the chance? It is better to assume the danger is there and protect yourself now, then to assume you're okay now but find out later you were not.

Is the smoke from the fires toxic? Absolutely

Experts have been interviewed on CNN and network news stations saying the smoke is toxic. It's easy to dismiss smoke as being from burning wood, but that is not what these fires are from. One major component of the flammable material is jet fuel. The planes both had full tanks when they crashed. I've heard there was so much fuel it leaked down through the towers before the collapses. Many people reported smelling the jet fuel smoke in the air. Natural gas from lines inside the buildings is also contributing to the smoke. Office furniture is generally either plastic or pressboard-type wood (wood treated with large amounts of formaldehyde-containing glues). Carpets are petrochemical based (nylon, polyester, etc). These are all burning in large amounts. Other contributors include: paint, freon from air conditioning, pesticide residue and probably stored containers, insulation, metal, drywall, wood that may have been treated with arsenic (pressure-treated) or other pesticides, papers, ink, computer and other equipment, stored cleaning supplies, cans of various toxins in offices and bathrooms, and many other things. The expert I saw on TV specifically mentioned jet fuel (as number one), natural gas, and office furniture.

Specific Safety Precautions

These are minimal precautions. There is nothing that will guarantee your safety. But you can reduce your risk. If you are told to do more than the suggestions here, follow that advice.

1. Obtain and Use Proper Safety Equipment.

Workers at the Pentagon site (shown below) had protective suits, canister masks, and eye protection from the beginning. In nearly all of the photos and news coverage I have seen at the site, they use their equipment correctly and whenever they are being exposed to smoke or dust. New York rescue workers, unfortunately, are not as lucky. They do not have access to enough equipment and no one is giving orders that they must use it. What this means is the New York rescue workers and others at ground zero are at risk.

We don't know exactly what toxic materials are at each site, but the World Trade Center site is objectively worse. There is far more dust and smoke present and it is harder to find clean air to take a break. This makes it even more important to have the proper equipment.

Safety Equipment Needs

Message from Janice Comer Bradley
(link to full correspondence)

The respiratory protection that search and rescue workers need are 1/2 mask respirators with N-R-or P series filters with an efficiency rating of 95 or greater. This is the filter portion of the respirator and does nothing for gases or smells from the decaying bodies. They also need an organic vapor/acid gas canister which absorbs odors and harmful gases.

Sanitation of respirators is necessary to ensure that the air is clean within the mouthpiece. In addition, any workers that are welding or cutting metal beams etc. need welding face shields and welding goggles and shields.

Here is the list of PPE (personal protective equipment) needs:

  • Half mask or full face air purifying respirators with N-R- or P, 95 or greater filters and OV/AG canisters.
  • Welding face shields with auto-darkening lenses.
  • Neoprene, nitrile gloves
  • Protective eyewear or goggles
  • Hard hats
  • Limited use-protective clothing such as Kimberly Clark's SMS suits, Dupont Tychem and Tyvek and Kappler Proshield and Proshield 2 full body protective suits that do not require decontamination.

Correct Use of Safety Equipment

  1. Choose a mask that filters the toxins you will be in contact with. Canister respirators are better than particle masks. Paper and cloth filters are useless
  2. Make sure the mask fits you well
  3. Put the mask on, put all straps in place, and tighten the straps
  4. Keep the mask on! It is useless around your neck; take your breaks in clean air
  5. Change your mask's filters as often as needed (if you can smell toxins, or need to breathe harder than before, it's time to change the filters)
  6. Full face masks are best; otherwise, choose and use appropriate eye protection (not regular eye glasses)
  7. Wear protective suits; do not allow contaminated clothes or shoes to go into your home or car (at the very least, set aside a set of clothes just for rescue work, keep it in a plastic bag, and throw it out when you are done--do not wash contaminated clothes with other clothes)
  8. Use other protective gear (hard hat, gloves, boots, etc) as required
  9. Err on the side of caution; use the safety equipment required by the worst case scenario
  10. Work with the equipment. Think of it as an extension of your skin, not as an annoyance. It will help you do your job better and keep you healthy so you can keep working

Pentagon Cleanup Worker
Pentagon Cleanup Workers
Arlington, VA, September 13, 2001 -- Urban Search and Rescue crews from Montgomery County work to clear debris and strengthen support at the crash site following Tuesday's attack. Photo by Jocelyn Augustino/ FEMA News Photo
Arlington, VA, September 13, 2001 -- Urban Search and Rescue crews from Montgomery County work to clear debris and strengthen support at the crash site following Tuesday's attack. Photo by Jocelyn Augustino/ FEMA News Photo

2. Reduce Contamination

Asbestos dust lasts forever and it is easy to track it into your car, home, or elsewhere. Protect your family by keeping dust away.

If you are a rescue worker, wear a protective suit whenever you are working. The suit should have long sleeves and pants and be set up so that there is no way dust can enter at your wrists (wear gloves) or ankles. Protect your hair and face as much as possible. Do not wear the dirty suit off site.

If such a suit is not available to you, put aside a set of old clothes to be your work clothes. They should have long sleeves. If you can, keep them on site. If that is not possible, keep them in a sealed plastic bag in your car or by your front door, away from your sleeping area. Change clothes before getting into your car or on public transportation. Use a separate clean plastic bag to hold your clothes for home and your commute. When the work finishes, put the clothes in a bag and throw them away. You will probably need to go through several sets of clothes so make use of donations and thrift shops.

In addition to asbestos, clothing can pick up toxic smoke, VOC's, and other chemicals. It is especially important not to sleep in the clothes you used to work in or to keep them near your sleeping and home living space.

Also change your shoes! Shoes will track dust all over your home.

If you are a New York resident who is being exposed to dust or smoke, set aside sets of indoors and outdoors clothes. Change immediately upon coming home or right before you go out. Keep outdoors clothes in plastic bags and wash them separately. Remove your shoes at your front door.

If you have clothes that have been coated with WTC dust, throw them away. They are not worth saving.

Do not vacuum WTC dust with a regular vacuum; it will only stir it up and spread it further throughout your air space. Follow expert instructions for decontaminating a home. Assume the dust contains asbestos and proceed accordingly.

3. Cleanse your body

Whenever you have been exposed to toxins the very first thing to do when you get home is to take a shower. No matter how drop dead tired you are, this step is essential. Remove your clothes before you sit down on anything. For minor smoke exposures, put them in the laundry (not in your bedroom). For larger exposures, deal with them as discussed above.

Go immediately to the shower. Wash your body, face, and hair. Especially your hair. Scrub everything well.

A good way to remove odors and grime is with baking soda. You can even wash your hair with it (make a paste with baking soda and water). Baking soda is slightly abrasive, so it makes a good mild scrub. Rinse well. Vinegar (plain white is fine) also helps (it will improve the condition of your skin and hair too). Use vinegar last if you choose to use it. Then rinse well with plain water.

Wash your hands well before you eat when in the field. Wash your face and eyes as often as needed (if you need to do this a lot, try to get a full face mask or goggles without air access on the sides).

4. Reduce your toxic load

Toxic exposure is cumulative. Every bit you can do to lessen the load on your body lowers your risk of long-term effects.

When your lungs are trying to stay clear and your liver and detox systems are working overtime to process what you're exposing your body to, it makes sense to stay away from additional toxins and to strengthen your body's systems.

As much as possible, try to avoid:

There are many ways to help your body clear the toxins. Here are a few:

5. Asbestos Safety Information from the White Lung Association

Asbestos Safety Information
Paul Safchuck
President, White Lung Association

Question (questions by Cyndi Norman): There are new cases of people getting exposed to the dust. Most of these have past but there may be more buildings coming down and anyone walking through the area will get the dust on their shoes, clothes, etc. Rescue workers are at greatest risk. The authorities are rinsing people with hoses and saying to launder dusty clothes separately, but I don't think that's enough, do you?

The destruction of the WTC buildings, particularly the Twin Towers has caused a great release of various toxins. It is unfortunate that those who are our heroes in the rescue and the innocent bystanders are being exposed to asbestos.

Over five thousand tons of asbestos were used in just insulation for the structural steel. The tragic attack on these buildings has rendered much of this to environmental dust. One only has to look at how NYC responded to the exploded gas or steam lines to see how difficult this problem will be for years to come. It is sad that lack of proper protection for the heroes and their support personnel and supporters has allowed the terrorists to plant miniature bombs in the lungs of thousands, if not millions, of those in New York City.

Spraying individuals off with fire hoses is a crude form of decontamination. Proper decontamination is relatively simple and quite possible to establish at Ground Zero. It would consist of tent stations in which the workers would leave though.

The magnitude of this tragedy makes many of the traditional ways of controlling asbestos dust impossible to use. However, public information, which would warn bystanders and promote personal protection amongst workers, is still an option. It is an option that should be utilized.

Question: What should you do if you've already tracked the dust throughout your home, car, work, etc?

Asbestos contamination of a home is very difficult to clean up. Under most conditions this job should be done by a company licensed to handle asbestos. If the home owner is unsure about the contamination and wants to take precautions for removing suspected dust, they may wish to follow these guidelines:

  • Asbestos contaminated dust must be taken up wet, such as wet cloth.
  • The cloth must be disposed of in a sealed bag.
  • Do not use normal vacuums on this dust. Asbestos fibers are too thin to be trapped by normal vacuum filtration.
  • The filtration which captures most of the asbestos fibers is known as High Efficiency Particulate Air Filter or HEPA. This filtration removes 99.97% of the fibers whose widths are .25 microns or greater.

If rugs, carpets and clothing are contaminated it is many times easier to bag them up and dispose of them. Automobiles and homes can be cleaned professionally by licensed professionals.

Question: How can you protect yourself if you live in the area--can asbestos be in the air?

Asbestos is most certainly in the air, to what amount is yet to be known. The farther you are from Ground Zero and the farther you are away from the wind currents going through Ground Zero, the better. Air conditioners should be set to recycle air rather than bring in fresh air. All dust should be wet wiped up where possible. You should not go to Ground Zero or close to it without respiratory protection, full body cover and disposable booties.

Question: What do you think about the advice for residents to close their windows and run the air conditioning? I read in another article that air conditioning ducts pull in asbestos and distribute them throughout a building.

See above, definitely keep windows closed if possible.

Question: How should you protect yourself if you are walking or driving through an affected area?

Unless you have full body protection and a respirator which is approved for asbestos use by the National Institute of Occupational Safety and Health (stamped on the unit NIOSH approved) do not go into this area. Until this area is thoroughly cleaned no one should go there unless they have a reason which is equal in weight to the elevated life time risk of cancer.

Question: How can protect yourself if you are a rescue worker (or other person) spending time around the WTC crash site. How can you not expose your family?

Do not bring your work clothes home, do not wear your work clothes in your car, do not work without full personal protection which includes respirator, body covering, and gloves. Leave all work-related clothing, tools, etc outside the home. Do not wash your contaminated clothing in your home. Discard it if possible in sealed plastic bags.

Question: What do you think of the statement that people at the WTC site don't have to worry because asbestos-based illness is the result of years of exposure, not a single one? I agree it's more likely the longer you are there, but isn't one small exposure enough for some people? And if you are covered with dust, head to toe, in the eyes, in the lungs, isn't that the equivalent of years of low to moderate level exposures?

The amount of exposure has not been measured to my knowledge. I would recommend that all rescue workers request air sampling where the samples are read with a Transmission Electron Microscope. I would also recommend that all workers retrieve one half 35 mm film canister of sample dust. This should be labeled and sent to a lab (pick from those in the phone book that advertise for asbestos analysis) with request for either Polarized Light Microscopy or Transmission Electron Microscope. The former is least expensive and is generally sufficient for most bulk samples.

6. World Trade Center Catastrophe Worker Health Fact Sheet

World Trade Center Catastrophe Worker Health Fact Sheet
New York Committee for Occupational Safety and Health
(link to full text)

Many of the workers involved in the World Trade Center recovery and cleanup operation have received safety and health training, but many other workers will be facing hazards that are unfamiliar, with the potential to cause serious illness, injury or death. The site is in a constant state of flux, with the result that new hazards can suddenly emerge. Workers and managers need to understand the existing hazards and how to minimize them as well as being alert to the possible development of new hazards.

This factsheet is for workers who are engaged in recovery efforts, as well as for those involved in the restoration of essential services and cleanup operations. All this work involves potentially unsafe conditions and exposures to hazardous materials.

ALL OF THE HAZARDS LISTED BELOW are likely to be encountered during World Trade Center recovery and cleanup operations. Anyone working at or near ground zero is more likely to encounter these hazards than someone involved in cleanup operations several blocks away, but at any location, dust and ash from the World Trade Center pose a potential health hazard.

DUST AND FUMES: Contaminated air poses health risks that depend on the nature and concentration of the contaminants and upon the physical condition of the exposed worker. Workers with any history of chronic conditions of the lungs or heart are at greater risk of adverse health effects from contaminated air.

Contaminants in the air, including toxic dust and chemicals, can cause serious illness or death. Dust and ash anywhere in the vicinity of the World Trade Center site is likely to contain asbestos, cement, drywall and polyvinyl chloride (PVC) combustion products.

CEMENT DUST AND DRYWALL DUST usually contain crystalline silica. Inhalation of silica dust can cause silicosis or other potentially fatal lung diseases. Cement dust can be irritating and can cause or worsen asthma and chronic bronchitis.

AIRBORNE PARTICLES OF BURNED PLASTIC, INCLUDING POLYVINYL CHLORIDE (PVC) or other plastics from insulation, conduit, furniture, etc., may cause respiratory irritation and provoke or worsen asthma and chronic bronchitis.

ASBESTOS was a major material used in the construction of the World Trade Center. That asbestos is a constituent of the dust and debris. Inhalation of asbestos fibers can result in serious or fatal diseases, including cancer. Although there is no known safe level of asbestos exposure, higher levels of exposure result in greater risk of disease.

OTHER DUSTS may cause asthma or bronchitis or other respiratory problems, such as difficulty breathing. Any dust can cause eye irritation. Some dusts can cause allergic skin reactions. If dusty work clothes are worn off the job, they can contaminate vehicles and residences.

HAZARDOUS GASES: Another concern in the World Trade Center area is the possible build-up of toxic or explosive gases from ruptured gas lines or stored chemicals. Of most concern is the presence of such gases in confined or restricted spaces.

FLAMMABLES OR EXPLOSIVES may be released from ruptured gas lines and storage containers.

CARBON MONOXIDE, a colorless, odorless gas, may be present as a byproduct of combustion (fire). Inhalation of carbon monoxide can cause a wide range of health effects, from loss of judgment to death by asphyxiation.

OXYGEN DEFICIENCY: There may not be enough oxygen present in the air to support breathing. This can result from other gases (such as carbon monoxide) replacing oxygen. Oxygen can also be used up during combustion.

Exposure to other gases can cause eye, nose, throat or lung irritation. Workers who enter confined spaces are at highest risk for these hazards.

COMMUNICABLE DISEASES: Workers who are exposed to infected blood or other bodily fluids can become infected. For infection to take place, infected blood or body fluids must enter a workers body through the eyes, nose or mouth or through a break in the skin, such as a cut or abrasion.

UNSANITARY CONDITIONS: Workers skin and clothing may be exposed to a wide variety of toxic materials and disease organisms. Care should be taken to protect food, beverage containers and smoking materials from contamination.


PREVENTING EXPOSURE TO DUST: Some exposure to airborne dust is inevitable, but, wherever possible, dust and ash should not be disturbed in such a way that it becomes airborne. Wetting dust and ash with water before disturbing it will prevent it from becoming suspended in the air. During cleanup operations, dust and ash should never be swept or handled when it is dry. Do not vacuum dust with any equipment that is not equipped with HEPA filters.

RESPIRATORS: A respirator is a mask worn over the mouth and nose that filters out harmful contaminants in the air such as dust or chemicals. Some respirators also provide eye protection. Any respirator that does not provide eye protection should be worn with goggles. Wherever respirators are worn, there should be an adequate quantity of respirator cleaning supplies, replacement cartridges or replacement respirators.

Respirators are designed to provide protection from specific air contaminants. If you are wearing a respirator for protection from one substance, do not assume that it provides protection from any other substance. A respirator does not provide any protection if it does not fit properly, or if the seal is compromised by dirt.

A DUST MASK IS NOT A RESPIRATOR and does not provide protection from asbestos, silica or other hazardous particulates.

RESPIRATORS FOR WORKERS AT GROUND ZERO where there may be a wide variety of airborne hazards, should be rubberized masks with screw-in particulate P-100 or R-100 HEPA cartridges (not N-100). Workers at ground zero should not wear disposable respirators (even those rated P-100 or R-100) because working conditions there are extremely rough and disposable respirator seals are not likely to stand up to the conditions. Respirator cartridges should be replaced once a shift at minimum or whenever there is an increase in the difficulty of breathing through them.

RESPIRATORS FOR WORKERS AT LEAST SEVERAL BLOCKS FROM GROUND ZERO, where dust and ash is the main air contaminant, should be rated N-100 or P-100 or R-100. Respirators with replaceable cartridges are preferable, but disposable respirators rated N-, P- or R-100 are acceptable if they can be protected from conditions that compromise the seals. Disposable respirators (or respirator cartridges) should be replaced once a shift at minimum or whenever there is an increase in the difficulty of breathing through them.

Respirators that protect from dust cannot provide protection for oxygen deficiency or flammable and toxic gases. The air in an unventilated area where toxic or flammable gases may be present should be tested before workers enter. No one who has not been trained and qualified in confined-space entry should enter an area where these hazards are present.

PROTECTIVE CLOTHING: Goggles should be worn during all work operations for protection from irritating dust. Protective clothing should be worn so you can change out of your work clothes before returning home. Work clothes should be bagged at work and washed separately from personal laundry to prevent contamination.

UNIVERSAL PRECAUTIONS FROM BLOODBORNE DISEASES: For protection against bloodborne diseases, follow Universal Precautions: (1) treat all bodily fluids as if they are infected; 2) place a physical barrier (such as latex gloves, goggles or face mask) between you and the fluid; and 3) dispose of all potentially-infected materials as segregated medical waste.

SANITATION FACILITIES: When you eat, drink or smoke you may ingest any toxic materials that are on your clothing, hair or skin. If you are exposed to any toxic materials, it is essential to wash before doing anything that could result in ingesting them. If washing water is not available, moist towelettes should be used before eating. It is also essential to remove contaminated work clothing to prevent the contamination of vehicles or homes.

Where to Get More Information:

If you are interested in more suggestions, or ones that take your specific situation into account, feel free to join the Immune mailing list and ask as many questions as you wish.

Or you can write me at cyndi@immuneweb.org.

Rescue workers, or those coordinating rescue efforts, are welcome to phone me, Cyndi Norman, at 510-531-5464. I will answer as many questions as I can. If I don't know the answer, I probably know where to find it out. This is my home number in Oakland, California (3 hours earlier than New York). Please call between 10am and 10pm Pacific Time, unless it is an emergency.

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Cyndi Norwitz / webmaster@immuneweb.org / Last Modified: 10/10/01