The Twin Towers came down in a cloud of toxic dust. Its health impact has lasted decades

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As a child growing up in Queens, Frank Kotnik watched the Twin Towers across the river growing taller and taller as their construction neared completion.

As a teenager, he and his friends once snuck into the original World Trade Center, hoping to take in the views from the roof. They made it almost all the way up before getting busted by a security guard. Still, as Kotnik looked out the window from his vantage point, towering above Manhattan, he felt a sense of awe.

And as an adult, Kotnik drove with two of his buddies, directly from a 12-hour shift as a blacksmith for the New York City Department of Transportation, to Ground Zero on September 13, 2001. In disbelief, he walked through a “moonscape” where the towers once stood.

It was all dust – the bustling life contained in those towers, the office spaces, metals, desks and chairs, computers, plastics, cleaning products, electronics and more that once sat inside the original World Trade Center had been pulverized into a thick powder that rose above Lower Manhattan as the towers came down and lingered long after.

Kotnik spent weeks dedicating his time and skills to the response effort following the 9/11 attacks, sifting through the dust to cut steel and clear debris.

“Thousands of New Yorkers were murdered. I wasn’t going to go play golf. If I could help somehow, I was going to help,” Kotnik, now 66 and in recovery from bladder cancer, told CNN.

Nearly 25 years later, the release of over 170,000 pages of documents from New York City has left the public reckoning with what exactly was contained in that dust, how much officials knew at the time and the lasting health consequences now faced by thousands of people.

Some of the information contained in the documents revealed what officials and doctors have known for years – that the dust contained materials and chemicals that can make people very sick.

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The dust was a complex mixture of inorganic and organic chemicals that lingered for a long time in large quantities – making it different from the exposure to natural dust seen in people living in areas like the Great Plains or the Southwest, Dr. Ana Navas-Acien, chair of environmental health sciences at Columbia University’s Mailman School of Public Health, told CNN.

“It’s not common for humans to be exposed to that level of dust,” Navas-Acien said.

Particularly concerning are the inorganic materials in the dust, including metals like cadmium and lead, she said.

“We know that metal inhalation means complete absorption very often, and those metals are not supposed to be in the body. They are going to be interacting with our own proteins. They are going to be absorbed in our different tissues, especially where minerals and metals are very relevant, such as the bone,” she noted.

Those metals can persist in the body for decades, she said.

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Other materials found in the dust include asbestos , a known carcinogen which lingered after the attacks and has long been linked to mesothelioma, a rare and aggressive cancer with a long latency period and symptoms that often don’t present until many years later, according to the Mesothelioma Center .

Other materials like wood, plastics and glass were also pulverized into fine particles contained in the dust.

“They became very, very thin, very fine particles,” she said. “The finer they are, the more deep into the lungs they can reach.”

People who were in and around the dust weren’t just dealing with exposure to one material or chemical, Navas-Acien noted, it was a mixture of all of them. That dust could have impacts on the lungs, brain, cardiovascular system and more, she said, and researchers are still trying to understand the scope of the health consequences.

In addition to the years-long research already done in this area, experts are now poring over pages upon pages of the newly released documents to determine whether they’ve fully and accurately characterized exactly what was contained in the dust around Ground Zero.

Over the years, Kotnik had watched his friends who worked with him after 9/11 fall ill. Some got cancer. Some got brain tumors. Some died.

Two decades after Kotnik spent time working in the moonscape of dust that blanketed Lower Manhattan, he discovered blood in his urine. Testing soon revealed that he had bladder cancer.

Courtesy Northwell Health

At one point, a friend of Kotnik’s suggested he enroll in the World Trade Center Health Program, so he did. The World Trade Center Health Program offers federal funding for the care of those with certain cancers and health conditions related to 9/11 exposure.

Dr. Jacqueline Moline, who directs the Northwell Health Queens World Trade Center Health Program, said she began treating patients in the immediate aftermath of 9/11 – before federal funding for the programs came in around 2002. She and her colleagues have since been monitoring the health effects they’ve seen as a result of the dust.

In the early days, Moline said they saw conditions like sinusitis, rhinitis, laryngitis, bronchitis, reactive airways disease, asthma, PTSD, anxiety and gastroesophageal reflux disease.

Much of what was contained in the dust “can penetrate into the tissue and cause irritation, and that may be why so many of the problems were longer lasting,” she said.

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The doctor noted she and her colleagues have seen permanent damage to the aerodigestive tract, including the upper and lower respiratory systems and the esophagus.

While many doctors have long known that asbestos, gypsum and other components of the dust made people sick, the level and persistence of contamination revealed in the documents released this week may help explain some of the long-lasting health conditions doctors have observed, Moline said.

About 10 years after 9/11, doctors began seeing cancers like mesothelioma, leukemia and lymphoma develop in World Trade Center Program patients, Moline noted.

“And over time we’ve seen more and more cancers, so we expect that we will continue to see a large number of cancers going forward,” she added.

Research into other potential health impacts, like mental health, cognitive function and fertility can help close the gaps in our collective understanding of the consequences of exposure to the dust, she noted.

For those who may have had exposure to the 9/11 dust, checking in with their doctors or joining one of the World Trade Center Health programs can be critical to early diagnosis and treatment, Moline said.

But treatment, as Kotnik found, is not always easy.

“Ain’t no joke,” he said of his chemotherapy sessions. “Kicks your ass.”

Eventually, Kotnik said he underwent a seven and a half-hour surgery, in which doctors removed his bladder and used a section of his bowel to create a new one. Before the surgery, Kotnik’s doctors at Northwell Health warned him the road ahead wouldn’t be easy.

“I’ll have a better quality of life if I go this way, but it’s a longer recovery period – and I’m still in it,” he said.

But Kotnik has never shied away from hard work. After 9/11, he spent years working on the Avenue of the Americas, the Brooklyn Bridge and other projects for the city’s Department of Transportation before retiring. His footprint is all over the city.

In Kotnik’s memory, those early days of working in the dust were “organized chaos.”

The renewed spotlight on that time has raised new questions about accountability.

“People got sick because the leaders they trusted lied and told them they were safe to breathe in toxic air,” New York Mayor Zohran Mamdani said during Tuesday’s announcement of the release of the documents.

At the time, few workers or residents had a complete picture of what was happening, said Joseph Allen, professor of exposure assessment science at the Harvard T.H. Chan School of Public Health.

“There was a great sense of national pride. People wanted to be back and volunteered to be down there. I think we knew it was toxic, and I think what these files are covering is that there was more known than the public was aware of,” Allen told CNN.

While progress in disaster response has been made in the last 25 years, there’s still a ways to go, Allen said. His research has found parallels between the 9/11 response and the response to the devastating Los Angeles area fires in 2025.

“Similarly, we found that the hazard remained many months after the fires were out, when a lot of people thought it was safe – and a lot of people were told it was safe,” he said.

It’s a pattern that has been observed with other disasters, Andrew Whelton, professor of civil and construction engineering and sustainability engineering and environmental engineering at Purdue University, told CNN.

People are faced with extreme uncertainty and a situation that is changing minute by minute, and they make decisions without all of the information they need, he said.

“That is the story of how people make decisions after these disasters,” Whelton said. “The only way to break that cycle is to recognize that what happened after the World Trade Center collapse in the exposures to the workers and residents and visitors was unacceptable, and then pivoting off that and saying we will not allow workers, residents and visitors to be similarly exposed to anything like this again.”

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The information learned after 9/11 can be transferred to other disaster situations, like earthquakes, fires and chemical explosions, Whelton said. He works with a team through his university that helps officials navigate uncertainty after disasters such as the Lahaina wildfires in Maui.

“What I hope is taken from this is that there’s a doubling down on understanding the importance of protecting workers that we expect to go into harm’s way, and being honest with them about the hazards that they could face, protecting them from the hazards they do face, and then walking with them in the future to make sure that we didn’t miss anything, and their health is protected,” Whelton said.

After everything Kotnik has experienced in the past 25 years – watching his friends fall ill with 9/11-related cancers and health issues, his own bladder cancer diagnosis, the brutal chemo sessions, the intensive surgery – he considers the question: Would he go back and volunteer in that dust again?

“Absolutely not,” Kotnik said. “I’m not stupid.”

But Kotnik said he doesn’t blame anyone for what’s happened except those who carried out the 9/11 attacks.

He said he’s immensely grateful for the team at Northwell Health that helped him tackle his cancer.

Doctors like Moline are hopeful that 25 years after the 9/11 attacks, more people impacted by the lingering dust and debris will have the information they need to find help.

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弗兰克·科特尼克在皇后区长大，小时候他看着河对岸的双子塔越来越高，眼看着它们的建设接近尾声。

少年时期，他和朋友们曾偷偷溜进原世贸中心，希望能从楼顶欣赏美景。他们几乎爬到了顶楼，却被保安抓住了。尽管如此，当科特尼克站在高处，俯瞰曼哈顿的壮丽景色时，他仍然感到无比敬畏。

成年后的科特尼克和他的两个朋友在纽约市交通局上了 12 个小时的铁匠班后，于 2001 年 9 月 13 日直接开车前往世贸中心遗址。他难以置信地走过曾经矗立着双子塔的“月球表面”。

一切都化为尘埃——曾经熙熙攘攘的世界贸易中心大楼里，曾经的办公空间、金属、桌椅、电脑、塑料、清洁用品、电子产品等等，都化作了厚厚的粉末，随着大楼的倒塌升腾到曼哈顿下城上空，并在之后很长一段时间里挥之不去。

在 9/11 袭击事件发生后，科特尼克花了数周时间，将自己的时间和技能投入到救援工作中，在尘土中穿梭，切割钢材，清理瓦砾。

“成千上万的纽约人被谋杀了。我不会去打高尔夫球。如果我能以某种方式提供帮助，我就会去帮忙，”现年 66 岁、正在从膀胱癌中康复的科特尼克告诉 CNN。

近 25 年后，纽约市公布了超过 17 万页的文件，这让公众开始反思那些灰尘中究竟包含着什么，当时的官员们知道多少，以及成千上万的人现在面临的持久健康后果。

文件中包含的一些信息揭示了官员和医生多年来都知道的事实——灰尘中含有能使人患重病的物质和化学物质。

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哥伦比亚大学梅尔曼公共卫生学院环境健康科学系主任安娜·纳瓦斯-阿西恩博士告诉 CNN，这种灰尘是由无机和有机化学物质组成的复杂混合物，会长时间大量存在——这与生活在大平原或西南部等地区的人们接触到的天然灰尘有所不同。

“人类很少会接触到如此高浓度的粉尘，”纳瓦斯-阿西恩说。

她表示，尤其令人担忧的是灰尘中的无机物，包括镉和铅等金属。

她指出：“我们知道，吸入金属通常意味着完全吸收，而这些金属本不应该存在于体内。它们会与我们自身的蛋白质发生相互作用，并被我们不同的组织吸收，尤其是在矿物质和金属含量很高的组织中，例如骨骼。”

她说，这些金属可以在体内停留数十年。

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为什么今年的世贸中心遗址纪念仪式上会新增默哀环节？

灰尘中还发现了其他物质，包括石棉。石棉是一种已知的致癌物，在袭击事件后仍然存在，并且长期以来一直与间皮瘤有关。间皮瘤是一种罕见且侵袭性强的癌症，潜伏期长，症状通常在多年后才会出现。间皮瘤中心表示。

木材、塑料和玻璃等其他材料也被粉碎成细小的颗粒，这些颗粒包含在粉尘中。

“它们变成了非常非常细小的颗粒，”她说。“颗粒越细，就能到达肺部的更深处。”

纳瓦斯-阿西恩指出，身处粉尘环境中的人们并非只接触一种物质或化学物质，而是接触了多种物质的混合物。她说，这种粉尘可能对肺部、大脑、心血管系统等多个器官造成影响，研究人员仍在努力了解其对健康造成的后果范围。

除了多年来在该领域进行的研究之外，专家们现在正在仔细研究新公布的文件，以确定它们是否已经全面准确地描述了世贸中心遗址周围尘埃中所含的物质。

多年来，科特尼克眼睁睁地看着9·11事件后与他一起工作的朋友们一个个生病。有些人得了癌症，有些人得了脑瘤，有些人去世了。

在科特尼克于曼哈顿下城尘土飞扬、宛如月球表面般荒凉的环境中工作了二十年后，他发现尿液中带血。不久后的检查结果显示，他患上了膀胱癌。

感谢 Northwell Health 提供信息

科特尼克的一位朋友曾建议他参加世界贸易中心健康计划，于是他便加入了。该计划为患有某些癌症和与9/11事件相关的健康问题的人提供联邦资助。

诺斯韦尔健康皇后区世界贸易中心健康项目主任杰奎琳·莫林博士表示，她在9/11事件发生后立即开始治疗患者——当时联邦政府尚未在2002年左右为该项目提供资金。此后，她和她的同事一直在监测因粉尘造成的健康影响。

莫林说，在早期，他们发现的疾病包括鼻窦炎、鼻炎、喉炎、支气管炎、反应性气道疾病、哮喘、创伤后应激障碍、焦虑症和胃食管反流病。

她说：“灰尘中包含的许多物质可以渗入组织并引起刺激，这可能就是为什么很多问题持续时间更长的原因。”

纽约州州长霍楚告诉CNN，政府没有公布9/11事件后的空气质量文件，这让纽约人感到“失望”。

医生指出，她和她的同事们已经发现呼吸消化道（包括上呼吸道、下呼吸道和食道）受到永久性损伤。

莫林表示，虽然许多医生早就知道石棉、石膏和灰尘中的其他成分会使人生病，但本周公布的文件揭示的污染程度和持续时间可能有助于解释医生观察到的一些长期健康问题。

莫林指出，在9/11事件发生约10年后，医生开始在世界贸易中心项目患者中发现间皮瘤、白血病和淋巴瘤等癌症。

她补充说：“随着时间的推移，我们发现癌症病例越来越多，因此我们预计未来癌症病例还会继续增多。”

她指出，对其他潜在健康影响（如心理健康、认知功能和生育能力）的研究可以帮助缩小我们对接触粉尘后果的集体认识方面的差距。

莫林表示，对于那些可能接触过 9/11 事件粉尘的人来说，与医生联系或加入世界贸易中心健康计划对于早期诊断和治疗至关重要。

但正如科特尼克所发现的那样，治疗并不总是那么容易。

“化疗可不是闹着玩的，”他谈到化疗时说，“简直要把你折磨死。”

科特尼克最终接受了长达七个半小时的手术，医生切除了他的膀胱，并用他的一部分肠道组织重建了一个新的膀胱。手术前，科特尼克在诺斯韦尔健康中心的医生就警告他，未来的路不会一帆风顺。

“如果我选择这条路，我的生活质量会更好，但康复期会更长——而且我还在康复中，”他说。

但科特尼克从未畏惧辛勤工作。9·11事件后，他为纽约市交通局工作多年，参与了美洲大道、布鲁克林大桥和其他项目的建设，直至退休。他的足迹遍布纽约市的各个角落。

在科特尼克的记忆中，那些在尘土飞扬中工作的早期日子是“有组织的混乱”。

对那段历史的重新关注引发了关于问责制的新问题。

纽约市长佐兰·马姆达尼在周二宣布公布这些文件时表示：“人们生病是因为他们信任的领导人撒谎，告诉他们呼吸有毒的空气是安全的。”

哈佛大学陈曾熙公共卫生学院暴露评估科学教授约瑟夫·艾伦表示，当时很少有工人或居民全面了解正在发生的事情。

艾伦告诉CNN：“当时人们有着强烈的民族自豪感。大家都想回去，并且自愿前往那里。我认为我们都知道那里环境恶劣，而这些文件所揭露的，是公众所不知道的更多内幕。”

艾伦表示，虽然过去25年里灾害应对方面取得了进展，但仍有很长的路要走。他的研究发现，9/11事件的应对措施与2025年洛杉矶地区毁灭性火灾的应对措施之间存在相似之处。

“同样地，我们发现火灾扑灭后数月，危险依然存在，当时很多人认为很安全——而且很多人也被告知很安全，”他说。

普渡大学土木与建筑工程、可持续发展工程和环境工程教授安德鲁·惠尔顿告诉 CNN，这种模式在其他灾难中也曾被观察到。

他说，人们面临着极大的不确定性，形势瞬息万变，他们在缺乏所有必要信息的情况下做出决定。

“这就是人们在灾难后如何做决定的故事，”惠尔顿说。“打破这种恶性循环的唯一方法是认识到，世贸中心倒塌后，工人、居民和游客所面临的风险是不可接受的，然后以此为出发点，明确表示我们绝不允许工人、居民和游客再次面临类似的风险。”

我们对纽约市新近公布的9/11事件记录的了解：这些记录揭露了官员们在航空安全问题上误导公众。

惠尔顿表示，从9·11事件中汲取的经验可以应用于其他灾难情况，例如地震、火灾和化学爆炸。他所在的大学有一个团队，专门帮助官员应对诸如毛伊岛拉海纳山火等灾难后的不确定性。

惠尔顿说：“我希望大家能从中吸取教训，加倍重视保护那些我们预期会面临危险的工人，坦诚地告诉他们可能面临的危险，保护他们免受实际存在的危险，并在未来与他们携手同行，确保我们没有遗漏任何事情，并保障他们的健康。”

在过去的 25 年里，科特尼克经历了种种磨难——眼睁睁看着朋友们因 9/11 事件引发的癌症和健康问题而病倒，自己也被诊断出膀胱癌，经历了残酷的化疗和高强度的手术——他不禁思考：他还会回到尘土飞扬的地方做志愿者吗？

“绝对不是，”科特尼克说。“我又不傻。”

但科特尼克表示，除了那些实施 9/11 袭击的人之外，他不责怪任何人。

他说，他非常感谢诺斯韦尔健康中心的团队帮助他战胜癌症。

像莫林这样的医生希望，在 9/11 袭击事件发生 25 年后，更多受残留灰尘和碎片影响的人能够获得寻求帮助所需的信息。