The backslapping over the bitterly contested passage of the Zadroga bill in the waning hours of the 111th Congress has quieted down. As the hard work of implementing the important $4.3 billion bill gets underway there has come the kind of news that forces us to stop once again and take notice. This time it's word of the death of retired New York City firefighter and ground zero responder Roy Chelsen. His passing is painful affirmation of the need for the kind of monitoring and research that will be made possible by the funds that flow from the Zadroga bill.
Chelsen, 51, had multiple myeloma, a blood cancer, and a tough ticket for anyone. It is the second most common blood cancer in the United States after leukemia. There were 20,000 new cases diagnosed last year in the United States, according to the National Cancer Institute, and half as many deaths. But multiple myeloma is generally considered a disease of the elderly. That's not to say that no one in middle age ever gets it.
But here's what's frightening. In 2009, the doctors at the Mount Sinai School of Medicine who have been out front in screening, diagnosing and treating more than 25,000 ground zero responders put out a red flag about multiple myeloma in responders based on a study of several instances of the disease among the workers they were treating.
As I reported in my book, "City of Dust," Mount Sinai had detected eight cases of multiple myeloma among the entire population of 28,000 workers and volunteers in the screening program by then. In a group that size, under the normal incidence rate, only 6.8 cases would have been expected. The difference was important, but not that striking. However, what concerned the doctors and many others who knew about it was this: four of those eight cases were men younger than 45 at the time the disease was diagnosed. Three of the four were law enforcement officers who had arrived at the trade center on the day the towers collapsed. As a result, they were engulfed in the heaviest, most contaminated dust, clouds of debris so thick they blotted out the sun.
Mount Sinai presented the information in the form of "case studies," not a formal epidemiological study. Some outside experts criticized the way the study had been conducted, while others found fault with it. They asked how it was possible for the disease to have developed so quickly in these people when the latency period for multiple myeloma linked to benzene and other solvents ranged from 10 to 20 years in peer-reviewed studies done elsewhere, leaving open the possibility that the disease was not linked to 9/11. Dr. Philip Landrigan, who heads the team of doctors dedicated to the responders, was aware of the limitations of the data. He acknowledged that the studies did not contain a big enough sample to act on. But he said it was important to make other clinicians aware of the unusual findings right away, and as he did so, he went out of his way to urge people not to overreact to the results. Still, the tabloids did just that, and the following day, in screaming headlines, proclaimed "New Horror for Heroes."
Now Roy Chelsen, a true 9/11 hero, has succumbed to multiple myeloma. A stem cell transplant last month, while the Zadroga bill debate was raging, had not stopped the disease that had reared its head in 2005. I say true hero because Chelsen showed the kind of quiet dignity that is so often associated with the heroes of the "Greatest Generation."
On September 11, 2001, he rushed into the flaming north tower and is credited with getting 18 of his fire department brothers out of the building before it collapsed. In the following days, he remained at ground zero aiding the rescue and recovery operations, exposed to heavy concentrations of the dust, ash and gasses from the burning jet fuel that made the 15 acres there an environmental catastrophe.
Chelsen didn't say much about his actions. He was not part of the outspoken group of responders who so often made the trip to Washington to lobby for the Zadroga bill. But his actions down at ground zero spoke volumes. And now his death also speaks volumes about the continuing danger, and the relentless need for continuing the kind of careful clinical observations and analysis of data that can detect serious warning signs of danger among the surviving responders. With the proper resources from the Zadroga bill, the doctors at Mount Sinai can continue their important work. And someday they may come up with the kind of definitive answers that can steal some of the sting from deaths like this one.
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