“There were two separate pollution events, and the first was an initial dust cloud,” Cahill explains. “What must not be forgotten is that the later effects from the smoldering pile were far, far worse.”

Unlike the publicly lambasted EPA tests and findings, Cahill’s studies, which were published in peer-reviewed forums, were widely praised for their accuracy. Though the University of California at Davis has offered the conclusions to the EPA, the Senate, and New York City health officials, Cahill says he isn’t aware of a single state or federal agency that has acted on his findings. Through sample analysis, Cahill first discovered that 21 percent of the initial dust cloud contained finely powdered, highly caustic cement—thought to be responsible for the “9/11 cough.” Cahill noticed that the heat generated by the piles was converting gases into highly toxic, very fine aerosols. His study “Analysis of Aerosols From World Trade Center Attack” indicated that the contaminated air sometimes descended to ground level over a mile from Ground Zero, far outside the safety zones established by the EPA. Within a few hours’ time, a person exposed to the fumes could ingest toxins that would otherwise take a year to accumulate in a typical environment.

“The fuming World Trade Center debris pile was a chemical factory that exhaled toxins in a particularly dangerous form that could penetrate deep into the lungs of rescue workers and local residents,” Cahill and his fellow researchers concluded.

It’s painful just listening to Susan talk on the phone. Her gasps and wheezes and long pauses in conversation give you the impression that she may not make it through an entire conversation, and I caught her on a good day. A bad day means that she won’t even be able to make the trek from Queens to her office downtown.

“The public isn’t aware of just how bad the effects have been,” Susan says.

“Susan,” an anonymous source, was one of 386,000 people who worked in Lower Manhattan before the attacks. A week after the attacks, she returned to her job downtown.

“Within 24 hours of returning to work, I had a problem,” she warbles. “I could not breathe at the office.”

Even though she had heard the assurances of officials on television, today she bears the signs of serious toxic exposure: internal chemical burns, chronic respiratory infections, and severe asthma attacks.

For average citizens like Susan, New York City offers only one publicly funded treatment option: the WTC Environmental Health Center (WTC-EHC) at Bellevue Hospital, a new program launched in January 2007 that will expand to treat about 6,000 New Yorkers with 9/11-related health problems. The World Trade Center Medical Monitoring and Treatment Program based at Mount Sinai and the Fire Department of New York’s Bureau of Health Services programs offer services to first responders. Politicians have proposed $1.9 billion in funding over the course of six years.

“We get about 100 to 200 calls a week,” says Dr. Joan Reibman, director of Bellevue’s WTC-EHC. “We have a couple of hundred people waiting, so to get an appointment takes six weeks.”

The Bellevue clinic currently serves about 1,300 patients in all. Although the three WTC treatment programs have been praised by Mayor Bloomberg’s office, Reibman explained to me that the WTC treatment programs were initiated by private organizations.

“Neither the city or the federal government asked anyone to start any of the programs,” she says. Eventually the programs drew the support of city officials and gained funding.

Critics of the WTC health programs contend that there is no central entity that integrates the gathered information, which could provide a greater understanding of disease incidence as well as a certain level of continuity of treatment.

“We [the WTC health programs] all work together on the development of guidelines,” Reibman says. “We all share our information with each other. We have different populations, so our questionnaires are different.”

Although it still makes her ill, Susan continues to plod downtown to work. She says sometimes the air in her workspace makes her eyes burn, but she doesn’t have a choice—disability payments won’t cover the rent or put food on the table.

“You can’t dwell on it every single minute,” she says. “If people dwelled on what happened, nobody would live downtown because they would be too frightened.”

Curious about whether the workers and residents of Lower Manhattan are still haunted by health problems like Susan’s, Nina’s, and Teroy’s, I took a walk through the streets surrounding the 9/11 reconstruction site. Although six years have passed since the attacks, the number of people I encountered seemingly with residual health problems surprised me.

“They told us it would be OK to come back here,” recalls Nicholas Rowe, a silver-haired bartender at a nearby Blarney Stone restaurant and bar. In an Irish lilt, Rowe chose colorful words to denounce the EPA’s assurances, none of them printable.

“Three months after the attacks, we would open the bar doors each day,” Rowe recalls. “And every time I would wipe off the bar counter, there was black dust. Now I have nose and throat and sinus infections that keep coming back, and I never had those before. My regulars come in with problems too.”

Just a couple of blocks from the Blarney Stone, I stopped and chatted with Jim Moock, a director of business development at CQG, a market-data provider located in a Broadway high-rise.

“Some people had painter’s masks on their faces, apparently the cops were giving them out,” Moock said, recalling the day of the attacks. “I didn’t get one. It was chaotic, and the only clear thought I had was, ‘Why didn’t I get one [of the masks]?’”

Moock developed a dry, hacking cough about two weeks after the attacks. Finally, after two months of aggravation, Moock scheduled a visit with a pulmonologist. That visit has resulted in the first of many subsequent checkups throughout the years.

“He gives me a test every year or two, and it has shown diminished [lung] capacity,” explained Moock. “He has me on two forms of inhaled medications that I take daily every morning. One is steroid based, and I’ve been on them since 2001.”

Moock believes he was exposed to the toxic dust in a number of different ways. “When it got to be windy, you would see it blow off the window ledges, and I would be outside and see it land on the sidewalk, and it would just sit there like a clump, not like ashes that would just blow away,” Moock said. “This went on for months. I remember watching it rain on this stuff, and it took a lot of rain to get rid of the dust because it was so dense.”

Moock claims he hasn’t seen the familiar pockets of dust for a long time, but does it mean the city is now clean and safe?

In March 2004, in an attempt to “get greater input” regarding the health concerns of New Yorkers, the EPA convened the World Trade Center Expert Technical Review Panel, made up of 18 professionals from academia and public-health organizations. The panel’s goal was to assess any remaining exposures and risks, ascertain any public-health needs that were unmet, and then to offer a recommended course of action. In order to arrive at educated suggestions, the panel needed solid data.

“The whole process [of gathering data] has been extraordinarily poor in terms of understanding the extent to which people were exposed and possibly remain exposed, and if there are pockets of pollution left,” says Jeanne Stellman, a professor of public health at Columbia University, who served on the panel.

Various panel members criticized the EPA’s testing methods, suggesting that the data obtained weren’t sound enough to draw the conclusions the EPA had acted on. “There is only a limited amount of data available on what the nature of the exposure was, which varied day to day and hour to hour,” Stellman explains. “There was remarkably little sampling and analysis.”

End Part III