from medicontext.co.il
By E. J. Mundell
NEW YORK, (Reuters Health) – To New Yorker Doug Macron, the scene near the World Trade Center Tuesday morning was like a "terrible snowstorm," the sun a dim gray orb as the air "filled with bits of dust and smoke that stung the eyes." The cloud of choking fumes covered downtown Manhattan, coating frantic passersby in a thick film of soot as they struggled to make their way to safety.
Like many others who used anything at hand to help them breathe, Macron, a reporter with this agency, took off his shirt to "cover my face and nose, protecting myself from the ever thickening smoke and dust."
That dust–containing everything from melted plastics, pulverized concrete, burnt jet fuel and asbestos–may have health effects that could linger for days, weeks, even years, according to one expert.
"Anyone is potentially at risk depending on their exposure," said Dr. Mark Siegel, an expert in pulmonary medicine at Yale School of Medicine, and director of the Medical Intensive Care Unit at Yale New Haven Hospital.
"A perfectly normal person close enough to the epicenter could have a profound injury to the lungs," he told Reuters Health. "In contrast, as you get farther and farther away, people who have underlying diseases such as emphysema, heart disease or asthma could prove to be very sensitive to relatively lower levels of exposure"
These individuals should see a doctor if they begin to develop symptoms, Dr. Siegel said. But he cautioned that even healthy individuals can develop acute respiratory distress syndrome (ARDS) in the hours and days following intense exposure to choking fumes.
"We don't really know how many people might develop [ARDS], he added. People who are rescued from the rubble may have ARDS, and currently hospitalized patients may later develop it. "So the numbers are unknown, but that's something that I'm certainly concerned about."
Many are concerned as well, about the risk to individuals caught in the Trade Center disaster from inhaled asbestos, which was used in the construction of the two towers, according to an ABC News Report.
But Dr. Siegel said asbestos is actually low on his list of dust-related health concerns. Individuals with asbestos-related illnesses such as mesothelioma or lung cancer typically "have asbestos exposure not just in high amounts, but usually over long periods of time," he explained. "So a single isolated asbestos exposure, even if it was large in quantity, would be unlikely to cause major lung damage."
At especially high risk of respiratory distress are the rescue workers. "You've seen pictures on the news of firemen coughing, and obviously that's related to their exposure," Dr. Siegel said. Although most of these individuals are relatively healthy and taking precautions, such as using masks and filters, he predicts that some of these individuals are "going to have some trouble."
For those who can not leave the city temporarily, "the best thing to do is probably stay indoors and put [the] air conditioner," Dr. Siegel said.
Whatever the precautions, the sheer scale of Tuesday's disaster may mean that hospitals and clinics see an influx of patients suffering from breathing disorders, he added.
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