The first responders who sprang into action in the aftermath of the 9/11 attacks have had no shortage of hardships in the years since - dealing with a huge increase in heart attack, stroke, cancer, PTSD and other mental health issues.
Now, doctors are adding another devastating condition to that list: dementia.
In a new study, academics found police officers, rescue crews, survivors and other first responders werenearly 40 times more likely to develop the memory-robbing disease under 65 than the average American.
Researchers warned the tiny, toxic dust inhaled on that day may have penetrated their bloodstreams and caused inflammation which can lead to poor blood-flow to the brain, causing dementia-like symptoms.
A paramedic and a police officer breath oxygen after the South Tower of the World Trade Center collapsed
Dozens of first responders continue to succumb to cancers and respiratory ailments connected to their heroism on 9/11. Now doctors suggest they could be at risk of dementia as well
The study, which was published in the Journal of the American Medical Association Network Open, looked at 5,000 9/11 responders younger than 65 without pre-existing signs of dementia.
Researchers included anyone who spent at least 80 hours in or around lower Manhattan from September 2001 to July 2002,except firefighters, who are monitored by a different research group.
Overt the five years the group was studied, 228 people were diagnosed with dementia - roughly five percent of the study group.
For comparison, less than one percent of the general population is diagnosed with dementia before 65 years old.
That means the 9/11 first responders were about 38 times more likely to develop dementia under 65 than the average American.
This was a bigger gap than expected, Dr Sean Clouston, an epidemiologist at Stony Brook University who led the study, told STAT.
'We would have expected one to two, maybe three cases at the very most, and so seeing several hundred was something of a surprise,' Dr Clouston said.
The study also found people who were exposed to more particulate matter for longer were even more likely to develop dementia than people who consistently wore protective equipment.
Particulate matter is drops of liquidabout 40 times smaller than the width of a human hair suspended in the air that are likely to get inhaled or eaten by humans.
It is released from a building collapse, a wildfire and even car exhaust.
Of the 89 of the responders studied who had high exposure to particulate matter, 12 developed dementia. Of the 342 respondents with low exposure to particular matter, 3 developed dementia.
Since the researchers had to rely on participants' recollection of these events, it's difficult to check how much particulate they were actually exposed to, the authors cautioned.
Regardless, the researchers wrote their findings suggest 'the reliable use of PPE might help prevent the onset of dementia before age 65 years among individuals exposed to an uncontrolled building collapse.'
This isn't the first study to link particulate matter exposure to dementia.
Air pollutants were associated with problems developing memory and thinking in a 2022 review of 70 studies from the Committee on the Medical Effects of Air Pollutants in the UK.
Experts don't yet know how particulate matter could contribute to dementia risk.
It could be that these particles are so minute, that when people inhale them, they're able to travel through the incredibly small openings in the membrane that protects the brain. Once in, the chemicals could damage cells in the brain through inflammation.
It could also be these particles block blood flow, which could gradually starve the brain of blood and oxygen, leading to dementia, according to the Alzheimer's Society.
The new research included civilian first responders and people who worked near ground zero in the year following the attacks
This has also been linked to a number of other health problems that plagues this group of people.
Lung damage from working at ground zero lead many to develop asthma and sleep apnea, according to the CDC. Many have also developed cancer, particularly of the thyroid, prostate, skin and blood.
In addition, many first responders have had to deal with injuries from the day itself - be it back pain, burns or bone fractures.
All these conditions have led to an increasing number of deaths in the years since the attacks.
In 2023, a tragic record was struck when the number of first responders who had died from 9/11-related illnesses equaled the number of firefighters lost in the initial attack.
This study emphasizes the importance of preparing first responders to disaster areas with adequate equipment,Roberto Lucchini, a professor of occupational and environmental health sciences at Florida International University WHO was not in the study, told STAT.
Preparing first responders to use proper equipment could be key in saving them from developing debilitating illnesses down the line.
This applies to far more than just terrorists attacks, he said: We have situations of exposure to these kinds of toxic substances and all these hazards in a variety of situations, including natural disasters … or destruction of buildings — collapses or demolitions or earthquakes.'
