25 Years After 9/11: What We Have Learned About the Long-Term Health Effects
Twenty-five years after September 11, 2001, the health effects of the attacks continue to be studied.
The events of that day resulted in an immediate humanitarian crisis, but the medical story did not end when the fires were extinguished or the debris was cleared. For responders, survivors, and people who lived, worked, or attended school or daycare in the affected areas, the health consequences have continued to unfold over decades.
A recent paper published in JAMA, “Twenty-Five Years After 9/11 — Lessons from the World Trade Center Health Program,” examines what has been learned through the long-term monitoring and care of this population.
The health effects can be long-lasting
One of the most important lessons from the World Trade Center Health Program is that disaster-related health effects can be chronic and dynamic.
They may change over time and involve multiple organ systems.
This is important because the immediate medical consequences of a disaster are often the most visible. Injuries, respiratory problems, and acute psychological trauma receive understandable attention in the aftermath.
But some health consequences may emerge or persist years later.
The experience of the World Trade Center population demonstrates why long-term medical surveillance can be important following major environmental or occupational exposures.
Those exposed have experienced greater health burdens
According to the JAMA paper, individuals exposed to the 9/11 attacks have a greater prevalence of certain chronic health conditions and poorer health-related quality of life compared with the general population.
The affected population is diverse. It includes first responders and recovery workers as well as people who lived, worked, or attended school or daycare in the New York City Disaster Area.
The nature and degree of exposure varied considerably among individuals.
That makes long-term research particularly important. Researchers can follow these populations over time and better understand which health problems may be associated with exposure and how those conditions evolve.
Preventive care remains important decades later
One of the striking findings discussed in the paper involves lung cancer screening.
In 2024, 54% of eligible World Trade Center Health Program members who met U.S. Preventive Services Task Force criteria underwent lung cancer screening.
The paper notes that this was substantially higher than national lung cancer screening benchmarks.
This is an important reminder that preventive care does not become irrelevant simply because many years have passed since an exposure.
For people who meet established screening criteria, appropriate screening can provide an opportunity to detect disease earlier.
The importance of ongoing, coordinated care
The World Trade Center Health Program also provides an example of what long-term care for a disaster-exposed population can look like.
Rather than focusing only on the immediate aftermath, the program connects:
Medical care
Preventive services
Health monitoring
Research
Long-term surveillance
This creates an ongoing system in which new information can inform clinical care and research findings can contribute to a better understanding of long-term health consequences.
The paper describes this as a model for responding to disasters not only in the immediate aftermath, but over the many years that follow.
The research continues
Perhaps one of the most significant lessons from 9/11 is that there is still more to learn.
The people affected by the attacks have aged over the past 25 years. Their health needs have changed, and researchers continue to study the long-term consequences of their exposures.
The information gathered through the World Trade Center Health Program may also help inform how healthcare systems respond to future disasters and populations affected by environmental or occupational exposures.
Remembering the people behind the research
Behind every statistic are people.
They are the firefighters, police officers, emergency medical personnel, construction and recovery workers, volunteers, residents, workers, students, and countless others whose lives were changed by September 11.
Some lost their lives that day.
Others survived but have lived with physical or psychological consequences.
Still others continue to participate in research and medical monitoring so that we can better understand what happened—and potentially help those affected by future disasters.
Twenty-five years later, the medical community is still learning from their experiences.
And perhaps that is one of the most important lessons of all:
The health consequences of a disaster do not necessarily end when the disaster itself is over.
Long-term monitoring, preventive care, research, and access to coordinated medical care can remain important for decades.
We remember the lives lost on September 11, the responders who answered the call, and the survivors whose lives were forever changed.
Twenty-five years later, we remember. And we continue to learn.