It took 18 years for me to realize I was a victim of September 11.

In 2019, I received an email from Chaka Ferguson, a former colleague from the New York City bureau of the Associated Press, asking for a favor. We had worked together at Ground Zero in the weeks and months after the Twin Towers collapsed, but I hadn’t heard from him in over a decade. Ferguson told me he’d since been diagnosed with thyroid cancer, believed it was connected to the toxic air around the site, and was planning to apply to the World Trade Center Health Program and Victim’s Compensation Fund. Could I write an affidavit swearing he had been there?

I told him I was happy to and that I was particularly sympathetic. I had also been diagnosed with thyroid cancer four years earlier. The significance of his email didn’t register with me until later.

“I don’t think it’s just a coincidence,” he wrote back to me. “That both of us had thyroid cancer after working at Ground Zero.”

Up until that moment, it had never occurred to me that my illness might have any connection to September 11. The picture most people have in their minds of a 9/11 victim is of an office worker trapped in the burning buildings or a firefighter rushing into the towers. I was neither of these. Ferguson and I had been journalists who spent several weeks reporting from the scene. We didn’t know at the time — because the government, in its rush to get the country back to work, had suggested otherwise — that the air we were breathing was poisonous. After the exchange, Ferguson recommended I speak to the law firm he was working with, and I soon learned there were tens of thousands of people like me.

There are many numbers that are inextricably linked with that terrible September morning. There are the 2,977 people who died at the World Trade Center, at the Pentagon, and in Shanksville, Pennsylvania. There are the 343 FDNY members, 23 NYPD members, and 37 Port Authority police officers who died trying to save lives. There are the 100 days that the stubborn fires burned beneath the rubble at Ground Zero. There are the more than eight months it took for workers to clear the nearly 1.8 million tons of debris at the site. The enormity of these numbers is still hard to grasp, but they remain fixed. One measure continues to grow: the number of people getting sick.

In the 25 years that have passed since that day, 154,700 people have entered the World Trade Center Health Program, which provides care and health monitoring to people who were exposed to toxic air after 9/11, many of whom have come down with illnesses linked to the attack. Of those, 9,224 have died, according to the Centers for Disease Control and Prevention. Every year, the number of sick people rises. In 2025, some 10,500 more people enrolled in the program — an all-time high.

You might expect that these deaths and illnesses were largely confined to the people who rushed in to help after the planes struck. In the early years of the health program, which launched in 2011, the majority of applicants were rescue and recovery workers: New York firefighters have by far the highest enrollment rate of any occupational group. They were people like former battalion chief Richard Alles. He had been sitting down with a pile of paperwork at Battalion 58 in Canarsie after a busy 24-hour shift when he turned on the news and saw a report about a small plane crashing into the World Trade Center. “We arrived at Ground Zero maybe about 20 minutes after the second collapse,” he said. Alles got to work organizing a search-and-rescue operation and did not stop for weeks.

A marathon runner, he started feeling the effects of the air almost immediately. “When I would come home, I would always try to go for a run,” he said. “I didn’t have the wind at all. That scared the crap out of me.” After he stopped working at the site, Alles’s breathing improved. But in 2023 he was diagnosed with prostate cancer. (A 2019 study found that an “excess incidence” of prostate cancer among 9/11 responders may be the result of “inflammatory and immune responses in prostate tissue” resulting from exposure to World Trade Center dust.) “If I’m speaking to responders, it’s always about getting checked. You don’t have to be a hypochondriac, but you’ve got to stay on top of things because, as I tell everyone, it’s not a question of if you’re going to get sick, but when.”

Of the 15,500 FDNY members who have been enrolled — which the agency believes account for nearly all its members known to have been at the site — 77 percent have developed a verified 9/11-related illness or injury, said Dr. David Prezant, the FDNY’s chief medical officer. Of those, some 4,257 have been diagnosed with cancer. More than 600 members of the department have died of suspected 9/11-related illnesses, eclipsing the 343 who were killed on September 11.

It’s now clear, though, that while the impact was more immediate for first responders like Alles, they were not the only people getting sick. By 2019, people who lived or worked near the towers had eclipsed responders among new enrollees in the program. In 2025, that group represented two-thirds of new enrollees.

These new enrollees may only be the beginning. The collapse of the towers rained down at least 70 carcinogens over miles of lower Manhattan and beyond, from dioxins, asbestos, and PCBs to lead and other heavy metals. It was one of the worst environmental disasters in American history in the heart of one of the most densely populated urban areas in the world. “You can’t collapse gigantic skyscrapers into highly respirable particulate matter and not create a huge environmental problem,” said Kimberly Flynn, director of 9/11 Environmental Action, which campaigns for greater transparency about the health impacts of the attacks. “The dust penetrated buildings. It was sucked into HVAC systems; it came through closed windows. It went everywhere.”

In people’s homes, dust was in rugs, curtains, and bedding and coated children’s toys, and residents, by and large, were left to their own devices to clean it up. Many building owners turned to immigrant laborers for help, often providing minimal protective gear, if any at all. As the fires continued to burn, more pollutants were being pumped into the air every day. Scientists eventually likened it to multiple municipal waste incinerators going around the clock.

According to the Centers for Disease Control and Prevention, an estimated 400,000 people were exposed to........

© Daily Intelligencer