New York Police Officers Post 9/11 Health Screening and Longitudinal Follow-Up Evaluation
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Over 1760 Rescue and Relief Workers have sought help since the program's first day, Friday, September 28, 2001 at the Police Academy, 235 E. 20th Street

The Living Heart Foundation (LHF) was privileged to be invited by the New York Police Officers to perform heart and lung health screening of 1,760 officers during the first month following the 9/11 World Trade Center terrorist act. The screenings were held on-site at the Police Academy in New York City. Since the initial health screenings concluded in October 2001, the New York Police Department has been unable to endorse a particular foundation according to their internal regulations.   Thus, the LHF is acting independently in its continuing support of the men and women police officers who consented to receive health screenings from the LHF.  The LHF continues to track the health conditions of the surviving officers since the late effects of the 9/11 exposure are unpredictable. Initially, a randomly selected cohort of 600 individual men and women members of the initial LHF health screening group were analyzed for their health status within less than a month after 9/11.   The clinical findings have been submitted for presentation and publications.  In April 2003, a telephone contact follow-up was done utilizing 600 surviving members of  New York Police Officers 9/11 responders. These combined evaluations showed that significant cardiac, pulmonary, and mental health abnormalities persist 1.7 years from the 9/11 insult.

The LHF has expanded its medical team since the first health screenings of the New York Police Officers immediately following 9/11. The Penn State Medical School and its Divisions of Pulmonary Medicine and Health Sciences have become the electronic database and scientific analysis partner for the LHF. The Massachusetts Institute of Technology (MIT) and its Department of Environmental Medicine is the particulate inhalation exposure and health reconstruction investigative team. Monmouth University and its Division of Psychology in conjunction with the New York Academy of Medicine has become the mental health evaluation collaborator for LHF. These new affiliate institutions join the initial affiliates including the University of Texas in Galveston, the University of Arizona, and Mount Sinai Medical School (NYC) Division of Cardiology as members of the LHF consortium.

Recently, on May 2, 2003, a public meeting was sponsored, in New York City, by the National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention. The purpose of this meeting was to provide input to NIOSH in identifying the needs and priorities for providing long-term medical monitoring to emergency services, rescue, and recovery personnel who responded to the September 11, 2001, terrorist attacks at the WTC. Public Law 108-7, makes available $90 million to administer baseline and follow-up screening, clinical examination, long-term health monitoring, and analysis for these emergency services, rescue, and recovery personnel, of which $25 million is designated specifically for New York City firefighters.

At the current time, federally funded programs related to the long-term evaluation of health effects related to 9/11 include the Medical Department of the New York City Firefighters and the Mount Sinai Medical Center, Department of Occupational and Environmental Medicine, the directing group for the World Trade Center Worker and Volunteer Medical Screening Program. In addition, the New York City Department of Health and Mental Hygiene (DOHMH) and the Agency for Toxic Substances and Disease Registry (ATSDR), a federal public health agency, have created a registry of people who were exposed to the smoke, dust, and debris around the World Trade Center disaster and the subsequent cleanup of the disaster site. Another federal funding source related to 9/11 has been the National Institute of Environmental Health Sciences (NIEHS) of the National Institutes of Health who has supported smaller research studies related to exposure assessment, epidemiology, and outreach.

The LHF and the Penn State Medical School have presented the early post 9/11 health findings in a preliminary randomized cohort of 600 New York Police Officers officers. This presentation was made at NIOSH headquarters in Morgantown, West Virginia in April 2003. In addition, preliminary discussions are ongoing between the LHF consortium and physician members of the Mount Sinai Medical Center concerning collaboration of the voluntary follow-up screening in New York City involving the men and women officers originally screened at ground zero.

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Youth Athlete Programs

 

Pilot Program Turns  Attention to Heart Health in Three Massachusetts High Schools

A pilot program tested in New England has raised awareness of the state of health among youth sports participants by offering heart, lung, and nutritional screenings to high school athletes and by working to disseminate automatic external defibrillators (AED's) in the schools.

The program was a  venture of The Chad Foundation for Athletes and Artists and the Living Heart Foundation, led by a mother who lost her son to sudden cardiac death and a retired heart surgeon, respectively.  Protocols and standards for the screening are overseen by the National Cardiovascular Screening Lifestyle Initiative (NCSLI), a physician group formed specifically to record and study the data collected by the screenings.

In May 2001, Holyoke High School, Holyoke Catholic High, and Dean Technical High - all in Holyoke, Massachusetts - completed the first phase of the pilot, said Holyoke High head Athletic Trainer Melanie Martin, MS, ATCA.

"We tested blood pressure, height, weight, body fat percentage, body mass index, cholesterol, glucose and arterial elasticity," Martin said.  "The second phase, which is planned for June 23, is the echocardiogram."

With local physicians donating their time and nearby health care centers providing echocardiogram technicians, about 200 athletes were scheduled for screenings in June.

The results of both phases of testing will be plugged into a national database being set up by the NCSLI, she added.

"This has been a whirlwind, but a good whirlwind," Martin said.  "We were first approached in April, and in a matter of weeks, testing began."

Martin and Vettori at Dean Tech generated the proper paperwork and spent hours coordinating the details of the cardio screening project.  The response, Martin said has been enthusiastic.

"For the most part, the parents have been very excited about it," she said.  "They think it's great.  These are tests that wouldn't normally be given to their kids.  If there's a chance we can pick up on something and prevent a death, that makes parents feel a little safer.

"Just this past year alone, "I've sent three athletes out for cardiac evaluations," she added.  "These test should help pick up on any potential problems."

About 45 percent of the student athletes at Holyoke High signed up for the voluntary screening this spring,  Martin said.  She expects a larger turnout this fall, when they will offer the screening again for incoming freshmen and other athletes who want to participate.

Arthur "Archie" Roberts, M.D., founder of the Living Heart Foundation, said the data eventually should help physicians get a more complete picture of conditions such as diabetes, heart disease, hypertension and cholesterol trouble.

Most people assume youngsters are healthy, he said, because they usually look, act, and feel healthy;  but the absence of symptoms does not equal the absence of disease, or the early onset of disease.

"We're finding in the Holyoke screenings that as many as 30 percent have one or more abnormalities already on the screening test," Roberts said. "I think we're onto something."

A Mother's Will.   A Surgeon's Care.

Holyoke was chosen as a pilot site because Roberts remembers his roots.

As a high school star athlete, Roberts was the heart of the team, leading his Holyoke teammates to greatness while his father served as Holyoke High's athletics director and guidance counselor.  Roberts eventually played professional football and then turned his attention to real hearts, becoming a cardiac surgeon.

His interest in sports and cardiac health prompted him to found the Living Heart Foundation and look for ways to promote heart-healthy lifestyles.

Enter Arista, a writer and former model whose son, Chad Butrum, suffered sudden cardiac death while playing a city league game in 1994.  He was 26 years old.

About a year ago, Arista organized echocardiogram screenings at North Hollywood High School (her son's alma mater) and Dunbar High in Baltimore, alma mater of basketball player Reggie Lewis, who died of sudden cardiac death in 1993.

The Chad Foundation also sponsored another organization that did a free screening in Fountain Valley, California where 16-year old Scotty Lang succumbed to sudden cardiac death.

"Working with sudden cardiac death has been a hard thing to do for a parent who's lost a child," she added.  "But knowing that it may save even one life makes it all worthwhile."

IN addition, the emotional desire to test as many children as possible as quickly as possible, must be balanced with the need to make sure all the data is gathered carefully and exactly, Roberts said.

"These are young kids with their whole lives ahead of them, and you want the very best for them, so it's easy to get involved emotionally," he said, "but we've got to be careful and cautious and thoughtful.  We need to do this properly and team as much as we can so that we spend our time, energy, and money in the right direction."

Eventually, Roberts said, he hopes the cardiac screening program will become part of every school's preparticipation exams - and he wants one nationwide method for gathering the data in order to aid research efforts.

NCSLI DATABASE

Roberts said the data from every screening by the Chad Foundation and the Living Heart Foundation will be stored in the NCSLI database and analyzed by the NCSLI physicians.

"Every individual who is screened becomes part of our database, and we follow these individuals on a regular basis for years, " he said, "We call it an interactive living database, which means that we will regularly exchange emails and letters with these individuals.  We will keep giving them the latest information on whatever abnormalities they are found to have at the screening tests.

"It may be that for medical or research purposes, we might ask them to be retested periodically."

Over time, Roberts said, the database should allow doctors to better understand how conditions such as heart disease or diabetes start.

"Not until you get older do diseases cause symptoms that force you to go to the doctor," he said.  "but that period of your teens and twenties is when these things are already starting.  If we can make early diagnoses and intervene early, we can really have an influence on these lives.  That's what we're trying to accomplish.

"This has been a neglected part  of American medicine," Roberts added.  "We're concentrated instead on the newest technology and best efforts to prolong life, but we've neglected the young people who are already developing these disorders that are later going to give them trouble."

Reprinted from NATA NEWS, 6/2001

see the Testing Results from the Holyoke Screenings

UPDATE

Ron LaMagdelaine, of the Living Heart Foundation, said the NCSLI screening could change the future for many youngsters.

"High cholesterol and glucose are the things that cause problems down the road," LaMagdelaine said. "If we address it when they're youngsters, we've got a good chance of getting those things under control before these kids become adults with health problems."

On-time screenings, he added, are not sufficient.

"We would like to have this testing set in place as a permanent part of the medical system in schools, as an ongoing thing," LaMagdelaine said.  "The proof is in the pudding:  this has to be done and it's got to be a continuing thing."

Reprinted from NATA NEWS, 1/2002

see also Columbia University Football Screening Program, Preliminary Summary