It’s been more than two decades since madmen with a twisted ideology hijacked American aircraft and killed thousands in New York City, the Pentagon, and a rural field in Pennsylvania.
The poisonous legacy of the collapsing World Trade Center towers continues to haunt the living. Today, on the 24th anniversary of 9/11, the toxic billows of that Manhattan morning are killing and sickening more Americans than the strikes themselves. This is not history. It’s a slow-motion disaster that creeps on in the lungs, blood, and bones of thousands.
Toxic Dust: The Seed of Slow Death
The collapse released a monstrous cocktail—a fine confetti of glass, asbestos, lead, benzene, and dioxins, blanketing Lower Manhattan. Nearly everyone within a mile and a half inhaled it. For first responders, workers, and residents, that dust became embedded in their bodies, silently setting off a chain of medical time bombs.
19. Aerial perspective of the World Trade Center’s collapse captured from a helicopter’s vantage point. pic.twitter.com/TK2GyXM2Ig
— Morbid Knowledge (@Morbidful) July 26, 2024
Diseases Carved from Rubble
Breathing that caustic air brought an epidemic of respiratory disease. “World Trade Center cough syndrome” emerged, marked by chronic rhinosinusitis, asthma, and bronchitis. Over 33,000 first responders still battle inflamed sinuses. Asthma afflicts about 15% of survivors—a staggeringly high rate. Gastroesophageal reflux disease (GERD) plagues a quarter of those tracked by the WTC Health Registry. The inhaled grit scorched people’s insides, and GERD only feeds the inflammation in battered lungs.
Cancer is the most ruthless late arrival. As of 2025, nearly 44,000 people hold 9/11-related cancer diagnoses, a number that’s still climbing thanks to long latency periods for asbestos-linked diseases like mesothelioma. Over half of new cancer cases strike first responders—firefighters, police, and medics, many now in the fight for their lives decades after their heroism.
Cardiovascular damage and diabetes also stalk the exposed. Arriving at Ground Zero earlier and staying longer heightened the risk of heart disease by 44%. The toxins did not discriminate: they scarred hearts and scrambled metabolic systems, turning some survivors into diabetics years after the towers fell.
Mental Fallout: An Unseen Disaster
The psychic shock still buzzes through many survivors’ brains. PTSD, depression, anxiety, and substance abuse crowd the rolls of the World Trade Center Health Program (WTCHP)—over 19,000 enrollees carry certified psychological wounds. Trauma, it turns out, can be as toxic and long-lasting as asbestos.
A Steadily Rising Death Toll
The body count from 9/11 illnesses now dwarfs the 2,753 lost on the day of the attacks. Nearly 7,000 Americans—firefighters, police, medics, recovery workers, and civilians—have died since, directly due to World Trade Center-related illnesses.
The FDNY alone has buried over 400 members from post-9/11 diseases, with another three dying almost every month. Deaths from respiratory failure and cancer—lung, digestive, and blood cancers at the top—lead the charge.
Currently, almost 49,000 WTCHP enrollees have been diagnosed with a 9/11-linked cancer, and more than 132,000 people are tracked as exposed survivors—tens of thousands still battling or bracing for disease. Each flag at a ladder company, each online fundraiser for a sick responder, writes another entry in a dizzying accounting of sacrifice.
Living With The Enemy
Today, the survivors of Ground Zero face a grim numbers game. By the end of 2024, about 30% of all WTCHP members had cancer. Let that sink in for a second. About a quarter remain afflicted by GERD, and more than a quarter have rhinosinusitis. Over 577,000 medical claims were processed last year for related diseases, and those numbers will surge as more cancers appear.
Beneath Manhattan, a new battlefield has been dug where the enemies are unseen, microscopic, and ferociously effective. There’s little glory left—just a long roll call of nurses, firefighters, NYPD, ironworkers, and office dwellers fighting conditions no one could imagine two decades ago.
The Harsh Truth
The 9/11 attacks did not end. They continue to evolve, molecule by molecule, in the marrow of the men and women who ran toward chaos.
Thousands are dying, many more are sick, and the number of active cases is counting down by the tens of thousands.
With each new diagnosis, the country is forced to reckon with the price paid over decades in cancer wards and graveyards—of being brave when called.
For some, the smoke never cleared. For too many, it never will.