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On Sept. 11, 2001, as thousands were dead or dying in the terror attacks in New York City, Pennsylvania and Virginia, Michael O’Connell was one of the many who rushed in to help.
O’Connell, then a 25-year-old probationary firefighter in New York, went to the World Trade Center’s twin towers as soon as they were attacked and subsequently spent weeks in lower Manhattan — breathing in the toxic air and fumes from the destruction as he worked through the pile of wreckage from the buildings, searching first for survivors and then their remains.
He carries those memories still. And something else: For the last dozen years, he’s been dealing with a rare inflammatory disease called sarcoidosis, which doctors say is linked to his time assisting the recovery.
He is far from alone.
The day after the attacks, Vito Oliva, with N.Y.C. police, began working what would be hundreds of hours at the nearby Staten Island landfill, sifting through toxic dust-covered debris delivered from the World Trade Center site. He wore nothing more than a paper mask.
Within the last three years, the now 53-year-old was diagnosed with prostate cancer and stomach lymphoma.
“I don’t think anyone went there with the thought, ‘Don’t go there. You will get sick,’ ” Oliva tells PEOPLE. “It was the opposite — everyone was another helping hand, doing what they could.”
Oliva and O’Connell are two of an estimated 90,000 people who responded to ground zero and the landfill for the massive rescue and recovery operation after World Trade Center towers collapsed in the deadliest part of the 9/11 attacks.
Some 40,000 of these workers have developed health conditions, including 10,000 responders and volunteers diagnosed with various cancers associated with exposure to the toxins, according to Dr. Michael Crane, medical director of the World Trade Center Health Program at the Icahn School of Medicine at Mount Sinai in Manhattan.
While Crane says he does not have a total figure of deaths from 9/11-related illnesses, the illnesses are absolutely fatal for some.
Among the losses are Luis Alvarez, a retired police detective who continued to speak out about the grave health issues facing him and others even as he underwent dozens and dozens of rounds of chemotherapy for colorectal cancer.
His funeral was Wednesday. He was 53.
Says O’Connell: “We are seeing people dropping like flies.”
‘A Slow Burn of Conditions’
O’Connell joined Alvarez and former Daily Show host Jon Stewart when Stewart recently excoriated lawmakers in Washington, D.C., over the lack of reauthorization for money for the September 11th Victim Compensation Fund. (Congress has since vowed to act.)
The fund has already paid out billions but is set to run out of money more quickly than expected, given the escalating claims from patients. Lawmakers have proposed extending funding into nearly the next century.
Many more first responders are expected to develop new cancers and will need help in the future, says Dr. Crane.
More than 76,000 of the estimated 90,000 rescue and recovery workers are registered at Mount Sinai’s World Trade Center Health Program, Crane tells PEOPLE.
“We look at this list and say, ‘What is unexpected and what looks out of sorts?’ ” he says. “Now we are seeing quite a bit of prostate cancer and thyroid cancer.”
The first illnesses to develop were sinus problems, asthma and gastroesophageal issues — all related to breathing and swallowing the dust coating Manhattan after the attacks. Also seen early were huge incidences of mental health issues from the shock of the carnage, including depression, anxiety and post-traumatic stress disorder. These conditions remain the most diagnosed among the responders.
As time passed, however, more and more people began getting sick with other illnesses, including a variety of cancers.
“A slow burn of conditions has developed over time,” Crane says.
Michael Guedes, 66, is a retired New York police sergeant who spent months at ground zero and the Staten Island landfill. Four years ago, he was diagnosed with breast cancer, like multiple other men who spent time in the area.
“I was pretty shocked,” he tells PEOPLE. “I know most men rarely get breast cancer. There is no family history.”
RELATED VIDEO: Children of 9/11 — Six Teens on Growing Up Without Dads 15 Years After Attacks
‘We Know It Was Dangerous’
When the towers collapsed, responders and emergency workers were exposed to materials in the dust and air as well as the fumes from the fires burning for weeks and months at the site. Among the carcinogenic substances people were exposed to: asbestos and components of jet fuel.
But scientists will never know about the toxins that dissolved on the day of the attacks in a cloud that headed south over Brooklyn. No sampling was done at the time.
“We don’t know what those responders were exposed to in real time,” says Crane.
“We know it was a mess,” he continues, “and we know it was dangerous, and we know what hit the ground.”
Dust scooped off the ground tested for “a lot of cancer-developing agents,” says Crane. Not just jet fuel and asbestos but fibers and metals.
“All that was breathed in and swallowed,” Crane says. “That exposure went on for days and days and weeks and months, and it was still burning for weeks afterwards. It was a terrible, toxic mess.”
Yet a week after 9/11, Christine Todd Whitman, then the head of the Environmental Protection Agency, said the air in New York was safe. In 2016, she admitted she was wrong.
City officials, led by then-Mayor Rudy Giuliani, allowed cleanup workers and responders to work at the site without respirators, despite federal requirements.
Over time, this exposure has led to some 50 to 80 new cancers Crane and his colleagues have certified each month. “The number is striking,” he says. “None of us can help but be moved and worried.”
He fears the worst is yet to come, with diseases such as lung cancer that are related to asbestos exposure, since it takes 20 or more years for those to develop
“I am quite concerned about the longer-term impact to our population,” he says. “We have to take care of these folks.”
It’s something that O’Connell and other responders have tried to make sure of with their recent appeals before Congress. But until reauthorization is again approved, the victim compensation fund — which was created as the government’s remedy after initialing mishandling the dangers to recovery workers — hangs in the balance.
The responders, joined by Stewart and other allies, want to see a permanent extension of money to the fund through 2089 for claims related to chronic illnesses and deaths.
“We told him it is his obligation that these people are taken care of,” O’Connell says. “He gave us his word he would get the bill passed by August.”