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The number of cancer patients has multiplied at a rate that Worby says he never anticipated. Back in 2004, he represented only 20 workers who had cancer. But by last March, he had watched that number soar to 200, and within six months after that, it had doubled. Now he gets at least several calls a week from clients who have just been diagnosed with some cancer. Or from new clients who have had the cancer for weeks or months.
Like many trial lawyers, Worby has a penchant for talking in fervent, breathless tones, as though his words were writ large, in bright, blinking letters. Convinced that the 9-11 fallout has made for a cancer explosion, he doesn't hesitate to say so. "There is going to be a cancer catastrophe the likes of which we've never seen in this country," he says. "The numbers are going to be staggering."
Perhaps it'd be easy to dismiss him as another hot-aired plaintiffs' attorney were it not for his own command of numbers. He has become something of a gumshoe epidemiologist, compiling the data on his cancer patients that are lacking in the larger worker population, tracking their diseases, ages, diagnosis dates, and their 9-11 exposures. "Look at the cancers my clients have," he says, flipping through a dozen pages of a document entitled "Seriously Ill Clients." It's updated every month; this one is dated September 13, 2006. The document outlines what he calls his "cancer clusters" and lists rare cancers often associated with the 9-11 toxins, such as thyroid (30 people), tongue and throat (25), testicular (16), and brain (10). He keeps a separate document on the 75 people with blood cancers. Two dozen of them have various forms of leukemia; the remaining four dozen have various forms of lymphoma, multiple myeloma, and other blood cell cancers.
"If I had two blood cancers, it'd be a strong coincidence," Worby argues. "But 70? That defies coincidence. The word coincidence should not be in anyone's vocabulary."
Worby contends that it wasn't just the unprecedented amount of toxins in the air that caused his clients to develop cancer; it was that the toxins worked together. Worby calls it a "synergistic effect," and cancer specialists say there is such a thing as toxic synergy, which occurs when chemicals combine. They can enhance the damage that the other ones would cause. Think of it this way: The benzene at ground zero may have caused Walcott's acute leukemia; the dioxin probably sped up its development.
"This amount of toxicological exposure is going to speed up normal latency periods," Worby argues. He makes this assertion with the same zeal that he exhibits in the courtroom, citing medical studies on animals, rattling off the findings as if they were second nature. Why would the doctors monitoring the effects of 9-11 on people's health not understand this connection, he wonders. "Why would people not make this link?"
Five years after September 11, there's no doubt that the toxic dust cloud has devastated the lungs of those who participated in the Trade Center cleanup. In September, the Mount Sinai Medical Center released data from its WTC Worker and Volunteer Medical Screening Program, which has tested 17,500 recovery workers to date. In that analysis, doctors found that nearly 70 percent of the 9,500 subjects they surveyed experienced new or worsened respiratory symptoms at ground zero; close to 60 percent saw those symptoms persist for years. Doctors have seen chronic sinusitis, laryngitis, asthma, gastroesophageal reflux disorder, and disabling musculoskeletal conditions. Even the famous World Trade Center cough has lasted much longer than anticipated.
"All of us have been badly surprised by the persistence and the chronicity of the World Trade Center diseases," says Robin Herbert, the director of the screening program.
But at the Mount Sinai program (and at the WTC program of the FDNY, which declined to comment for this article), the link between the dust cloud and cancer is discussed more as a possibility than a reality. It's not that doctors aren't extremely concerned about the connection, Herbert says, given the cancer-causing agents and other toxins in the mix. While individual cancer cases may be attributed to 9-11 toxins, she says, the doctors, so far, lack full epidemiological proof linking the two.
"We don't know if we're seeing a spike in cancer rates," Herbert says, as they have in the rates of respiratory illnesses. Herbert confirms that the Mount Sinai doctors have seen some workers with cancer, including unusual cancers, but says they'd expect some workers to develop malignancies over the last five years anyway. Is there more incidence of cancer among Pile workers than among those who didn't toil on the Pile? "That's the key question," she says. The Mount Sinai epidemiologists have just begun to try to answer that by launching an initiative to update medical records, document new diagnoses, and track less-com mon diseases like cancer. It's a slow process, with no timeline. Still, she says, "We are now aggressively investigating every case of cancer that has been reported to us."
But the WTC programsfunded by the federal governmenthave their share of critics, who wonder how interested the doctors are in the 9-11 and cancer issue. Al O'Leary, the spokesperson for the Patrolmen's Benevolent Association, says that many of its members feel as if the doctors are ignoring the signs of a growing cancer cluster. "It was our impression that no one in the medical-monitoring programs believed the cancers could be happening this early," he explains.