Immigrant workers at World Trade Center faced health care barriers

Immigrant workers involved in rescue and recovery efforts at the World Trade Center had health concerns similar to those of U.S.-born workers but experienced many barriers to obtaining adequate care, according to a report.

In the study, published in the December Journal of Occupational and Environmental Medicine, Dr. Rafael de la Hoz and colleagues at Mount Sinai Medical Center in New York analyzed a sample of 168 patients of the center's World Trade Center Health Effects Treatment Program -- a clinic dedicated to the diagnosis and treatment of health problems in WTC rescue and recovery workers. Because the HETP was funded by philanthropic organizations, all patients with WTC-related diseases received similar health care services.

Overall, researchers said that 44.5 percent of workers seen at the HETP were immigrants, nearly all from Latin America and Poland. In general, the immigrant workers had health problems similar to those of U.S.-born workers, but there were some differences. The study found that immigrants had a lower rate of respiratory problems. Researchers said that this may reflect the fact that most did not start working at the site until a few days after the 9/11 attacks, and thus were not highly exposed to the dust and smoke cloud after the collapse of the World Trade Center towers.

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The study also found that immigrants had a higher rate of disabling chronic musculoskeletal problems, possibly because most were laborers involved in heavy cleanup work. Although they arrived later, researchers said the immigrants continued working at the World Trade Center site longer than U.S.-born workers.

Variety of factors hindered medical care. Researchers said a range of factors made it harder for immigrant workers to receive medical attention. In addition to lack of insurance and language barriers, the study found that they faced economic pressures to continue working and lacked information about the benefits available. Even if they qualified, many immigrants were hesitant to apply for benefits because of heightened security measures.

As part of HETP, doctors developed a clinical program to deal with the "formidable economic and psychosocial challenges" faced by immigrant workers. The physicians helped patients seek diagnostic and treatment services for World Trade Center-related problems, with special attention to language and cultural barriers.

February 2, 2009

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