Like the rest of America, Dr. Bruce Bernard and Dr. Boris Lushniak stared in horror at the television as two jets slammed into Manhattan's Twin Towers a year ago today.

        Four days later, they were at Ground Zero, trying to protect rescue workers from the hazards of dust, asbestos and mercury at the nightmarish site. A few weeks later, their teams were in Florida, New York, New Jersey and Washington, D.C., investigating anthrax mailings. After that, they made recommendations to federal officials on who should be vaccinated against smallpox in the event of a bioterrorism attack. Now the researchers are studying what health hazards are faced by workers who spray for mosquitoes as America tries to stamp out the West Nile virus.

        Their little-known federal agency headquartered in Pleasant Ridge doesn't get much attention, but staffers log a lot of miles. In an average year, investigators travel to 250 work sites to find out what's making American workers sick and injured. The technical term for the work done by the 400 staffers at the Hazard Evaluation and Technical Assistance Branch of the Centers for Disease Control and Preventionis field epidemiology.

Boris Lushniak (left), Dawn Tharr, and Bruce Bernard. (Glenn Hartong photo) | ZOOM |

        “We call it shoe-leather epidemiology,” says Dr. Bernard, HETAB's medical section chief.

Ground Zero

        Dust inhalation was initially a big issue at Ground Zero. Watching the dust cloud on television in Cincinnati, members of the agency put together a memo outlining worker safety recommendations. The first of 26 Cincinnati investigators at Ground Zero arrived Sept. 15. A CDC sampling of 790 injured survivors who received emergency room care in the 48 hours after the attack showed that 29 percent were rescue workers. Inhalation injuries from smoke, dust and debris made up nearly half of the injuries the survivors suffered, followed by eye injuries, cuts and sprains and strains.

        As the scope of the disaster became more apparent, dust wasn't the only concern. Fluorescent light banks from the Twin Towers contained mercury, which is poisonous. Asbestos was present. Fumes and smoke on the site posed risks. Falling debris was an issue. Blood-borne pathogens from survivors and bodies trapped in the rubble could be dangerous for rescue workers. .

        But worker safety was the last thing on rescue crews' minds in the hours and days following the attacks on the Twin Towers.

        “If you're a firefighter and you have a buddy missing down in there, you're thinking, "My buddy's dead or dying down there, so how important is it that I wear a respirator?' ” Dr. Lushniak says. “It's not that we're criticizing that behavior. We understand it. But part of our job is to try to counteract that behavior and keep people from getting hurt.” Agency team members managed to convince rescue workers that the respirators and hearing protection and other safety equipment would help them do a better job, Dr. Lushniak says.

        “We wanted to protect the workers so they could do a better job with rescuing. A lot of the equipment they were using was so loud that it might have caused short-term hearing loss, so they couldn't hear someone screaming for help,” he says.

        Emotionally, workers were drained by the growing hopelessness of rescue efforts. The scene became surreal as the surrounding city stumbled back to some semblance of normalcy. Ground Zero was a world unto itself.

ABOUT THE AGENCY

The primary focus of the Hazard Evaluation and Technical Assistance Branch of the Centers for Disease Control and Prevention is to eliminate work-related illness and injury.    Sprains, strains and carpal tunnel syndrome are among common injuries suffered on the job.    Sixteen Americans die on the job every day.    In 2000, American workers suffered 5.7 million injuries and illnesses on the job.    The Hazard Evaluation and Technical Assistance Branch (HETAB) of the Centers for Disease Control and Prevention is a public health agency headquartered in Pleasant Ridge with additional local offices.    HETAB is part of the National Institute of Occupational Safety and Health (NIOSH).    NIOSH is a subdivision of the Centers for Disease Control and Prevention (CDC).

        “Ultimately, it was hallowed ground,” says Dr. Bernard. “We really felt that we were at the site where people had been sacrificed, and in this place there was so much giving. The best of America was really there, assisting without limit.”

        After a while, it was easier to remain at Ground Zero than to leave to go to a hotel, says Dr. Lushniak.

        “Part of the difficulty was the transition from the site to the rest of the city,” he says. “The rest of New York was still numb, but it was coming back to life. ....”

        There were many support mechanisms.

        “Any hour of the day there would be a group of people with signs saying "Thank you' when you'd leave the site,” says Dr. Lushniak. “At two in the morning, there would be people waving at the vans leaving Ground Zero to say thank you. McDonald's set up a booth on site and by the second week, you'd get a bag with your burger or whatever and there would be a hand-written note from a child in Utah or wherever.

        “That got to me.”

Anthrax scare

        Weeks after the terrorist attacks, Americans reeled from the news that someone was mailing letters containing anthrax spores. Five people died of anthrax,and the investigation still is ongoing.

        Agency team members barely had time to unpack from Ground Zero when they were back on the road to every affected site.

        Anthrax was uncharted territory. Little was known about how the disease could be spread within a work setting.

        “It was a very challenging situation because we knew that we needed to do the work very quickly and there were no established protocols for collecting anthrax as a compound. We were very concerned about protecting our own staff,” says Dawn Tharr, a certified industrial hygienist who heads the agency's industrial hygiene section.

        The nature of the anthrax campaign added to the challenge. Because the spores were sent through the mail, investigators had to tracethe path of the letters and packages and look at every facility, worker and machine in contact with the contaminated letters.

        The industrial hygienists wore environmental suits as they worked at contaminated sites to protect themselves from infection. They collected samples with gauze wipes, socks and vacuums from mail-sorting machines and storage bins to find anthrax. .

        “We had a lot of people who worked anywhere from 24 to 36 hours with no sleep in some sites just trying to get done what we needed to do at all of the sites,” Ms. Tharr says.

        While she stayed in Cincinnati for the Ground Zero and anthrax investigations, most of her 40-member staff was at one site or another.

        “It was almost amazing to have these two things back-to-back,” Dr. Lushniak says.

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