E1210. Never Forget 9/11: A Review of Common Pathologies on Chest Radiograph in Survivors and Responders Enrolled in the WTC Health Program
  1. Katherine Chung; Stony Brook Teaching Hospital
  2. Michael Jin; Stony Brook Teaching Hospital
  3. Mutshipay Mpoy; Stony Brook Teaching Hospital
  4. Jolanta Norelli; Stony Brook Teaching Hospital
  5. Almas Abassi; Stony Brook Teaching Hospital
The World Trade Center (WTC) Health Program was established on July 1, 2011. Their mission was to offer high-quality healthcare to responders and survivors of September 11th terrorist attacks, including yearly chest Xray to monitor and screen for disease processes. According to an article by Howard1, there are about 353 biologic and chemical agents that patients may be exposed to during the attack. These include blood borne pathogens, asbestos, carbon monoxide, lead, lithium, mercury, and heavy metals such as iron and copper. The purpose of this presentation is to present long term cardiopulmonary complications found on chest radiographs in survivors and responders of WTC attack.  

Educational Goals / Teaching Points
In this exhibit, an illustration of common and uncommon cardiopulmonary pathologies seen on chest radiographs are presented to guide radiologists when formulating a differential diagnosis for patients who are enrolled in WTC health program.  

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
In this study, we performed a retrospective chart review on all patients who had routine chest radiographs coded for WTC exposure. In our institution, there were 3924 chest radiographs for WTC screenings from May 2017-May 2020. There were 103 (2.62%) chest radiographs that had abnormal cardiopulmonary findings. These findings include: nonspecific lung findings (45), atelectasis (18), pulmonary nodules (33), pulmonary edema (2), and pulmonary effusions (3). We will present multiple cases of abnormal chest radiographs, and the corresponding cross-sectional imaging if available. A brief overview of the pathology and imaging findings associated with potential exposures such as asbestos, lead, and lithium that were not observed in our patients but may manifest in these patients in the future.

The WTC attack occurred almost 20 years ago, yet we still do not have a full understanding of complications that survivors and responders of WTC may experience. At least 79,000 patients are enrolled in the WTC program to date, therefore it is important that radiologists are familiarized with various pathologies that these patients may exhibit.