On Sept. 11, 2001, former New York City Fire Chief Jim Riches lost his son, also a firefighter, when the North Tower of the World Trade Center collapsed to a heap of rubble.
Four years later, he nearly lost his own life to a severe lung complication that he says is a direct result of the recovery efforts in which he was involved in the months following the tragedy.
"My lungs shut down in 2005," he says. "I was in a coma for 16 days, hooked up to a machine that let me breathe. They told my family I had five hours to live. This was all attributed to 9/11 [by the doctors]."
Now, Riches, 58, fears that up to 11,000 firefighters and other rescue workers may lose their battle for compensation for what they say are illnesses caused by the toxic dust from the World Trade Center, after a news report this week questioned the cause of death of a New York Police detective repeatedly described as the first emergency responder to die of a 9/11-related illness.
The report, published in the New Yorker magazine, says that a 2003 biopsy of Detective James Zadroga showed no signs of some of the toxic chemicals that have been blamed for many of the illnesses 9/11 recovery workers have suffered.
Zadroga's lawyer said that while the 2003 biopsy was "unremarkable," a later autopsy and other medical tests showed serious illness allegedly caused by Zadroga's work at the World Trade Center site. He said Zadroga would be alive if it were not for his work there.
It remains unclear what impact, if any, the controversy over Zadroga's death will have on the cases of thousands of others who are seeking compensation for the health conditions they say were linked to their work in the aftermath of 9/11.
But because Zadroga's case has become a symbol for those seeking compensation, Riches says the publicity generated by the report could lead many to mistakenly believe that those claiming injury were not harmed by the air around the World Trade Center site.
"What happened in the Zadroga case, I don't know," he says. "But it seems to me a lot of people are trying to bad-mouth this case and say that for the rest of the cases that these health effects are not even related to 9/11."
The new report represents the latest chapter in the saga over what exactly led to the illness that brought about Zadroga's death -- as well as the illnesses suffered by other rescue workers at the site. It also highlights the difficulty of proving that the trade center dust sickened workers.
The collapse of the World Trade Center towers brought 200,000 tons of steel, 600,000 square feet of window glass, 5,000 tons of asbestos, 12,000 miles of electric cables and 425,000 cubic yards of concrete crashing down into lower Manhattan, according to a joint city and federal report issued in September 2002.
The calamity, caused by a passenger jet that was flown into the building, produced a caustic cauldron of concrete dust, glass fibers and cancer-causing asbestos, as well as particles of lead, chlorine, antimony, aluminum, magnesium, iron, zinc and calcium. About 24,000 gallons of jet fuel and burning plastics released carcinogens including dioxins, polycyclic aromatic hydrocarbons, polychlorinated biphenyls and polychlorinated furins, according to a 2004 scientific analysis that called the collapse the "largest acute environmental disaster that has ever befallen New York City."
A federal compensation fund for those affected was established shortly after the tragedy and paid out a total of about $7 billion to the families of those whose injuries and deaths were determined a result of the 9/11 attacks.
Another 11,000 firefighters, police officers and other emergency workers are suing the city for injuries they say were caused by working at the World Trade Center site. The claims have left rescue workers and the city embroiled in a years-long legal battle that shows no sign of reaching a conclusion soon. The city could face $1 billion or more in liability if it is found to be negligent for failing to protect workers.
Kenneth Feinberg, who was special master of the September 11 Victim Compensation Fund, says the effect of the Zadroga case on these cases will most likely be minimal.
"The cases are so specific to the individual, in terms of the medical corroboration, the exposure to dust on 9/11," he says. "It's better not to draw long-term conclusions from one case about the thousands of other cases."
And Mark Bern, one of the lawyers who represents rescue workers who say their health was affected, agrees that the Zadroga case, while symbolic, will have "no bearing" on his cases.
"There are a multitude of studies to show that dust was harmful, that the air was bad" and that the air caused injury to the workers, he says.
Nonetheless, lawyers for the city of New York have already taken steps to discredit some of the injury claims aimed at the city. In May, lawyers said in court papers that a review of medical records showed that one out of every three of those claiming injury are not seriously ill -- and that hundreds may not be ill at all. "Certain plaintiffs allege injuries that could never be related to exposure at the WTC Site," they wrote.
The statements have been attacked by the claimants' attorneys.
While denying liability for the injured workers, the city and New York's congressional delegation are pushing for the federal government to reopen the compensation fund. That drawn- out battle has left many workers claiming injuries, such as Riches, bitter.
"The ultimate thing is this catastrophe happened," said Jeffrey Goldberg, a lawyer representing several hundred firefighters. "Now a lot of first responders are getting shortchanged because of a political battle between the city of New York and Washington."
Working in the claimants' favor may be the fact that in the days and weeks after the collapse of the towers, the vicinity of the smoking pile of rubble, glass, metal and asbestos was a very unhealthy place to be.
According to at least one study, published in May 2007 in the medical journal Chest, those who inhaled the airborne cocktail of chemicals and dust at the WTC site appear to have increased their risk of sarcoidosis, a condition in which the body's immune system triggers uncontrolled inflammation. This inflammation wreaks havoc on the lungs and, less commonly, on other internal organs.
Another common complaint was severe gastroesophageal reflux disease, or GERD, in which the acid in the stomach makes its way up the esophagus, burning the internal lining and causing significant and sometimes debilitating pain.
Thousands have already been treated for their injuries and health problems. According to the 2008 Annual Report on 9/11 Health, released this month by the World Trade Center Medical Working Group of New York City, doctors screened more than 40,000 rescue and recovery workers nationally. Of these, about 10,500 received federally funded treatment for physical health conditions and 5,500 received treatment for mental health conditions.
But even those who have received some level of medical treatment for their conditions still bear the scars. Riches was forced to leave the fire department in 2007 due to the injuries to his lungs.
While says he he has recovered somewhat, Riches must take a pill daily to compensate for his failed thyroid, which he also believes occurred as a result of 9/11. He must also sleep with an inhaler at his bedside, as he still occasionally wakes up unable to breathe.
"I used to bike and run and everything else," Riches says. "Now, if I walk a bit, I get very winded. Still, I thank God I'm still alive."
And he says that he will continue to press forward for the compensation he feels he deserves -- regardless of the most recent findings in the Zadroga case.
"I was down there. I don't know where these people who are saying all these things were," Riches says. "The way it looks to me, they're just trying to get out of the accountability for what happened."