They're sick, they're dying, and they're dead. They are the firefighters, police officers and paramedics who raced, without a thought to their own personal safety, to the World Trade Center when the towers were attacked and destroyed by Arab Islamist terrorists on September 11, 2001. They are the iron workers, sanitation men, and cleaners who helped get Lower Manhattan back on its feet. They are the residents who remained downtown despite the fact that it was a war zone, with the smell of acrid smoke that lingered for three months. They are the returning office workers who got the financial center up and running. They never imagined that they would succumb to acute chronic illnesses from their exposure to the dust, debris and gases from Ground Zero on 9/11 and the following months. They never imagined that, having once been hailed as heroes for selflessly helping others, they would be forgotten, neglected and ignored when they themselves needed help. They find it hard to believe that their government, after promising billions of dollars to rebuild New York, would actually take that money back and make them fight for their rights.

Almost 3,000 human beings were annihilated on that terrible day. Emergency medical teams waited at their ambulances while doctors and nurses waited at the emergency rooms of their hospitals for the thousands of injured people they believed would come. While there were many serious injuries, the wait was in vain. On 9/11, you either made it or you didn't. Now, however, doctors are seeing tens of thousands of patients with a plethora of maladies caused by World Trade Center exposures that have been manifesting themselves slowly over the last few years. A health crisis of epic proportions is emerging, caused by the attack itself and governmental response to the attack. Illnesses from asthma to cancer are causing people to lose their jobs and even to lose their lives. Many of these illnesses and deaths could have been avoided, had the director of the U.S. Environmental Protection Agency, Christie Todd Whitman, not lied about the danger in the air. And many illnesses and deaths could have been avoided, had the New York City Fire Department given its workers proper Personal Protection Equipment.

These are some of the toxins and irritants released on 9/11 and its aftermath: pulverized concrete, asbestos, polycyclic aromatic hydrocarbons, silica, fibrous glass, benzene, hydrochloric acid, cadmium, mercury, lead, copper, chromium, dioxin, polybrominated diphenyl ethers, toluene, furans, PCBs and PVCs.

These are some of the diseases and illnesses that people exposed to these substances on 9/11 and the months afterwards are suffering: reactive airway disease, restrictive airway disease, sinusitis, persistent laryngitis, persistent inflammation of the nose and throat, asthma, shortness of breath, chest tightness, coughing and wheezing, lung scarring, severe headaches, heart irregularities, hypertension, gastro-esophageal reflux disease, skin problems, blindness from chemical keratosis, nodules in lungs, bone problems, liver damage, fatigue. There are many reports of lung, throat, tongue, testicular, breast, bladder, kidney, colon, and intestinal cancers in addition to cancers such as lymphoma, leukemia, Hodgkin's Disease and myeloma. Many 9/11 survivors also suffer from anxiety, depression, PTSD, insomnia, hallucinations, dizziness and memory loss.

Living only six blocks north of the World Trade Center, I was home when the attack occurred and ran to the site with my cameras. (You can read that account on The Digital Journalist.) When the first tower collapsed I was caught in the storm of debris that filled my lungs and breathing passages. So far, the health effects on me of that experience are short-term. I continued to cover the aftermath of 9/11 and the rebuilding of Lower Manhattan these past years. In 2006, my editor at Polaris Images, J.P.Pappis, and I decided that I should do a feature story on the health effects of 9/11 in preparation for the fifth anniversary of the attacks. I made contacts with first responders and have compiled a long list of people, many of whom I have photographed and interviewed.

My approach has been to take environmental portraits of people that would tell the story of their medical and psychological problems. In many cases, these problems are not so visible and have to be explained by showing their medications, for example. I let the subjects tell their stories in their own words, accepting what they had to say at face value. Although there has been some skepticism expressed about some of these people, such as Cesar Borja whom The New York Times savaged after his death, I think there is ample evidence for the links between the toxic exposures and the diseases documented here. There have also been some amazing coincidences, such as finding firefighter Tim Duffy, whom I photographed on 9/11 arriving on the scene on his Harley-Davidson in full bunker gear. Tim had to retire from the FDNY due to his illnesses. I also ran into construction worker Frank Silecchia, who had found the I-beam cross during the recovery effort and whom I had photographed in 2002 in front of that cross, when it was removed from the site to a church nearby. He told me that his health was not good, and I went to photograph him at the RV in which he was living in Brooklyn.

The following are quotes from the interviews with the 9/11 responders, recovery workers, and residents who have gotten sick. Some quotes are from family members of those who have died.

Former NYPD patrolman Chris Baumann: "This wall of black and gray swept over us. A shock wave actually knocked me backwards about 10 feet and I landed on my back. I lost my wind. I was in the middle of a cloud at that point. Everything was black. The unimaginable had just happened."

Former NYC paramedic Marvin Bethea: "What people must remember about 9/11 is that the cops, firemen, EMTs all had very physical jobs. These were healthy people who had these jobs. We had to pass a physical every year. The question now becomes, if all these people were healthy, why are they all sick now? You don't need to be a rocket scientist to figure this out. What is the common denominator? 9/11 – Ground Zero."

Former St. Vincent's paramedic Mary Elizabeth Bishop: "On 9/11 I was transporting injured people to the hospital all day. After that, I stayed at Ground Zero and wrapped body parts like heads, torsos, legs, and arms. I didn't realize that I was inhaling all these toxins into my body. They didn't give us respirators and on September 24th I started to get sick but I stayed until October 2nd and went right to the hospital."

Retired NYPD officer Cesar Borja's son Ceasar: "I know I can honestly say that my father is the greatest man I've ever known. I have so much respect for him. So much faith in him and he's taught me so much. Two things he told me have been ringing in my mind since he's been here: Nothing in life is ever easy, and there's no such thing as quitting. Never give up."

Ex-cleaner Mercedes Burgos: "The conditions at 130 Liberty were very bad. I was in the basement. Everything was damaged; there were spoiled food, dead rats, fungus on the walls, contaminated water on the floor. They had me putting papers in a machine and right there I started to feel bad and I couldn't come back to work."

Former EMT Reggie Cervantes, who went to Cuba with Michael Moore for his film "Sicko": "After 9/11, I was unable to get assistance because I had no income and no insurance. In Cuba, nine specialists treated me and I was given tests and medications which were inaccessible to me in the U.S. The doctors treated my asthma, bronchitis, COPD, pulmonary fibrosis, sinusitis, rhinitis, vocal cords lumps, enlarged liver, RADS, chronic acid reflux, and PTSD."

Former volunteer firefighter William Maher: "While volunteering at Ground Zero, I fell off an ATV and worsened a pre-existing spinal injury. None of the specialists in N.J. were in my network, so I couldn't get treated. In Cuba, they took a battery of tests and came up with the diagnosis that I needed surgery. They also replaced my teeth which I had ground down due to PTSD."

Downtown resident Kelly Coangelo: "I knew my apartment would be trashed. It was covered with dust and it was hard to breathe. I started feeling that my throat was raw, I started coughing like I had been smoking cigarettes for half my life, and I got a rash on my hands and face. I got excruciating headaches. I felt horrible – walking up and down stairs was painful. I had the dust tested and the results came back with 1.4 to 2.1% asbestos – higher than EPA regulations requiring a cleanup."

Former FDNY firefighter Tim Duffy: "I'm half the man I used to be – I have to take it slow. A lot of people look at what I'm doing and say that I'm doing fine – they don't see me sucking wind after climbing up and down the ladder. I was a soccer player and a gymnast and used to run long distance – I can't do any of that now. I gotta take rest and take breaks and take my medicine."

Brooklyn resident Jenn Duncan: "I have trouble breathing and burning in my nose and throat, migraine-like headaches, severe nausea, burning joint and muscle pain, great difficulty sleeping and eating, and worst of all, my cognitive capabilities are affected. Before, I was a programmer, technical manager, and business person, very active, organized, and productive. Now, I have trouble walking across a room. It's tough to put two thoughts together, to try to remember anything – thinking is physically painful now."

Demolition supervisor-turned-advocate John Feal: "Christie Todd Whitman lied to the men and women on that pile and said the air was safe to go back to work because of economics – because they wanted to open Wall Street. Men and women who risked their lives without questions are now getting sicker and dying. We were given a death sentence – we just don't know when we're going to die."

Former volunteer firefighter Vincent Forras: "I honestly believe that the number of people who died on 9/11 will be far eclipsed by the number of people who will die directly because of their exposure at Ground Zero."

Stuyvesant High School graduate Amit Friedlander: "Anecdotal evidence of rescue workers at Ground Zero getting similar kinds of cancer made me think that my Hodgkin's Disease might be related to 9/11. I think getting sick opened my eyes to potential health problems and trying to make sure that everyone who was exposed to all this toxic debris after 9/11 is going to have the means for health screening and treatment for their 9/11-related illnesses."

Former FDNY firefighter Ralph Geidel: "When we first got there it was actually like working inside of a volcano – it was extremely hot. We were digging by hand. There was this orange-yellowish smoke coming out. Our skin was turning maroon. We were hoping to find someone alive but it was just bodies. I knew my brother Gary had a skin graft on his heel. I removed firefighters' socks and boots trying to find him. It was horrible from day one to the very end – it was a nightmare."

Former EMT Bonnie Jean Giebfried: "They've left us in the dust because it's about money. Had they given us treatment from the get-go, a great majority of people would not be dying a painful, painful slow death. We're walking time bombs – our time is limited. And 9/11 and the exposure to toxins and not getting treated in time have shortened our lives."

Former volunteer fire chief Thomas Harrigan: "They're turning their backs on us. They don't want to know us. In the very beginning it was, 'You guys are our heroes,' and now they want us swept under the carpet."

NYPD officer Reggie Hillaire: "I just thought that if it was that bad they would have shut us down. No way would our government, which just suffered the worst terrorist attack in the country, open the first responders up to something like that. If it was that bad, they wouldn't have sent us there. I wasn't really thinking about the toxins. One of the reasons I kept going was because Christie Todd Whitman said that the air was safe to breathe."

Lower Manhattan residents Mariama James and her family: "I think that the attack of 9/11 hasn't seen the last of its victims, not even remotely. There's going to be victims for many years to come, unfortunately. I just hope that the government would decide to look into this and maybe give back the money that they've taken from New York City and start looking into some respiratory health for everyone. Right now there's at least some for adults. There's nothing for children. We all need to be checked."

Dr. Stephen Levin, Medical Director, Mt. Sinai Center for Occupational and Environmental Medicine: "When we heard Christie Todd Whitman get on TV and say that the air quality was safe we were horrified because we already knew that there were people being exposed to high burdens of irritants down there and that people were already suffering respiratory problems, so we knew that it couldn't possibly be safe. It had terrible consequences."

Former Air National Guardsman Mike McCormack: "I noticed a large swatch of red cloth under a large beam. My immediate thought was that this was a woman victim. We started digging like mad. Soon I realized that it was an American flag that I had found. The flag was identified by the Port Authority as the flag which was flying atop the towers as they were attacked and destroyed."

David Reeve, FDNY paramedic and husband of the late FDNY paramedic Deborah Reeve: "I'd like my wife to be remembered as a person who wasn't afraid to do her job, and her most important thing was the kids. Really, everything she did was for our two kids. When it came time to do her job she did her job, no questions asked. She was a very good mother, a good wife, and an excellent paramedic."

Former NYC Sanitation boat driver Jack Saltarella: "The dust was outstanding – I never smelled or tasted anything like this in my whole life – it was horrible. Orders were given to not hose down debris at the risk of destroying evidence. It got much worse, because now there was no water to hold down some of this dust. It was all over the place. It blew all over. The boats were totally filthy black, us guys were filthy. Our nose, our ears, our hair, everything about us was covered in this dust."

Former iron worker John Sferazo: "Most of America wants to just forget about 9/11. And you know what America? So help me God I don't blame ya. But just understand – there's people like us out there who can't forget. We can't go on with our lives. Our lives will never be the same. We can't heal, America. There's a lot of who can't get back to where we were."

Former NYPD detective Belinda Shaw: "9/11 was something we didn't expect. It was an attack on our city. Even though I became ill, because I love being a police officer and a detective, it brought me such joy and happiness and accomplishment, to just help people. If I had to do it again, I would do it again, because that's how our police officers are. That's our job – we had to help the families bring closure, to find a loved one."

Former construction worker Frank Silecchia: "I've tried to go back to work but I've been discharged. I don't have the stamina any more from this 9/11 stress that I'm going through and the physical disabilities. Financially I am destitute, mentally I am destroyed, and physically I am inept. I'm tired of living in my trailer and of not being able to perform work. I need to exist. Scraping by is not existing."

Former union official Vito Valenti: "We were in the pile. You could smell death. Everything was burning still. It was like war. It went from a nice sunny day to total devastation. For me it will always be September 11th. I could have chosen to run over that bridge but I wanted to help. I would do it again in a heartbeat. I would go with my oxygen tank."

Former NYPD detective John Walcott: "My doctor said 'You got leukemia, you got a week to live, get to the hospital.' My form of leukemia is a toxin form, not a hereditary cancer – caused by exposure to benzene which is in jet fuel."

Former NYPD detective Rich Volpe: "My diagnosis was IgA nethropathy. The filters in my kidneys are shutting down. It's causing high blood pressure, high cholesterol, and high levels of uric acid so I get gout very often which is probably the most painful thing I ever felt in my life."

Former administrator of the Environmental Protection Agency Christie Todd Whitman: "It's utterly false then for EPA critics to assert that I or others at the agency set about to mislead New Yorkers and rescue workers. Every statement I made was based on what experts, who had a great deal of experience in these things, conveyed to me."

Joseph Zadroga, father of NYPD detective James Zadroga whose death was linked directly to 9/11 exposure: "I want James to be remembered as a hero that he was. I'd like them to recognize him as a line of duty death so he gets the respect that I think he deserves. The same thing for the other guys – they all deserve that. They never even recognized these guys' heroism. They didn't even recognize what they did for the city and the country. To me that's outrageous. They didn't appreciate what everybody did, that's for sure."

The above excerpts are from interviews up to one hour long. One universal comment from all of the first responders was that they would do the exact same thing all over again, even knowing the consequences. They worry, however, that other responders may hesitate to act selflessly in a similar crisis knowing that they would not be treated well by their employers and governmental authorities.

My plan is to continue documenting the story of these hidden victims of 9/11, despite the difficulty of getting this work published in magazines. For the fifth anniversary of the 9/11 attacks, Newsweek ran a cover story on "World Trade Center," the movie; Time magazine's cover story was a think piece called "Looking Back on 9/11 From 30 Years in the Future" or something silly like that. New York Magazine ran a cover story titled "What If 9/11 Never Happened?" That really vexed me, because 9/11 really did happen, and heroes as well as everyday people are suffering and dying. The human toll is staggering, and it's only going to get worse. The public and the politicians need to know this. I hope that room is left on the memorials for the names of future 9/11 dead.

View "The Hidden Victims of 9/11" Gallery

NOTE:

• Sick 9/11 first responders can get help at The World Trade Center Medical Monitoring Program.

• Sick residents and workers can get help at The Bellevue Hospital Center.

• The following organizations help those sick from 9/11: Unsung Heroes Helping Heroes; The Fealgood Foundation; Faithful Response; and The Gear Up Foundation.