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9/11 Dust, Air Hunger, and City’s Lung Specialist

Majid Ali, M.D.

There are two profound ironies in the annals of 9/11-related breathing disorders. First, a doctor on center stage who should have foreseen the grave and imminent dangers of 9/11 dust—a lung specialist—completely failed to do so. Second, this doctor could have played the perfect part in the prevention of considerable preventable lung injury—being the Deputy Medical Officer of the New York City Fire Department—but completely neglected his ethical responsibilities of assuring optimal nutritional and detox needs of the firemen sickened firemen by the consequences of 9/11 dust. He fully participated in the wide-ranging acts of denying the rescue workers sorely needed nutritional and detox therapies. Seven years later, he claimed that no one could have predicted the scale of suffering. That is a brazen distortion of the facts. In 2002, in my book September 11, 2005 I did exactly that. 1 I reproduce text from this book to show how clearly I forecasted the 9/11-related breathing problems seven years earlier.

That doctor was David Prezant, M.D. He was in charge of the health matters of the New York Fire Department in years before and following September 11, 2001. His work has been widely praised,,2,3 but requires a careful scrutiny. Specifically, I raise these crucial questions:

1. Did he remember what he was taught in medical school about environmental toxins: the liver detoxifies most toxins with glutathione, vitamins, and other nutrients?

2. Did he recognize that people sickened by massive environmental toxins have special detoxification needs?

3. Specifically, did he realize that the sick 9/11 rescue workers required the crucial nutrients in larger amounts?

4. Did he have any clinical experience in nutritional medicine?

5. If he did not, did he seek advice from the city’s experienced nutritional physicians who had published peer-reviewed scientific papers?

6. If he had not studied the principles and practice of environmental medicine, did he try to find that information from the practitioners of environmental medicine?

7. Within days of the massively toxic exposures, all firefighters working at Ground Zero reported severe hacking cough, dark mucus containing black solid particles, sinus symptoms and gastric reflux symptoms. Why did he not recognize that usual drug regimens would not work for them?

8. Toxicity caused by chemicals cannot be controlled with more chemicals. As a pulmonologist, how could he remain blind to severe and incremental respiratory toxicity which was recognized by all citizens?

How can Dr. Prezant’s spectacular failures be explained? How could an experienced lung specialist listen to so many sickened firefighters, and for so long, and not see the obvious: his drugs were not working for the firefighters. Why was he not aware of the American Academy of Environmental Medicine? Or of the City’s large number of practicing nutritional physicians? The answer: there are deep prejudices against nutritional and environmental medicine in the United States. The champions of the prevailing model of pharmacologic drug medicine mercilessly suppresses these disciplines. The most disturbing aspect of these problems is that most doctors in the country are woefully uninformed about the enormous body of published peer-reviewed American and international scientific papers on the subjects. Lamentably, they do not seem to remember basic biochemistry of metabolic detoxification, and therefore are unable to clinically apply that knowledge.


*  9/11 — A Tragic Story of Neglected Ethics

* The Untold Story of 9/11 Toxicity, Politicians, and the City’s Medical Examiner

* 9/11 Dust, Air Hunger, and City’s Lung Specialist


Environmental Toxicity in the Age of Drugs

In 2002, I published my book September 11, 2005 because of these crucial issues. I was certain that even the deep, persistent, and long-lasting toxicity of the cataclysmic events of the Twin Tower inferno would not change their minds about environmental toxicities. I was so certain of the malignant prejudice of the editors of medical journals and medical professors that I predicted all people sickened by the 9/11 dust will only be treated with drugs and talk therapy at the city’s medical centers. That, as history shows, was all that happened.

Here is the follow up: David Prezant, M.D. was trained as a lung specialist. For four decades, I worked with many pulmonologists. None of them showed any interest in critical detoxification and detergent cellular functions of oxygen—nutritional deficiencies and environmental pollutants are the principle threats to oxygen homeostasis—and never put such knowledge into clinical practice. Prezant proved not to be an exception. He has no record of any work with nutritional and detox therapies to treat severe respiratory toxicities. After the 9/11 catastrophe, he was in an eminent position to restore the health of people sickened by 9/11 dust by focusing on oxygen homeostasis with nutrient therapies and detoxification. There is no record that he did any of that. Lamentably, he only supported drug medicine that was utterly irrelevant to the deep and massive cellular injury caused by the 9/11 terror and toxicity. In my book September 11, 2005 (2002), I predicted that many people exposed to 9/11 dust would develop air hunger, a symptom often experienced by people exposed to air toxins but not described in medical textbooks. When chest CT scans are negative in such cases, doctors usually think the patient imagines air deficiency.

The Predictable Was Predicted

Professor David Prezant claimed that the 9/11 lung-related (pulmonary) toxicity issues could not have been predicted (see his quote below). He was completely wrong. I predicted it succinctly in my book September 11, 2005. Below are his precise words followed by my exact words:

"This exposure at ground zero was so unique that no one could have predicted the impact on lung function. We demonstrated dramatic decline in lung function, mostly in the first 6 months after 9/11, and these declines persisted with little or no meaningful recovery of lung function among FDNY rescue workers (firefighters and emergency medical service workers) over the next 6 and a half years," said David Prezant, M.D., Professor of Medicine at Einstein and senior author of the study. 4

Here is my response to the above:

No one could have predicted! Yes, it was definitely predicted.

Little or no meaningful recovery of lung function. Why would he expect a difference? Did he ever lift a finger to detoxify any of those people?

Below, I reproduce some text from my book to provide a frame of reference in this matter: One of the most troublesome symptoms experienced by most sufferers of the black tragedy was air hunger. That also puzzled the doctors most. Cardiologists performed cardiograms, echocardiograms, and heart scans and pronounced the heart to be normal except for some raciness which they attributed to anxiety. Pulmonologists analysed blood gases and found normal oxygen saturation levels. Lung scans were read as negative by radiologists. Hematologists ran tests for anemia but found none. How could anyone ever be hungry for air, they asked with consternation.

And yet, the sufferers continued to report air hunger. They used words to express their sensations which would be hard for anyone to make up. Some examples follow:

"I'm breathing but I'm not."

"I'm oxygen-starved. Has anyone ever told you that? I mean someone who doesn't have pneumonia or something."

"I'm only nineteen but I breathe like a ninety-one year old."

"How can I be so short-winded when I do so little?"

"Breathing takes so much energy. I feel awkward telling you that."

"It's oxygen. I know I don't have enough of. I just know that."

"I have the metabolism of a snake. I don't really know what that is. I guess what I mean is that there is not much air in me."

Many people, who were healthy before exposure to 9/11 dust, developed sinus and lung inflammation, chronic cough, and air hunger. Ten years after the dust exposures, some still complain of air hunger. Most doctors dismiss it as hypochondria because it does not fit into their preconceived notions of lung injury. Only a handful of enlightened pulmonologists recognize the problem. Even they fail to reduce inflammation by prescribing liver and bowel detox therapies. Below, I include additional text from September 11, 2005 to show how individuals with the symptom of air hunger describe it:

"I work 20 hours in a week in an antique shop. It is a lot of fun. But sometimes I can't breathe there. I have this air hunger, then my chest hurts."

"After three dances, my muscles suddenly went dead. I simply couldn't breathe, just like they tell you what happens after a heart attack."

When some of the victims began to feel better, their words went like this: Now after 3 years, I can breathe again, feet connected again."

Why Didn’t Prezant Seek Proper Medical Advice

New York City officials responded to the 9/11 crisis with admirable intelligence, promptness, and diligence. This makes Dr. Prezant’s failure to seek and obtain sorely needed advice from consultants in nutritional and environmental medicine all the more puzzling. The contrast between his inaction and the responsible action of Kelly McKinney, another senior level City executive is revealing. McKinney, the City health department’s Associate Commissioner for environmental health quickly discovered something important in the City’s response to the cataclysm: he could consult with—ask and receive expeditiously just about anything from just about anyone—without heeding the City’s rigid requisitioning procedures. For example, to his credit, he rapidly requisitioned five environmental consultants from the New York City School Construction Authority.5 What makes this contrast so significant is that while McKinney sought and received environmental consultant advice within a day of the 9/11 inferno, Prezant has failed to do so even after seven years. Indeed, it seems probable that he would dismiss my arguments at hand today if he were asked to defend his inaction in September 2001 and his continuing failure to provide optimal care to firefighters ever since. It was not sufficient then—as it is not today—to simply monitor the sickened firefighters in 9/11 registries and withhold robust and deeply needed nutritional therapies and detox measures.

Why Didn’t Prezant Challenge Whitman

On September 18, 2001, EPA administrator, Christine Todd Whitman, declared: "We are very encouraged that the results from our monitoring of air-quality and drinking-water conditions in both New York and near the Pentagon show that the public in these areas is not being exposed to excessive levels of asbestos or other harmful substances." Next she spoke her now immortalized words: "Given the scope of the tragedy from last week, I am glad to reassure the people of New York … that their air is safe to breathe and the water is safe to drink." This was a stunning statement from the country’s highest official for environment protection. Indeed, I was so deeply offended by the statement that I decided to write a book to protest Whitman’s outrageous assertion and state my predictions in unequivocal words.

How could David Prezant, a lung specialist who claimed to be an expert on the matters of environmental toxicities routinely encountered by the city’s firefighters, ignore Whitman’s absurd words? There is no record he publicly challenge Whitman.

My first images of the collapsing North Tower conjured a clear vision of plumes of a thousand chemicals. I knew the news media would focus on asbestos—City lawyers had made fortunes popularizing this substance over many more potent carcinogens—because they couldn’t even pronounce most chemicals in that devil’s douse. I imagined a thousand chemicals released from the Twin Towers and a thousand more produced by reactants melting in the inferno. Days later arrived the estimate of 2,500 chemical components of the dust offered by the air pollution expert and University of California Davis Professor Emeritus Thomas Cahill. Specifically he referred to unprecedented levels of dioxin (the most potent carcinogen known), hundreds of PAHs (polycyclic aromatic hydrocarbons), pulverized plastics, crystalline silica, mercury, lead, cadmium, and myriad elements known to cause kidney, heart, liver and brain damage. All this, of course, was well known by the EPA at the time of collapse. 6

How could Prezant, a senior city official, ignore all of the above? How could he see sick and sickening firefighters, day after day, and not raise his voice against the EPA administrator? Perhaps, the answer lies in his loyality to his boss, Mayor Rudolph Giuliani, who declared the City air to be safe on September 12. 5

Lung Specialists and Evolutionary Oxygen Design

Pulmonologists consider themselves to be lung specialists. One would expect them to be interested more deeply in oxygen than any other element. In intensive care units, indeed, they are most sharply focused on oxygen. They also serve well individuals with lung scarring who travel with oxygen tanks. However, they have little, if any, interest in crucial oxygen roles, such as cellular energy generation, development, differentiation, and death. In my clinical work, I recognize oxygen’s cellular detergent function to be the most significant. A Google search on September 11, 2010 failed to show a single article written by a pulmonologist addressing oxygen’s detergent functions.

Evolution did not design oxygen homeostasis only for burning foods to produce energy. Oxygen is the organizing principle of human biology and governs the aging process. I began my book Aging and Oxygen (2000) with these words. I followed that volume with a series of articles in which I marshaled evidence for the Unifying Oxygen Model of Disease. Specifically I presented oxygen models of inflammation, pain, liver injury, asthma, allergy, colitis, heart disease, stroke, kidney failure, cancer, and other disorders. The crucial importance of the Unifying Oxygen Model of Disease is:

* It explains the primary aging processes in the body;

* It sheds light how health can be preserved by addressing all oxygen-related issues;

* It elucidates how toxicities of foods, environments, and thoughts cause disease;

* It allows the development of rational and effective designs for reversing chronic disease; and

* It provides mechanisms by which time-honored natural remedies work.

So for understanding molecular biology of all diseases and for rational measures for the prevention and treatment, first and foremost, we must understand how oxygen governs human biology. Next, it requires ecologic thinking and holism.

Human lungs do not exist only to deliver oxygen to blood and breathe out carbon dioxide. It conferred upon the lungs special mechanisms to protect themselves from dust, particulate matter, and, to some degree, obnoxious gases. However, there is a limit to such self-protective and self-cleansing functions. The 9/11 dust was far too dense, polluted, penetrating, and pervasive for the lungs to cope with. People exposed to this dust did not need to be reminded of this. They knew the truth even when Mayor Giuliani deceptively tried to assure them on September 12, 2001 that the air was safe to breathe. Nor did the dust become less toxic when Christie Whittman pronounced the official position of the Environmental Protection Agency that air was safe. People choked with that air, coughed, and experienced stinging eyes. They trusted their deeply insulted tissues rather than believe official white lies.

I refer professional readers to Darwin and Dysox Trilogy (2009), the tenth, eleventh, and twelfth volumes of my textbook entitled The Principles and Practice of Integrative Medicine for a detailed discussion of the above subjects, as well as for extended citations. All twelve volumes of these textbooks are devoted to three unifying principles?

* First, no part can be understood without understanding its relationships with the whole—the Darwin Principle is my designation for this—and so relatedness of natural phenomena must be the basis of all efforts to understand and treat all diseases;

* Second, oxygen is the organizing principle of human biology and governs all healing in the body—all relevant oxygen issues must be addressed in all diseases for best long-term results;

* Third, each individual is a unique person and requires an individualized application of the principles of relatedness and The Oxygen Model of Disease.

The Oxygen Disorder

In my book Oxygen and Aging (2000), I introduced the term oxygen disorder for dysfunctional oxygen homeostasis (metabolism and balance). Below is text reproduced from September 11, 2005 to describe the oxygen disorder in simple words:

A car engine mixes fuel and oxygen to produce energy. A properly maintained engine performs without generating excessive toxic exhaust. An engine clogged with soot produces less energy and more toxic fumes. The basic difference between the two is that fuel is completely burned in the first instance, leaving relatively little toxic residue behind, whereas in the second instance incomplete combustion leads to the generation of excess toxic residue.

Like the good engine, a healthy person uses oxygen to extract clean energy from his meal. By contrast, a human canary with an oxygen disorder cannot do so without producing excess toxic waste which, in turn, causes fatigue and immune weakness.

The presence of the oxygen disorder can be easily established by doing urine analysis for toxic acids.

Professional Misconduct With Diligent Record Keeping

The diligence of Dr. David Prezant and his colleagues on the faculty of Einstein Medical School University in precise documentation of the long-term effects of respiratory toxicity of the 9/11 dust is commendable. But it must not be allowed to hide their reprehensible professional misconduct in completely neglecting the special needs of the sickened firefighters and emergency rescue workers. The website of the University Hospital and Academic Medical Center for Einstein Medical school lists Dr. Prezant as Professor of Medicine and the Chief Medical Officer of the FDNY, Office of Medical Affairs and the co-director of the FDNY WTC Medical Programs. No physician was in a better position to recognize the true magnitude of the toxicity of the 9/11 dust. And yet, as a physician he utterly failed the people in his trust. This is harsh but well deserved indictment. To support my assertion, below I include two quotes: (A) the first from the University web site that definitely proves the Prezant team recognized the dangers; and (B) the second from their his report published in The New England Journal of Medicine in which they admit that the lung injury of firefighters and EMS workers worsened under their noses, year after year, while they withheld sorely needed nutritional and nondrug anti-inflammatory therapies.


David Prezant, M.D." All smoke contains particulates, but not at the density seen in the WTC collapse, especially if you were at the site during the first two or three days or for long durations thereafter," said Dr. Aldrich. "In a normal fire, you don’t get enveloped in a particulate cloud so thick that you can’t even see through it."3


"Surprisingly, we observed little or no recovery of average lung function during the 6-year follow-up period. Indeed, from 2002 through 2008, FEV1 values continued to decline, so that the overall loss in lung function from early 2001 until late 2008 averaged almost 600 ml for firefighters who had never smoked and more than 500 ml for EMS workers who had never smoked."4

9/11 Dust, Inflammation and, Lung Function.

Inflammation in any part of the body fans the flame of inflammation everywhere else in the body. Specifically ecologic disruptions in the bowel and impaired detoxification pathways of liver cause and intensify inflammtion in the lung. The enormous clinical significance of this is: Detecting and addressing all bowel- and liver-related causes of inflammation are essential for reversing inflammation and tissue injury in the lungs. This is where the true potential of effectively addressing lung injury of the firefighters and EMS workers was and this is where Dr. Prezant and his team failed completely with serious consequences.

I anticipate a rebuttal of my arguments from Dr. Perzant and his defenders. They will counter that there is no scientific evidence that nutritional therapies and restoration of bowel ecology can reduce inflammation in the lungs and improve respiratory function. In response I refer them to a an enormous body of medical literature which I summarized in two articles prestigious peer-reviewed journals, one being the American Recent advances in integrative allergy care. Current Opinion in Otolaryngology & Head and Neck Surgery8 and the other, the European journal entitled Environmental Management and Health.9 In these and other articles, I also present personal microscopic observations to demonstrate the bowel-lung links. For an in-depth discussion of these crucial issues, I refer professional readers to Darwin and Dysox Trilogy (2009), the tenth, eleventh, and twelfth volumes of my textbook entitled The Principles and Practice of Integrative Medicine.10-12


1. Ali M. September Eleven, 2005. New York, Aging Healthfully Book 2002.

2. DePalma, A. City of Dust — Illness, Arrogance, and 9/11. 2001. FT Press. Upper Saddle River, New Jersey.

3. (

4 Aldrich TK, Gustave J, Hall CB, Prezant DJ, et al. Lung Function in Rescue Workers at the World Trade Center after 7 Years. N Engl J Med 2010; 362:1263-1272April 8, 2010.


6. DePalma, A. City of Dust — Illness, Arrogance, and 9/11. 2001. FT Press. Upper Saddle River, New Jersey. Page 49.

7. Anita Gates, "Buildings Rise from Rubble while Health Crumbles", The New York Times, September 11, 2006, reporting on the documentary by Heidi Dehncke-Fisher, "Dust to Dust: The Health Effects of 9/11".

8. Ali M. Recent advances in integrative allergy care. Current Opinion in Otolaryngology & Head and Neck Surgery. 2000;8:260-266

9. Ali M. Oxidative coagulopathy in environmental illness. Environmental Management and Health. 2000;11:175-191.

10. Ali M. The Principles and Practice of Integrative Medicine Volume X: Darwin, Oxygen Homeostasis, and Oxystatic Therapies. 3 rd. Edi. (2009) New York. Institute of Integrative Medicine Press.

11. Ali M. The Principles and Practice of Integrative Medicine Volume XI: Darwin, Dysox, and Disease. 2000. 3rd. Edi. 2008. New York. (2009) Institute of Integrative Medicine Press.

12 Ali M. The Principles and Practice of Integrative Medicine Volume XII: Darwin, Dysox, and Integrative Protocols. New York (2009). Institute of Integrative Medicine Press.

Related Tutorials

* Environmental Health

*  9/11 — A Tragic Story of Neglected Ethics

* The Untold Story of 9/11 Toxicity, Politicians, and the City’s Medical Examiner

* 9/11 Dust, Air Hunger, and City’s Lung Specialist







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