Tuesday, October 20, 2020


From an interview with (RET) FDNY Chief Anthony Bruno

Chief Anthony Bruno, decorated career firefighter with the FDNY (1962-1989) achieved top ranks of leadership as Captain of ladder 12 on 17th Street in Manhattan in the late 70's then Chief in Bushwick, several years later.  Celebrating his official retirement from the department in 1989, Chief Bruno found himself suiting up again, this time as a volunteer in the 9/11 WTC disaster of 2001.  He and the thousands of first responders raced to southern Manhattan to help all survivors, only to be exposed to some of the most lethal neurotoxins and carcinogenic compounds expelled by the incinerated building materials where The World Trade Center towers once stood.

Throughout his career, Chief Bruno took the initiative to research and investigate the health effects of carbon monoxide exposures to first responders. Standardized blood samples showed reports of lethal levels of carbon monoxide in the system three or four hours after the event. Because of this, he implemented the use of advanced testing devices (c/o the NY EPA) to check for CO levels in the exhaled breath- with 97% accuracy. Chief Bruno saw the value in this testing protocol as he proposed a department-wide screening program to identify those suffering from too much exposure.

"Doctors (at the time) posed the misconception that carbon monoxide did not have a cumulative effect. The average resident in a house fire may not usually get affected this way, but firefighters on regular duty can often be exposed frequently throughout a single night. This frequency in exposure holds somewhat of a half-life theory, similar to radiation as far as toxins staying in the bloodstream. The build-up from elevated levels continue to rise after further exposures. 


During active duty, Chief Bruno claimed to directly know (and work with) firefighters who died from frequent exposures -- having gone to three or four fires each shift while never getting tested for carbon monoxide. "From what we now know, early detection and regular exposure testing could have prevented a lot of occupational injuries. Learning from history is also why the firefighter is much more protected these days. Today's use of masks is much more universal and mandatory, unlike the old days where firefighters hardly used them. Technology evolved and eventually so did we... but sometimes a little bit too late."

Referencing historical fires in NYC with recorded health effects to the responders, Chief Bruno noted landmark disasters including the 1975 NY Tel Fire and the 699 firefighters who were all exposed to the most lethal black smoke from burning PVC's and hazardous plastics. He also shared his own experience as the covering captain in 1979 at the fire in St. Batholomeow's Church (several blocks from St. Patrick's Cathedral) where he recognized great similarities to both incidents - including the deadly effects of burning pool & gardening chemicals and PVC's from the church.  Responders of both fires (within the same era) identified "a new type of fire"- incinerating high levels of carcinogens resulting in latent mortality cases.

The Diagnosis and Treatment of Carbon Monoxide Poisoning:
Excerpt from source: NCBI/NIH

The symptoms of carbon monoxide poisoning are usually non-specific. In patients with unclear neurological symptoms and possible exposure, carbon monoxide should be urgently considered as a differential diagnosis.

The treatment aims in particular to prevent long-term harms, such as cortical dysfunction, Parkinson‘s syndrome, Parkinson‘s disease, dementia, cardiac complications, as well as reduce mortality in the long term. All patients with symptomatic carbon monoxide poisoning should be treated with 100% oxygen as soon as possible. In severe cases of fire fume intoxication, combined poisoning with CO and cyanides should be considered. The evidence for the benefit advantage of hyperbaric oxygen is weak in view of the heterogeneity of the available studies. The decision in favor of HBOT seems sensible in severe CO intoxication or in pregnant women.

Assessment of hyperbaric oxygen therapy versus normobaric oxygen therapy
According to a report from the NIH, the intracellular and extracellular effects of carbon monoxide poisoning affect in particular the organs without oxygen reserves (heart, brain). Toxicologically, the quickest possible elimination of the poison is the most sensible way to prevent further injury. The higher the partial pressure of oxygen provided, the shorter the elimination period—which would in theory support hyperbaric oxygen therapy (HBOT). In practice, however, HBOT is the subject of controversial discussion (20, 21). Critics point out the great logistical challenges and lacking evidence. In actual fact, the heterogeneity of the studies to date (in terms of study design, kind of exposure, severity of intoxication, delay in treatment, treatment pressures applied, and follow-up period) barely allows for any evidence-based recommendation regarding the type and extent of HBOT (25). What adds to the dilemma is the fact that the HBOT therapy schemes applied vary widely across Europe (e57), which imposes limitations on future meta-analyses and their validity too. (See complete report on NIH)

20. Wolf SJ, Maloney GE, Shih RD, Shy BD, Brown MD. Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with acute carbon monoxide poisoning. Ann Emerg Med. 2017;69:98–107. [PubMed] [Google Scholar]
21. Buckley NA, Juurlink DN, Isbister G, Bennett MH, Lavonas EJ. Hyperbaric oxygen for carbon monoxide poisoning. Cochrane Database Syst Rev. 2011;4 CD002041. [PMC free article] [PubMed] [Google Scholar]
22. Mintegi S, Clerigue N, Tipo V, et al. Pediatric cyanide poisoning by fire smoke inhalation: a European expert consensus. Pediatr Emerg Care. 2013;29:1234–1240. [PubMed] [Google Scholar]
25. Hampson NB, Piantadosi CA, Thom SR, Weaver LK. Practice recommendations in the diagnosis, management, and prevention of carbon monoxide poisoning. Am J Respir Crit Care Med. 2012;186:1095–1101. [PubMed] [Google Scholar]

As part of our evaluation of all occupational illnesses contracted by first responders, we enter the world of TOXICOLOGY- the branch of science focused on the effects and detection of poisons.  It is also the discipline overlapping chemistry, biology and pharmacology- studying the adverse effects of chemical substances on living organisms.  In pursuit of first responders’ safety as far as chemical effects on the body, we connected with Professor David Purser of the Hartford Environmental Research (UK), a renowned toxicology expert who conducted major reviews on fire-exposed carcinogens published worldwide. “9/11 was unusual in that a major environmental hazard resulted from the dust cloud released as and after the Towers collapsed,” says Prof. Purser.  “The dust inhaled by responders at the time, and afterwards working at the site, has resulted in serious ongoing and developing health conditions and to this day.  For fires in general, there is also increasing evidence and concern regarding FF exposure to carcinogens, especially from soot contamination to skin and clothing following attendance at incidents and during training.” An abstract from Prof. Purser’s latest presentation – “ Toxins Including Effects of Fire Retardants, During Fires and Post-Fire Investigation Activities” indicates a remarkable breakdown of some of the major toxins and carcinogenic compounds that the average firefighter would be exposed to. (See complete article)

According to Dr. Paul Schulster, (pulmonologist from Oceanside, NY) the COUGH can say a lot, but often misleads the patient as a "nothing" or a "simple little cough".  For firefighters, it is usually a telltale sign of various possible issues. The first syndrome often comes from a post-nasal drip. The second most common cause is from irritation, inflammation and bronchiospasm. Third is Gastroesophageal Reflux Disease. My 9/11-related patients that have GERD starts with that warning cough while others' coughs can trigger the asthma.  Finally, Irritative Cough Syndrome can also happen where one cough leads to another cough, irritating the airway, exacerbating another cough - and then another.

Having a cough here or a wheeze there is not enough for most first responders to raise the flag of alarm. Seasoned specialists like Dr. Schulster recognizes that unique and unusual symptoms or maladies do not reach the patient's consciousness for quite some time.  Ignoring or not paying more attention to these "little" anomalies tend to often be the norm.  These coughs may progressively grow worse over the years and then one day they begin to wheeze a little more than usual and wind up with advancing shortness of breath.  Once this becomes significant and finally enters their consciousness, only then will the thought of seeking medical help actually come to mind.

Oftentimes, an exam from the pulmonologist starts with the CAT scans of the chest. The firefighters are being tracked for pulmonary nodules. They're referred to as sub-centimeter nodules, which are so small that you can't read it. "You don't really see them on a plain X-ray, chest X-rays, PA and lateral. A lot of these first responders already come to me with CAT scans from the past and have been followed by World Trade Center program and the FDNY doctors that are also pulmonary doctors"- states Dr. Schulster.

In a pulmonologist's tool kit exists certain standard pulmonary function examss- including the SPIROMETRY [2].  This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out [5].   This allows us to  see the best way of determining the lung function in numbers, more or less, is a complete pulmonary function test.  Next is the METHACHOLINE CHALLENGE [3] - also known as an asthma trigger that, when inhaled, will cause mild constriction of your airways.  If you react to the methacholine, you likely have asthma. This test may be used even if your initial lung function test is normal. [5]   Another test used is THE COLD AIR CHALLENGE [4]. The  patients generally come with having had those in the past and most are positive for asthma. In the asthmatics. 

See original article published 7/2019 @ The Journal of Modern Healing


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Sunday, February 16, 2020

45th Anniversary of the 1975 NY Telephone Exchange Fire

Red Star of Death
By Danny Noonan- retired FDNY Firefighter and former Fire Technology Instructor
Miramar College, San Diego, Calif.

The gravity of the situation hit me when I and five other FDNY firefighters arrived in our apparatus, slightly after midnight, in front of the New York Telephone Exchange Building on 2nd Avenue and East 13th Street in Manhattan. We descended to the sub cellar where lobby display panels indicated the fire was located. I was unaware at the time that 694 additional firefighters over the next 17 hours would follow our lead. I was 26 and had been a firefighter for two years.

Following 9/11, many consider the fire at The New York Telephone Company the second most deadly and costliest in the history of the Fire Department, City of New York (FDNY). Internationally, first responders refer to the fire as The Red Star of Death because a red star was stamped on the medical folder of each firefighter.

Photo source: Wikipedia
The timing for the retelling of the story is prescient:  February 27, 2020 marks the 45th year of this horrible incident that caused loss of life, communication disruption and the unconscionable abandonment by the City of New York of its firefighters.

The New York Telephone Company Main Switching Center building was a virtual fortress. The structure, designed to be earthquake and riot proof, with windows constructed of heavy wire glass in reinforced steel frames that were mounted with ¼ inch Lexan--- a bullet-resistant plastic. At the time of the fire, all windows at street level and on the second floor were covered with heavy metal cages to protect from vandals.

Constructed in 1925, the art deco, 11 story structure, located at 204 Second Avenue, served as the main switching center for the Lower East Side and downtown Manhattan.  It served a 300 square- block area and was equipped to handle 10,000’s of calls an hour.  Its customers included major business, six hospitals, nine housing projects, three universities - including NYU, 11 secondary schools, several NYPD police precincts, all units in the FDNY’s First Division and 190,000 residential phones.

The fire in the sub cellar grew to where there were 300 firefighters operating at one time, eventually as more alarms were transmitted, that figure expanded to 699 firefighters. We began the deep decent into the basement of the building.  The halls were long and tiled: an intricate labyrinthine maze, with several steel doors in several locations.  Smoke had gathered at the top of the corridors, creating a dim mist that caused the fluorescent lights to give off an eerie glow fading into blackness.  The constant ringing of the fire Klaxons - identical to a submarine dive alarm - added to the surreal environment.  The smoke was so thick that everyone used a lifeline (search rope) to enter and exit the building.

To gain access to the cable vaults firefighters descended a steep steel ladder to a passageway that led to series of three five – foot ladders.  This led deep into the underbelly of the sub-cellar cable vaults.  There was no vertical ventilation and no apparent means of secondary egress. The basement vault contained a maze of cables. The PVC coating on the thousands of copper cables were burning inside the pipe risers that led to the upper floors of the building. Visibility inside the cable vault was zero.  Adding to those harsh conditions was the melting polyethylene from the cables that was sticking to the firefighters boots, making our search even more taxing

The building was eventually engulfed in 10 million square feet of toxic smoke.  FDNY firefighters were exposed to thousands of pounds of burning polyvinyl chloride (PVC), hydrogen chloride, vinyl chloride monomer, and chlorinated dioxins.  The chlorinated dioxins are the most potent cancer carcinogens known to man.

The wind driven toxic smoke engulfed the whole neighborhood. At midday, motorists on the FDR drive seven blocks away – had to turn on their headlights to drive through the thick clouds of black smoke. Patients at the adjacent New York Eye and Ear Hospital were removed by stretches and wheelchairs to ambulances where they were evacuated to other hospitals. The Red Cross set up shelter for evacuees at local YMCA’s

The following transmission came from George Meade, WINS radio reporter, from a helicopter at 1,200 feet, at 08:20 , “It’s unbelievable. It’s like a movie.  It’s the fire in the phone company down there.  It’s a very smoky fire. The smoke extends all the way to Queens.”  The Mayor made a brief appearance at the height of the fire.  After taking a breath of the acrid smoke, he quickly returned to his limo and left the scene.

The firefighters depleted nearly 2,000 air cylinders for their self contained breathing apparatus (SCBA).  Firefighters who lost consciousness were rushed to Bellevue Hospital emergency room. Phones in Lower Manhattan went silent. The 911 emergency systems also were silent.  The Department was operating on its emergency back-up communication system.  From the initial alarm at midnight until late afternoon the following day it was a total of 17 hours before FDNY commanders announced that the fire was now “Under Control”.

At this fire 250,000 pounds of PVC insulation bound to One Billion feet of cable that would melt into hundreds of tons of smoldering toxic chemicals; bent structural steel, spoiled concrete and sent hundreds of citizens from the community to hospital emergency rooms. PVC emits hydrogen chloride gas when it comes in contact with moisture - such as a throat - it turns into hydrochloric acid. The acid damages tissue and the carcinogenic chemicals initiate and/or promote cancer.

Consequently: for weeks, there were 8,500 businesses and thousands of professional people without phone service, in a pre e-mail era, who were unable to communicate with customers, clients and their supplies.  The destruction led to catastrophic economic impact that was felt nationally and also had many global implications.

As time passed the firefighters from the “Phone Fire” were dying off –as young men.  The word was spreading through the firehouses that scores of firefighters had been diagnosed with cancer or lung disease – all of whom were responders to the fire.  We the “Phone Company Firefighters” were ironically sounding the alarm to the City and the Departments Hierarchy – with no response!

I started writing and calling the FDNY Bureau of Health Services.  How could they be unaware?  Were they not informed of Dr. Deborah Wallace, Ph-D, an expert in environmental health, in her book, “Into the Mouth of the Dragon - Fires in the age of Plastics” She devoted a chapter to the Phone Fire, she states, and “Virtually every firefighter who responded to the phone fire’s first two alarms has cancer”. She said there is no doubt that PVC and the Telephone Co. fire caused a cancer cluster.

Were they ignorant of the Bill Moyers, PBS special, ‘Trade Secrets” in which investigative journalists conducted an in-depth study of the manufacture of PVC. Once again, the investigation revealed that manufactures of PVC knew as early as the 1960s that PVC caused cancer and other illnesses—their workers were dying from exposure.   Thirty-one executives of an Italian company were actually indicted and tried for manslaughter because they chose to ignore the overwhelming life-and-death scientific data in favor of the bottom line. Now it appeared that the City of New York was indifferent to the plight of hundreds of its firefighters.

The City’s response in every instance was complete silence.  They ignored us and did not acknowledge our written or verbal pleas in any way. My written and verbal plea to mail cancer warning letters to Telephone Co. responders was not implemented – my thought: ‘Early Detection is the Best Cure!’  There was no post incident analysis to identify cancer clusters and subsequent measures that may be needed – just a Red Star stamped on our folder.

AT&T who was in the midst of a antitrust lawsuit with the Justice Department, on the breakup of the Bell System, marshaled 5,000 employees from across the country (mostly members of the Communication Workers of America - CWA) to begin reconstruction of what was the New York Telephone Building.  AT&T workers along with employees from Western Electric and Bell Labs (Now Nokia Bell Labs) their Herculean task included: Removing hundreds of thousands of pounds of smoldering PVC wiring, Replacing 1.2 Billion feet of wire, Replacing 16 Million switches, Replace 18,000 vented or melted pane’s of glass, Remove 12,000,000 lbs of burnt out debris.

One can connect the dots and assume communication workers cancer rates are as high as the FDNY Firefighters.

There is legislation pending in New York State.  Assembly Bill 4879 and Senate Bill 4920 relate to the time period for filing a toxic tort claim. This could help the firefighters and other victims of the incident including communications workers and others living and working near the Phone Company Fire.

The firefighters unions went ballistic when the “Phone Company Firefighters" were excluded from the New York State Cancer Presumptive Act of 1986 –

The failure of the system to adequately monitor and treat the Phone Company Firefighters is the basis for the FDNY World Trade Center monitoring program.  There was no epidemiology study conducted on the “Phone Company Firefighters” nor the communication workers and residents.  The cancer’s suffered by the phone fire responders is akin to those cancers now prevalent in 9/11 responders.

Located at Fire Department Headquarters, in Brooklyn, is the department’s Wall of Honor, a 40-foot long bronze memorial, with eternal torches burning at each end, is where the New York City Fire Department honors those who have made the supreme sacrifice.

Since 1865, 1,147 firefighter’s names, companies and date of death have been inscribed on individual gold tags. There is an adjoining 9/11 Wall of Honor that lists the 214 members who have died post 9/11 as result of developing cancers and other illnesses subsequent to working at Ground Zero. Yet, firefighters who lost their lives as a direct result of the New York Telephone fire ---“The Phone Fire” --- are not listed.  For they did not die at the scene of the toxic inferno; they had expired only after years, even decades, of suffering from varieties of cancer and respiratory disease.  Yet, paradoxically, they received no department mention of any kind; neither a memorial nor a plaque.

Of the hundreds of deaths, in my opinion, that are a result of the toxic terror that was reined on the 699 fearless firefighters – they are no less noble than 9/11 or any other Line of Duty deaths.

On November 17, 2019, The New York Times published “A Town 'Afraid to Breathe': a Chemical Fire in France Deepens Mistrust". The people of Rouen, France are fearful of the future consequences of a chemical fire in their city; perhaps, they can look to the FDNY Firefighters of the New York Telephone Fire for their answer. Assuredly, the solution is not a stamp of a Red Star!

In the spirit of 9/11, where we proclaimed to “Never Forget” we should encourage our elected officials to implement the necessary legislation to empower first responders, past, present and future with the means to seek recourse and advocate for a safer environment. Together, we must always remember those responders who have been diagnosed with cancer and other aliments resulting from their toxic exposure and “Never Forget” their unending contribution to our communities.

45 years later, the first responders' community including the remaining survivors of the 1975 NY Tel Exchange Fire recognizes this to be one of the most significant disasters in firefighting history next only to 9/11.  The many health impacts from this historical event also resulted in countless safety references from its many occupational hazards as well as prevention protocols and protective innovations.

The NY Cancer Resource Alliance (NYCRA) expresses eternal appreciation to Ret. Ff. Dan Noonan for his contribution and sacrifice to the City of New York and his generosity in the publishing of this report about the 1975 NY Telephone Exchange Fire.  Mr. Noonan was assigned to Ladder Company 3 on East 13th street where only two years into the fire service, he experienced one of the most historical and devastating fires in the history of NYC Fire Department. He has been an advocate for those firefighters who responded to the Telephone Company Fire.  

As one of the remaining survivors of this fire, Mr. Noonan retired from the department in the early '80's and pursued a career promoting fire safety education in the west coast.  Following the Sept.11th attacks, Mr. Noonan flew back to NY to volunteer at Ground Zero and assist his brethren on "the pile".   Now a permanent New York Resident, Mr. Noonan, a former Volunteer Tour Guide at the 9/11 Tribute Center and who was part of the New York City Uniform Firefighters Association  (NYCUFA) Congressional Lobbying Team for the passage of the Zadroga Act - 9/11 Heath Care.  Dan Noonan enjoys his retirement while volunteering his presence in the community as a speaker for cancer prevention and early detection and is one of the latest advocates and awareness ambassadors of NYCRA's First Responders Cancer Resource and the "Get Checked Now!" program.


(Firefighters Against Cancer & Exposures)  www.facingtogether.com 
Active Firefighter / Paramedic at Bedford (TX) Fire Department
"As a current firefighter with almost 17 years of service, I have seen brothers and sisters battle cancer more frequently than I could have ever imagined.  Unfortunately, some of those cases  are more personal and create a greater sense to act.    This film “THE FIRE STILL BURNS” provides a great look at how we began recognizing  firefighters’ illnesses and cancer, but also discovers that these issues were not isolated to 9/11.   Firefighters have performed at the highest standards to protect life and property long before  there was ever a thought about exposures...  They risk  their lives for people they do not know because of their passion to help others.  The general public has no idea  of the true dangers we face while doing a job we love." 

DEBI CAVOLO - president | Breast Cancer Comfort Foundation
"As a sister of an FDNY hero who gave his everything at every fire, I can say that this was an amazing piece of history.  This film shows that although we have looked at 9/11 as the centerpiece for firefighter’s illnesses, it started many years earlier.  We all know that firefighters are heroes but this short film put into perspective the hidden dangers that are beyond the fire. We learned after 9/11 that the fumes and the burning embers were dangerous to inhale BUT how many other buildings have these brave people gone into that were just as bad.  I have alerted my team at Breast Cancer ComfortFoundation that this film (and story) will go on our site.  We will remind everyone that cancer has heroes in every corner." 

SAL BANCHITTA - Ret. Ff. FDNY  (Engine 316 /49 Battalion)
Cancer Patient Support - www.CousinSal.org
"There is no such thing as a RETIRED FIREFIGHTER. The spirit to respond to a call for help stays with all of us until our last day. We are 'built' to stand watch for any threats to our community and be at the ready to do what needs to be done to restore safety and normalcy to the lives of our neighbors. Without hesitation, seeing our city in peril is an instant call to help and sacrifice everything all over again. This was Dan Noonan THEN... and NOW!  He spoke powerfully about the sacrifice of all the responders of the 1975 Tel Fire- and his writing and the film helps keep those lessons fresh in all of us.  Dan is still ON THE JOB and on watch - the kind that looks out for the health and safety of all brothers and sisters through awareness."

DR. ROBERT L. BARD -  Editor: First Responders Cancer Resource News
Advanced Cancer Imaging & Diagnostics - www.CancerScan.com
"Since the start of my career (including my years in the military), I have met countless rescue personnel who have put themselves at harms way for the noble cause of helping others- and they do this without hesitation or regret.  Plain and simply, firefighting is a dirty and dangerous job- and one with tremendous risks.  I applaud Dan for continuing to remind us all of the 'other fire burning' which is the constant battle against illness and cancers. His depiction of an historical disaster gives loving homage to the many who lost their lives in this and all other fires- but it also resonates an inspiring lesson about prevention and safety concerns throughout the global fire rescue service community."

GREG OLIVA​ - Community Development Manager at 
Movember Foundation (men's health group)  https://us.movember.com/
"The first responders community has always been near and dear to us at Movember.  Historically, they have always been our first and last line of defense without fail and without question.  Learning about the 1975 NY Telephone Exchange Fire was so heart wrenching and devastating.  It truly aligned cancer matters with occupational hazards that members of the fire service face- and this story fully prompts the need for more safety protocols for our rescuers and more conversations around how to support their health.  We owe a tremendous debt to all fire rescue service personnel and the best way to honor them is to keep them healthy and safe!"

DR. JESSE A. STOFF - Medical Director/ Cancer Specialist
at Integrative Medicine of NY (www.IMofNY.com)
"Thank you, Dan Noonan for your courage, your spirit and your commitment to fire rescue.  Your undying work to bring awareness about the fire and cancer risks is so important to the current sufferers/survivors.  But it is even more valuable to the future of all fire departments because as time goes on, more hazards continue to develop from fires and we need to thwart this with continued research for prevention, early detection and safety equipment.  I loved your writing and seeing you on the video interview adds impact to the message you bring us all."


Additional articles available:

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