• John P Pryor.
• Division of Traumatology and Surgical Critical Care, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
• Eur J Trauma Emerg S. 2009 Jun 1;35(3):212-24.

ObjectivesTo collect and analyze data from deaths and injuries, and from evaluation of the responses by medical services and by fire, rescue, and police services 1 year after the terror attack on World Trade Center.MethodologyEpidemiologic data were collected from all involved agencies and analyzed. The authors personal experience from working at the scene during the event and several other personal testimonies were also included in this analysis.ResultsTotally 2,762 death certificates were issued by the state of New York for victims of the terror attack. 1,361 (49.9%) of these were issued for victims whose remains could not be identified. All but nine of these victims died at the day of the attack. 77% of the victims were male, medium age 39 years. Of the dead were 342 fire fighters and paramedics and 60 police officers. A total of 1,103 patients were treated during the first 48 days in five key hospitals receiving the majority of the injured. 29% of these were rescue workers. 66% of the injured were male, average age 39 years. The most common injuries were respiratory impairment (49%) and ocular affection (26%), many severe. The most common trauma was lacerations (14%) and sprains (14%). Of those administered to hospital, 19% had trauma and 19% burns. Head injuries were registered in 6% and crush injuries in 4%. With regard to response from involved agencies, communication failure was the most common and difficulties in command operations and scene control were also prevalent.ConclusionsThe difficulties encountered were very similar to those commonly seen in major accidents or disasters, although on a great scale. Response plans have to be critically reviewed based on the experiences from this and other events, in order to pre-empt difficulties such as those described here in future responses to major urban accidents and disasters.

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