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Bronx resident Robert Stokes, 50, served as a volunteer firefighter on 9/11 and throughout its aftermath. He can't help but wonder if severe health challenges he's had since are related.

“I have a couple of heart attacks, bypass surgery, some breathing difficulty throughout the years,” he says.

What doctors and researchers do know for certain though is that tens of thousands of responders were caught up the dust cloud generated by the collapse of the towers on 9/11. There are three categories of illness they continue to see: respiratory disease affecting the upper and lower tract, gastrointestinal disease, and mental illness like post-traumatic distress disorder.

The most recent study from the New York City Fire Department shows firefighters lost the equivalent of 12 years of lung capacity in a one year span – a direct link to exposure. And Mt. Sinai doctors have identified rare blood cancers in responders.

“What's so sad is that these health problems these responders are suffering are the direct consequence of their heroism,” says Dr. Philip Landrigan, chair of the Department of Preventative Medicine at Mount Sinai Medical Center. “They ran in when others ran away. They inhaled dust. They suffered the terror, and now they are suffering the consequences.”

Since 9/11, Dr. Landrigan, one of the experts heading up a team of doctors at Mt. Sinai's World Trade Center Medical Monitoring Program, has seen more than 27,000 responders. And that’s not counting responders who have yet to experience symptoms.

Nine years later, illnesses are still cropping up. And there are concerns about asbestos, where diseases linked to exposure can take decades to develop. Landrigan says the exposure that continues to drive the most lung problems was from cement dust.

“Cement dust was two-thirds of the dust cloud rolling through the streets,” he says. “Cement is very caustic, a pH of 10 or 11, which makes it as caustic to the lining of the lungs as Drano.”

Landrigan says the monitoring program still gets a 100 or so new patients each month, and he's imploring more to continue to come in, even if not sick, to further establish patterns of illness. An environmental exposure the likes of which we've never seen before, says Landrigan, deserves an unprecedented health response as well.

To find out more, go to wtcexams.org.