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After the World Trade Center was attacked on Sept. 11, 2001, Neal and other members of Indiana’s Task Force One were sent to Ground Zero to help with recovery efforts. They wore respiratory protection. But when the masks came off, the smell washed over them. It was acrid, like burning plastic. The mangled steel that surrounded them continued to burn.

The Twin Towers, the heart of the World Trade Center and the symbol of America’s financial strength, were destroyed after two hijacked aircraft struck the buildings in a 17-minute span. Their collapse blanketed the surrounding area in several inches of gray dust that contained a deadly cocktail of concrete, insulation, glass and lead.

As Americans pause to commemorate the 15th anniversary of a day that changed the world, the first responders that were sent to Ground Zero are still living with lingering mental, emotional and physical effects of the attack’s aftermath.

The effects of exposure to substances found in the dust and wreckage at Ground Zero are well-documented. A study published in 2011 showed that in the first seven years after the attacks, firefighters that were on-site were 19% more likely to be diagnosed with cancer. Newsweek reported that 5,441 of the 75,000 people enrolled in the World Trade Center Health Program have at least one cancer diagnosis due to 9/11 exposures.