Compressed Mortality File: Supporting Reference Material
Morbidity and Mortality Weekly Report (MMWR)
Deaths in World Trade Center Terrorist Attacks --- New York City, 2001
Weekly Special Issue
September 11, 2002 / 51(Special Issue);16-18
On September 11, 2001, terrorists flew two hijacked airplanes into the
World Trade Center (WTC) in lower Manhattan in New York City (NYC),
destroying both towers of the WTC. This report presents preliminary vital
statistics on the deaths caused by the terrorist attacks and describes the
procedures developed by the New York City Department of Health and Mental
Hygiene (NYCDOHMH) to issue death certificates in response to the attacks.
These data underscore the need for legal mechanisms to expedite the
issuance of death certificates in the absence of human remains and the
need for vital registration systems that can be relocated in case of
As of August 16, 2002, a total of 2,726 death certificates related to
the WTC attacks had been filed. All but 13 persons died on September 11;
of the 13 persons who were injured on September 11 and died subsequently,
three persons died in other states, one each in Massachusetts, Missouri,
and New Jersey. Of these 2,726 decedents, 2,103 (77%) were males and 623
(23%) were females. The median age for these decedents was 39 years
(range: 2--85 years); the median age was 38 years for females (range:
2--81 years) and 39 years for males (range: 3--85 years). Three persons
were aged <5 years, and three were aged >80 years. These data
represent 97% of the estimated 2,819 WTC deaths; fewer death certificates
have been issued than the estimated number of decedents because some
families have not yet requested certificates, and investigations into
several requests are still in progress.
Of these 2,726 decedents, 1,659 (61%) were non-Hispanic white males,
407 (15%) were non-Hispanic white females, 177 (6%) were Hispanic males,
81 (3%) were Hispanic females, 136 (5%) were non-Hispanic black males, 79
(3%) non-Hispanic black females, 122 (4%) were Asian/Pacific Islander
(API) males, and 54 (2%) were API females. A total of 1,837 (67%) had
graduated from college or had postgraduate education (males, 69%; females,
A total of 2,158 (79%) decedents were born in the 50 U.S. states,
compared with 59% of the NYC population (1). A total of 568 (21%)
decedents were born outside the 50 states, including the United Kingdom
(n=56), India (n=36), Puerto Rico (n=34), the Dominican Republic (n=26),
and Japan (n=25). By place of residence, as reported on the death
certificates, 1,169 (43%) decedents were residents of NYC, 593 (22%) were
residents elsewhere in New York (NY) state, and 674 (25%) were residents
of New Jersey (Table
2). A total of 27 (1%) were residents of foreign countries. A total of
90 decedents were residents of Massachusetts, the origin of the two
airplanes that struck the WTC, and 29 were residents of California, the
destination of the flights.
NYCDOHMH processing of death certificates includes assignment of
underlying cause-of-death codes. The NYC Office of Chief Medical Examiner
(OCME) classified all reported deaths as homicides*. (Death certificates
for the 10 terrorists on the two airplanes have not been issued and are
not included in these data; these deaths might be classified as suicides.)
As of August 22, 2002, OCME had issued 2,734 death certificates, including
1,373 for decedents whose remains had been found and 1,361 for decedents
whose remains had not been found; the discrepancy might reflect the later
date, and these data might contain some duplications. Methods used to
identify decedents included DNA (645), dental radiographs (188),
fingerprints (71), personal effects (19), and photographs (16). Multiple
methods were used to identify 407 decedents, and 966 were identified by a
single method (Shiya Ribowsky, OCME, personal communication, 2002). Death
certificates listed the cause of death as "physical injuries (body not
found)" for decedents whose remains were not found and were specific when
remains were found (e.g., "blunt trauma to head, trunk, and extremities").
Reported by: SP Schwartz, PhD, W Li, PhD, L Berenson, MS, RD
Williams, Office of Vital Statistics, New York City Dept of Health and
Mental Hygiene, New York.
NYC is an independent vital registration jurisdiction; all of its vital
statistics and vital records functions are concentrated in NYCDOHMH's
headquarters building, which is 10 blocks (0.4 miles; 0.7 kilometers) from
the WTC site. Following the attacks, the area was evacuated; within 6
hours, the Office of Vital Records (OVR) moved its death registration
function to another location 7.9 miles (12.8 kilometers) away. All death
certificate and burial permit services were resumed by 4:00 p.m. Telephone
and computer communications were disrupted by the attacks; key-entry of
death certificate data resumed September 17. However, use of the data for
analysis and death certificate retrieval was not possible until October 3,
when the system's connection to the mainframe computer in Brooklyn was
The WTC attacks created an unprecedented need to issue thousands of
death certificates in the absence of human remains. NY state law (Estates,
Powers and Trusts Law §2-1.7) provides for the presumption of death
because of absence related to exposure to specific peril. However, no
procedure existed to receive, evaluate, adjudicate, file, and issue death
certificates at the volume and speed that was required. By September 25,
the NYC Law Department, the NY State Office of Court Administration, OCME,
and NYCDOHMH had developed and implemented procedures for issuing a death
certificate in the absence of human remains. OVR then provided 10
certified death certificates to each family within 24 hours of receipt
from the medical examiner, waiving the usual fees.
To prevent fraudulent issuance of birth certificates of decedents, on
October 23, NYCDOHMH began mailing copies of death certificates to states
of birth and residence through the Interstate Transcript Exchange Program.
NYCDOHMH also began sharing fact-of-death information with the regional
Social Security Administration office to prevent fraudulent issuance of
death benefits, and provided information to the NYC Police Department.
The findings in this report are subject to at least two limitations.
First, the data are preliminary because some families have not yet
requested death certificates, and investigations into certain requests for
certificates are ongoing. Second, demographic information was collected
from family members through special affidavits; this information is being
revised as corrections are made by family members.
Other vital records agencies might find the emergency death certificate
procedures developed by NYCDOHMH to be useful in preparing for and
responding to similar disasters (2). States should develop
procedures to issue death certificates in the absence of human remains,
registration systems that can process both the normal volume of births and
deaths and high volumes in emergencies, and systems and operations that
can be relocated if power and communications systems fail.
- New York City Department of City Planning. 1990 Census STF3 and 2000
Census PD-2, DP-3, DP-4 Profiles, May 2002.
- Schwartz S. The World Trade Center disaster: lessons learned.
Available at http://www.naphsis.org/.
*The new terrorism codes issued by CDC's National Center for Health
Statistics (NCHS) did not exist when the WTC certificates were first
received; to identify these deaths, a unique code was developed and used,
which will be changed to conform to the new NCHS codes.
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Source: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm51SPa6.htm accessed July 27, 2006.