Study Finds Lack of Data on Health Effects of 9/11 Dust
By Marc Santora, New York Times, September 8, 2004

Days before the third anniversary of the destruction of the World Trade Center, federal agencies have yet to make a coordinated and comprehensive effort to study the health effects of the debris that filled the air in the weeks after the attack, according to a draft copy of a government study to be presented to Congress today. The study also shows that there is still no federal treatment program for those suffering from related problems.

As a result, the ability to ever fully answer even the most basic questions about the health impact of that day on the public may have been seriously compromised.

While there has been a growing consensus since the attack that thousands of people may have grown ill because of the toxic mix of dust, debris, smoke and chemicals that were released when the towers collapsed, there is still no definitive answer to what exactly was in the dust or to how many people suffered because of their exposure.

Moreover, there is no system in place that adequately tracks people's health with physical examinations, provides treatment and can make authoritative determinations about the impact.

According to a continuing study by the Government Accountability Office, the various monitoring programs set up to address health concerns related to the trade center disaster "vary in their methods for identifying those who may require treatment," and "none of those programs are funded to provide treatment."

A copy of the study was provided to The New York Times by a government official who believes that the federal government has not done enough.

The issue of the air quality in and around the area of the World Trade Center has been the subject of intense debate since the first days after the attack, when the Environmental Protection Agency declared that it was safe to return to the area.

Critics contend that in their eagerness to get the city moving again, and, in particular, to reopen the New York Stock Exchange, officials underestimated the possible impact of the contaminants that first billowed into the air and later settled in offices and homes throughout downtown.

While limited monitoring programs have been set up to identify problems among emergency personnel, construction workers and volunteers who spent day after day in the rubble, little has been done to identify and assist others who may have been exposed to the dust, according to politicians and health care experts in the New York region.

"No one is in charge," said Representative Carolyn B. Maloney, a Manhattan Democrat. Representatives Maloney and Christopher Shays, a Connecticut Republican, are leading the hearing today. Both have lobbied aggressively for more money.

The government study finds that 250,000 to 400,000 people who were visiting Lower Manhattan; working, living or attending school there; or responding to the attack were exposed to the dust.

The largest program set up to try to establish who might have been exposed is the World Trade Center Health Registry, created two years after the attack. Many labor unions and other groups discouraged people from signing up, expressing concern about how the data would be used. One year after the registry was created, only 55,226 people had been enrolled, according to the government study. The registry does not provide physical examinations or formal treatment.

The most extensive health-related program set up to date is run by the Mount Sinai Center for Occupational and Environmental Medicine, which received federal grant money to provide physical examinations for police officers, firefighters and other emergency workers. Again, this program does not involve treatment. And it has enough money for only about 12,000 screenings, according to an official at the center.

The official, Dr. Stephen M. Levin, co-director of the screening program, said so many people showed up that the program did not have the resources to examine all of them.

"We are finding high rates of persistent respiratory problems," Dr. Levin said. He noted that while medical experts have a sense of the health impact on volunteers and workers at ground zero, little has been done to understand the wider health impact because of a lack of federal money.

While some people have been able to rely on their own insurance to deal with health problems, and many workers who suffered serious respiratory illnesses received workers' compensation to help them deal with the costs, many others have run into resistance from insurers.

There are a handful of other monitoring programs, including some for firefighters and state workers, but none are scheduled to run beyond 2009, the government study said.

"The duration of the monitoring programs may not be long enough to fully capture critical information on health effects," the study found.

Dr. Levin and others worry that some health consequences, like cancer, may take years to develop.

Still, many of the effects were recognized immediately. Within 48 hours of the attack, the study says, the Fire Department found that about 90 percent of its 10,116 firefighters and other emergency workers reported an acute cough. "Almost all F.D.N.Y. firefighters, 9,914, who had responded to the attack developed respiratory effects, and hundreds, about 380, had to end their firefighting careers due to W.T.C.-related respiratory illness," the study reports.

It also cites other research that shows how screenings across a wide swath of those who were in the downtown area in the days after the attack - including carpenters, police officers and truck drivers - show similar respiratory problems.

The Environmental Protection Agency, in the immediate aftermath of the attacks, warned people working directly on the rubble to wear protective masks. But the agency maintained that the dust that settled over a wider area included only low levels of asbestos and generally was not harmful, a position that a spokeswoman said the agency continues to hold.

http://www.nytimes.com/2004/09/08/nyregion/08airstudy.html

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