After the Towers Fell

Ten years ago this week we experienced the worst terrorist attacks in US history. In many ways, September 11th, 2001 was the defining moment of our generation. Most of us still vividly remember where we were and what we were doing when we first heard about the collapse of the Twin Towers, in the same way that our grandparents remember Pearl Harbor and our parents the assassination of President Kennedy.

In the days, months and years that followed, the public and private response to  September 11th demonstrated both the best and the worst of America, its people and its politicians. This is particularly evident in the way we have treated the policemen, firemen and other first responders of the World Trade Center attacks. I’m not talking about the recent controversy over the decision to exclude these individuals from last Sunday’s memorial services, but rather the lack of comprehensive healthcare
benefits and support we provide.

Immediately following the terror attacks, then Administrator of the US Environmental Protection Agency Christie Todd Whitman released a statement declaring the air in and around the World Trade Center to be safe to breathe. She actually had no proof of this. Monitoring systems to test the air in Lower Manhattan had only just been put in place, and EPA scientists had not yet had the time to analyze samples hastily collected in the aftermath of the terror attacks. Rather, Ms. Todd Whitman’s declaration was politically expedient. The Bush Administration needed to convince first responders, Manhattanites, and the US public that it was safe to live and work in New York City’s Financial District.

We now know that the smoke and dust that persisted in the days and weeks that followed the collapse of the Twin Towers was a toxic brew of pulverized cement, microscopic shards of glass, asbestos, dioxin, lead, PCBs, and a host of other carcinogenic chemicals. Thousands of people who were exposed to this foul air are now suffering from a variety of physical ailments — including asthma and other respiratory illnesses, skin disorders, digestive problems, and cancer.

Despite this, it took almost ten years for Congress to pass the James Zadroga 9/11 Health and Compensation Act, named in honor of the first policeman to die of a disease linked to the World Trade Center attacks. One of the things the Act did was to create a federally-funded program to provide health care for first responders and survivors of the World Trade Center attacks. One of the reasons this Bill took so long to pass was that conservative politicians felt that the Zadroga Act encouraged “careless spending” of limited health care resources.

A cornerstone of the Zadroga Act was the establishment of the $1.5 billion World Trade Center Health Program, which offers free treatment for illnesses linked to the World Trade Center attacks. Unfortunately, this program doesn’t do nearly enough. For example, the Program has strict eligibility requirements. In order to qualify for benefits, first responders and other volunteers must provide proof of having worked at the World Trade Center site for a certain number of hours. Many of the people working for volunteer organizations like the American Red Cross, however, lack such documentation. In the post-9/11 chaos, these volunteers and organizations were primarily focused on providing support and care to survivors, not recording hours of work. Many of the those who selflessly responded to the terror attacks are thus ineligible for the World Trade Center Health Program. The people living in and around Manhattan at that time are also ineligible, despite the fact that the toxic plume of smoke and dust created by the Twin Towers fall blanketed large parts of Manhattan and Brooklyn for over four months, an area inhabited by almost 3 million people.

Worse yet, cancer is currently excluded from the list of conditions covered by the World Trade Center Health Program. Just this week, the federal administrator in charge of the Program stated that there was insufficient evidence to link the attacks or the cleanup efforts that followed to the elevated rates of cancer seen among first responders. This is despite the fact that a new study looking at nearly 10,000 firefighters exposed to World Trade Center dust found that they were 19% more likely to develop cancer than the firefighters who did not spend time at ground zero.

I am a consummate researcher. I often demand rigorous scientific proof before accepting any assertion. But I feel that the decision not to include cancer on the list of conditions covered under the Zadroga Act is reprehensible. As one of the co-author’s of this Act, Representative Carolyn Maloney, has stated “we have a moral imperative to help those who are suffering because of 9/11.” Representative Maloney is absolutely right. The fact of the matter is that we will never be able to identify all of the illnesses directly attributable to the World Trade Center attacks. So, we should provide free care and treatment for any unusual or unexpected disorder experienced by a survivor or first responder. To do otherwise is unconscionable.

[This blog entry was originally presented as an oral commentary on Northeast Public Radio on September 15, 2011. It is also available on the WAMC website .]

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About Sean Philpott-Jones

A public health researcher and ethicist by training, Sean holds advanced degrees in microbiology, medical anthropology, and bioethics. He is currently Chair of the Bioethics Department at Clarkson University's Capital Region Campus and Director of the Bioethics Program of Clarkson University-Icahn School of Medicine at Mount Sinai, and Director of two Fogarty-funded programs to provide research ethics education in Eastern Europe and in the Caribbean Basin. Until his term expired in August 2012, he served as Chair of the US Environmental Protection Agency’s Human Studies Review Board, an advisory panel that reviews the scientific and ethical aspects of research involving human participants submitted to the EPA for regulatory purposes.
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One Response to After the Towers Fell

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