A Fallen Hero - Video Inside

Enzyme tied to WTC ills
May explain cough, study sez

http://www.nydailynews.com/front/story/465120p-391263c.html

BY PAUL H.B. SHIN
DAILY NEWS STAFF WRITER
10/25/2006

Doctors unveiled a tantalizing glimpse yesterday into why some firefighters may suffer from the "World Trade Center cough" while others who endured the toxic dust and fumes at Ground Zero are relatively healthy.

Firefighters whose lung capacity deteriorated faster in the wake of 9/11 were more likely to be deficient in a key natural enzyme that protects against lung damage, according to a study of 90 of the 12,000 Bravest who responded to the attacks at Ground Zero.

But Dr. David Prezant, the study's lead researcher and the FDNY's co-chief medical officer, cautioned against drawing too broad a conclusion from the report.

"This is very, very preliminary information that cannot in any shape or form be translated into a diagnosis or treatment initiative," Prezant told the Daily News from Salt Lake City, where he presented his findings at a gathering of the American College of Chest Physicians.

"It is only one small piece of a puzzle," he said. "We are trying to understand the science behind why some patients come down with World Trade Center respiratory diseases and others do not."

However, the research could eventually help solve the puzzle years down the road, said Prezant, a lung specialist at Montefiore Medical Center.

Using a blood test normally used to screen people at risk of early-onset emphysema, Prezant found that 11 of the 90 firefighters had low levels of an enzyme called alpha-1 antitrypsin, or A1AT.

Of the 11, four had a significant deficiency of A1AT while seven had a moderate deficiency, the blood tests showed.

But none had the most severe kind of genetic deficiency. All have the WTC cough.

"What this enzyme does is it protects the lungs from damage," said Dr. Mark Rosen, a pulmonologist at North Shore-Long Island Jewish Medical Center and president of American College of Chest Physicians.

"It prevents the destruction of lung tissue by a variety of mechanisms," he said.

About 150,000 Americans have a severe shortage of A1AT, but many are undiagnosed.

"Many more have a partial deficiency, and most of those people are not diagnosed for their whole lives because most of those people don't get sick" unless they are exposed to toxins such as cigarette smoke, Rosen said.

Prezant stressed that trying to determine whether a particular disease - whether it's WTC cough or breast cancer - is due to genetic or environmental factors is a science that's still in its infancy.

"It's not going to be one genetic trait" that is responsible for WTC cough, Prezant said.

That's why simply testing responders for the enzyme won't be useful, he said.

But the ongoing research at the FDNY is "on the cutting edge for trying to find future cures."

A study published in August by one of Prezant's colleagues at Montefiore painted a grim picture of the lung ailments among the 12,000 firefighters who inhaled dust and smoke on 9/11 and in the following months.

Those firefighters suffered a dramatic loss of lung capacity - 12 times the normal rate that occurs each year as people age, the study found.
 
CHEST: World Trade Center Cough Linked to Enzyme Deficiency

http://www.medpagetoday.com/MeetingCoverage/CHEST/tb/4354

By Michael Smith, Senior Staff Writer, MedPage Today
October 24, 2006

SALT LAKE CITY, Oct. 24 -- Researchers are slowly beginning to tease out why some people exposed to the toxic dust from the collapse of the World Trade Center towers developed respiratory disease and others didn't.

Advise patients who ask that little is known about why some people exposed to the fumes and dust from the collapse of the World Trade Center towers developed respiratory disease and other did not.

Note that this preliminary study finds a link between disease and deficiencies in the enzyme alpha-1 antitrypsin, which has been linked to an increased vulnerability to chronic lung and liver disorders.

This report is based on an abstract presented at a meeting. These data and conclusions should be considered preliminary as they have not yet been reviewed and published in a peer-reviewed publication.

One factor that may have played a role is a deficiency in the enzyme alpha-1 antitrypsin (A1AT), an investigator looking into the so-called World Trade Center cough said at Chest 2006, the meeting of the American College of Chest Physicians.

Alpha 1-antitrypsin is a serine protease inhibitor. It protects tissue from enzymes released by inflammatory cells, especially elastase.

In a study he repeatedly characterized as "very preliminary," David Prezant, M.D., of New York's Montefiore Medical Center found that firefighters with an A1AT deficiency had significantly faster declines in lung function than those with normal A1AT levels.

But, he cautioned, the finding is based on a small sample and needs more research before it will have clinical relevance.

"It is too early to apply this at this time," Dr. Prezant told reporters before presenting his data. Indeed, he said, it's likely that A1AT deficiency is only one of many factors that played a role in determining who got sick after the towers collapsed.

Dr. Prezant and colleagues have been studying 12,000 of the New York firefighters who were "down there during the days and weeks that followed the collapse of the towers" and for whom lung function tests both before and after are available.

About 25% of the 2,000 to 3,000 firefighters who were exposed to the toxic fumes and dust on the first day -- Sept. 11, 2001 -- are still suffering from pulmonary symptoms consistent with asthma, he said.

A small subset of 151 exposed firefighters were enrolled in October 2001, and offered annual spirometric testing until 2005, when the 90 remaining in the group (60%) were given a blood test for A1AT deficiency.

Eleven were deficient in the enzyme -- four severely and seven to a lesser degree -- although none was homozygous for the genetic variants that would have given them the worst level of deficiency.

"That's to be expected," Dr. Prezant said. "These were healthy people before 9/11 doing a tremendous amount of aerobic activities."

But when the researchers statistically correlated A1AT levels and declines in lung function in the year after 9/11, they found that severely deficient subjects had a greater decline in one-second forced expiratory volume (FEV1) than normal participants, by about 125 mL.

Over the four years after the buildings were destroyed, those with severe deficiency continued to decline more than normal participants, at a rate that was significant at P=0.003. Also, those with moderate deficiency had declines that were intermediate.

The American College of Chest Physicians estimates that about 150,000 people in North America have an A1AT deficiency, but only about 5% have been diagnosed.

"A1AT deficiency can greatly affect the health and well being of patients, particularly in those who remain undiagnosed," commented Mark Rosen, M.D., of Beth Israel Medical Center in New York, president of the college. "It is important for pulmonologists and other clinicians to understand screening guidelines for A1AT deficiency and recommend appropriate testing for patients accordingly."
 
A Call to the NY Media: Save the Volunteers!

http://loho10002.blogspot.com/2006/10/call-to-ny-media-save-volunteers.html

by Jonathan Bennett
10/25/2006

I am writing to ask your assistance in publicizing a change in New York State’s Workers’ Compensation Law which will allow workers and volunteers who participated in the rescue, recovery and clean up efforts after 9/11 to register to preserve the right to file for workers’ compensation benefits.

As you know, many people traveled from all over the U.S. to New York City after 9/11 to work or volunteer in the rescue, recovery and cleanup effort. Now tens of thousands of 9/11 responders are experiencing or are at risk of disease or post-traumatic disorders resulting from their exposures and experiences. Fortunately, their right to file for workers’ compensation will now be protected, as a result of a New York State law that went into effect on August 14. The law applies to the vast majority of 9/11 responders,, including volunteers, even those who are now healthy, but workers and volunteers must register before next Aug. 14 to establish their permanent eligibility.

NYCOSH (the New York Committee for Occupational Safety and Health), in collaboration with World Trade Center Medical Monitoring Program, the Laborers’ Health and Safety Trust Fund, Balcony, the Business and Labor Coalition of New York, the United Church of Christ's National Disaster Ministries and workers’ compensation law firms, is trying to get this word out to workers and volunteers from all over the country.

It is imperative that everyone who is eligible to register receives information about this program before it’s too late. Anyone who does not register before the August 14, 2007 deadline – and who later develops a 9/11-related disease or disorder – will have missed an opportunity to have all medical expenses for the treatment of that condition covered by workers' compensation.

You are in a uniquely important position to make post-9/11 workers and volunteers aware of the program by placing an article in your newsletter, magazine or by send the story to your email list.

Pasted below is a short article that is an introduction to the new compensation program for post-9/11 workers and volunteers. For a formatted version of the article, go to New law provides benefits for 9/11 workers and volunteers: Registration open for a year. Or go to an even shorter version of the same article. The articles are not copyright and can be revised in any way and put to any appropriate use.

In the last paragraph of the articles there is a Internet link to the NYCOSH website where you can find detailed information (in English and Spanish) about the program. We will soon be posting the same information in Polish. Other translations are in the works.

If you would like to receive occasional updates about news concerning resources for treating and compensating those with 9/11-related health effects, please let me know by email. My contact information is pasted below the article.

I hope you can help.

For more information about 9/11-related disease, which in many cases is not recognized as such, visit Clinical Guidelines for Physicians Treating Adults Exposed to the World Trade Center Disaster on the New York City Department of Health and Mental Hygiene's website.

Jonathan Bennett is Public Affairs Director of the New York Committee for Occupational Safety and Health
 
More allegations from EPA whistleblower

http://www.rawstory.com/news/2006/More_allegations_from_EPA_whistleblower_1026.html

Brian Beutler
Published: Thursday October 26, 2006

An Environmental Protection Agency whistleblower who has long argued that her agency failed to issue proper warnings about air quality at the World Trade Center disaster site, has leveled new accusations against the agency, RAW STORY has learned.

As RAW STORY reported this past August, Cate Jenkins, an EPA biochemist, sent a letter to the New York congressional delegation, alleging that the inconsistent official reports about inhalant alkalinity were part of an intentional cover up by government scientists and officials.

Jenkins' latest sixty-page document, addressed to the acting Inspector General of the EPA, is in large part a compilation of her previous allegations, but also claims to offer new evidence that criminal fraud is to blame.

In the latest report, Jenkins contends that by failing to report that some of the particulates in the air constituted a severe health hazard--and by suppressing the results of tests for the presence of other toxic chemicals--the EPA misled the public about the dire health consequences of remaining near ground zero or participating in the clean-up effort in the days following the attack.

Tens of thousands of cases of lung disease have reportedly resulted from exposure to the smoke and debris that hovered in the vicinity of the disaster site for months after the towers collapsed.

Earlier this year, federal judge Deborah Batts ruled that then-EPA director Christine Todd Whitman had misled residents and rescuers when she pronounced that the air quality in lower Manhattan met public safety standards and necessitated neither a surgical mask nor a respirator.

John Manibusan, spokesman for the office of the Inspector General, told RAW STORY that he had not yet received the complaint, but added, “[Jenkins] has issued a number of complaints to our office, about the World Trade Center and other things. We always take a look at them. In some cases we issue a response. How long that takes depends on a lot of factors.”

Manibusan directed Raw to a 2004 official response to earlier Jenkins allegations of a conflict of interest in the peer review of EPA's assesment of ground-zero health hazards. That investigation found that though the “EPA's Contractor did not inquire whether the three panelists had received funding from industry or had publically expressed viewpoints on the issues to be reviewed,” they “did not find that the panel's input was biased,” or “that any of the panelists should have been excluded” from participating.

Jenkins' full memorandom may be read here.
 
Nun Dies From Illness She Said Stemmed From 9/11 Dust

http://www.wnbc.com/news/10219330/detail.html

November 2, 2006

NEW YORK -- A nun who worked at the World Trade Center site in the wake of the Sept. 11 attacks died Wednesday after a battle with lung disease that she said stemmed from inhaling toxic dust at ground zero, according to her lawyer.

Sister Cindy Mahoney volunteered at ground zero to bless the remains of victims.

Attorney David Worby said Mahoney, who was suffering from interstitial lung disease, hoped her story would help prove the connection between exposure to dust at the World Trade Center site and fatal illness.

According to Worby, Mahoney requested that an autopsy be conducted after her death to prove that the toxic dust at ground zero made her sick.

Worby, whose lawsuit against New York City was given a green light last month by a federal judge, said Mahoney's initial autopsy was conducted in South Carolina Wednesday, but that additional tissue samples would be tested in the coming weeks.
 
very sad....this whole thread.

hopefully the result of the autopsy will get a fire under peoples ass to demand justice.
 
yeah I remember that story....I was wondering what happened to her. Then the other day on blogger they had a video with one of the first responders talking about his ailments and those of others one of whom was the nun, who he said was dying.
 
yeah thats the one. I get completely teary eyed watching these guys talk. Just a bunch guys trying to make ends meet, doin' the best they can, having to clean up that horrible disaster, having to see 'god-knows-what in the rubble; only to have the government stick it to them.

But yet that Kerry slips up on some stupid joke or that some guy being manhandled at an Allen campaign is found by the mass media to be more news worthy. Sickening
 
Nun Dies Of Respiratory Disease After Serving At Ground Zero

http://www.ny1.com/ny1/content/index.jsp?stid=1&aid=64007

November 03, 2006

A nun who spent six months working at the World Trade Center site has died.

While the official cause of death has not yet been determined, Sister Cynthia Mahoney believed her lungs were damaged from the six months she spent working as a chaplain and EMT downtown.

The 54-year-old nun died Wednesday at her home in South Carolina.

In interviews, she said she developed asthma, along with respiratory, digestive and lung problems from working at the site.

At her request, her autopsy results will be included in a class action lawsuit filed by first responders.
 
SC nun who says lung disease from 9/11 sickened her dies

http://www.wistv.com/Global/story.asp?S=5629267

(Aiken-AP) November 3, 2006 - A nun who says her lungs were permanently damaged after spending six months at Ground Zero following the September 11th, 2001, terror attacks died Wednesday.

Sister Cynthia Mahoney was 54 years old.

Shellhouse Funeral Home says she died at her Aiken home.

No cause of death was given, but Mahoney has said she thinks poisoned air at Ground Zero gave her a deadly mix of asthma as well as pulmonary and digestive problems.

Mahoney spent every day for six months after the attacks as a chaplain and an emergency medical technician.

Mahoney's funeral will be Saturday at Shellhouse Funeral Home's chapel in Aiken. A private burial will follow.
 
Lawyer fights for ‘Ground Zero’ angel

http://www.thepeninsulaqatar.com/Di...November2006&file=World_News2006110412524.xml

Web posted at: 11/4/2006 1:25:24

new york • A nun who spent months at the site of the September 11, 2001 attacks in New York, comforting relatives of the dead and blessing body parts, has died of lung disease, her lawyer said yesterday.

David Worby said there was no doubt in Sister Cindy Mahoney’s mind that she had contracted her respiratory illness from sifting through the rubble of the World Trade Center, and he said he would fight to prove the link.

Mahoney, 54, knew she was dying and requested a thorough autopsy be carried out after her death to prove that her symptoms — like those of thousands of people who worked at the site — were linked to working there.

“She said that considering the rest of the city was just calling this a cough and wasn’t recognising the severity, she wanted to make sure that when she died I was personally responsible for having an appropriate autopsy and pathology report” carried out, Worby said.

Five years after the attacks, thousands of workers, residents and rescuers have reported respiratory problems that scientists believe to be linked to the fine particles released from the debris and inhaled deep into the lungs.

Several lawsuits have been filed, notably against the Environmental Protection Agency, which assured residents that the air quality at Ground Zero was safe a week after the attacks.

New York authorities have also come under fire for not forcing people to wear respirators during the recovery and clean-up operations.

An autopsy carried out on a 34-year-old police officer in January for the first time established an official link between respiratory complaints and the hours workers spent sifting through the rubble at Ground Zero.
 
GROUND ZERO'S 'ANGEL' NUN DIES
AUTOPSY WILL EYE 9/11 DUST

http://www.nypost.com/seven/1103200...angel_nun_dies_regionalnews_susan_edelman.htm

By SUSAN EDELMAN

November 3, 2006 -- An Episcopal nun who spent five months blessing remains at the World Trade Center died this week and has been granted her dying wish - to be autopsied to prove her lung disease was caused by toxins she inhaled.

Sister Cindy Mahoney, 54 - who became known as the "Angel of Ground Zero" - arranged for the autopsy from her deathbed months ago, hoping to help the cause of 9/11 rescue and recovery workers seeking financial aid and medical care.

"This can't happen over and over and over again," she told David Worby, a lawyer for 8,000 recovery workers in a videotaped statement in August.

"There are people like me who have given up [the struggle to survive]. Because we're asking for help we're made to feel like malingerers.

"Don't let them shut us down," she begged.

The autopsy was performed by Dr. Janice Ross, a pathologist in South Carolina, where she moved in 2002.

The findings will be reviewed by Dr. Michael Baden, the city's former chief medical examiner.

They are waiting for lab results from tissue samples, which are expected in the next two weeks.

The autopsy could prove that WTC dust was deadly - because Mahoney had been a healthy, active, non-smoker. "She came to 9/11 with clean lungs," Worby said.

A New Jersey medical examiner has attributed the death of retired NYPD detective James Zadroga to his time at Ground Zero - the only such ruling so far.

Worby said 81 of the workers he represents in a class-action suit against the city have died, but none was autopsied.

"Her whole life was about helping people," said Mahoney's niece, Elizabeth McManus, 23, who cared for her aunt around the clock in the Aiken, S.C., home of friends.

The big-hearted, feisty Mahoney. a former EMT who grew up in Aiken, became ill and destitute after returning to her hometown from New York.

Two weeks before 9/11, she had been transferred to a lower Manhattan convent, and raced to the Twin Towers when the planes hit.

She spent nearly every day consoling relatives of the dead, blessing body parts, and comforting fellow workers.

About 4 a.m. Wednesday, Mahoney called frantically for her niece.

"I can't breathe. Help me! Help me!" she cried.

"Those last few minutes she was absolutely terrified," the niece said.

Mahoney suffered chronic obstructive lung disease, asthma, and other respiratory and gastrointestinal diseases common to Ground Zero workers, Worby and relatives said.

"She was so sick and suffering so badly, and that's over for her now," McManus said.

"She believed in heaven and would say, 'I'm just waiting to be called home.' "
 
Judge caps NY City's 9-11 liability at $1 billion

http://www.jpost.com/servlet/Satellite?cid=1162378322068&pagename=JPost/JPArticle/ShowFull

By ASSOCIATED PRESS
11/3/2006

A judge said Friday that thousands of emergency workers expected to claim they were harmed by World Trade Center dust after the Sept. 11 attack may have to share up to $1 billion, the amount he believes is the city's limit on liability.

US District Judge Alvin K. Hellerstein indicated he might soon make a formal finding that the liability has a limit and appoint a special master to speed claims so that injured workers can recover money they need to cover their medical expenses.

At least 6,200 lawsuits have been filed by emergency workers. Hellerstein expects between 10,000 and 11,000 people who worked at the Trade Center site will file lawsuits.

The judge said he did not believe the workers can recover additional money from 150 private contractors who worked at the site because the city was ultimately responsible for the work conditions.

Hellerstein told more than 100 lawyers packed in his courtroom that the cap on damages would shorten litigation needs and speed payouts to those who need them.

Otherwise, he said, "we'll die and our children will die and our grandchildren will die before this litigation ends."

The judge said he wanted to lessen the work for lawyers because otherwise a greater proportion than necessary of the $1 billion will go to lawyers rather than victims.

Paul Joseph Napoli, a lawyer for the plaintiffs, first praised the judge's analysis but later said he believed insurance policies held by contractors could add another $500 million to the payouts.

James Tyrrell, a lawyer for the city and the contractors, said it would be "truly a breakthrough" if the plaintiffs agreed that the city's liability was limited to $1 billion.

"How would you respond?" the judge asked him.

"Positively," he answered.

The judge last month ruled that the city, its contractors and the Port Authority of New York and New Jersey, which owns the site, were only partially immune from lawsuits filed on behalf of workers who cleaned up the World Trade Center debris for months after the Sept. 11, 2001, terrorist attacks.

The lawsuits claimed the city and its contractors were negligent in monitoring the air and assuring appropriate safety in the workplace, particularly adequate respiratory equipment.
 
9/11 responders seek options for care

http://www.newsday.com/news/health/ny-nywtcvr4972450nov12,0,7496420.story?coll=ny-health-print

BY T.W. FARNAM
November 12, 2006

Leslie James has spent two years appealing his workers' compensation claim for injuries he suffered fleeing from the World Trade Center and returning a week later to clean up toxic dust from the kitchen nearby where he worked.

The burning around his heart, his difficulty breathing and the plastic kneecap that makes his left leg swell - all stemming from Sept. 11, 2001 - have kept him from working since then.

"This is almost five years going, and I have to live with my three kids, my wife and myself," said James, 52, adding that the only income for the family is his 4-year-old son's $627-monthly disability check. "We use that for wash. We use that for travel. We use that for food."

James, of Crown Heights, and about 400 workers who helped clean up 1.8 million tons of trade center debris, gathered in lower Manhattan yesterday to learn about options for health care and fill out forms guaranteeing their eligibility.

Many said they are hopeful the new Democratic Congress will extend funding for monitoring and treatment.

"We have a large task ahead of us," Rep. Jerrold Nadler (D-Manhattan) said.

"But I'm hopeful that with the election returns last Tuesday, we will have a less-deaf Congress and a less-deaf administration."

Without congressional action, federal funds for the treatment of 9/11 first responders will run out in July. Funds to monitor the ill workers are expected to last less than two years.

"The response of the government to the health effects of 9/11 has been disgraceful in the extreme," Nadler said. "The attitude of government has been 'Help us clean up the mess and then we'll throw you overboard.'"

Two bills are pending before Congress: The Remember 9/11 Health Act and the James Zadroga Act.

The first would provide $1.9 billion over five years for monitoring and research, and would provide Medicare benefits for patients. The James Zadroga Act - named for the New York City police officer who was the first 9/11 responder whose death was directly attributed to Ground Zero toxins - would reopen the September 11th Victims Compensation Fund.

Yesterday's event was organized by the World Trade Center Medical Monitoring Program based at The Mount Sinai Medical Center, which published findings in September showing that 60 percent of Ground Zero workers still suffer health effects, including reduced breathing capacity, pulmonary fibrosis and asbestosis.

Doctors said the worst effects may not surface for years. Prior to the study's release, the program had examined nearly 12,000 first responders.

Thousands more workers have entered the monitoring program since the study was published, bringing the total number of patients to 17,600.

"People coming in now are much sicker," said Dr. Jacqueline Moline, a co-author of the Mount Sinai study. "They've waited five years."

The program will have to notify patients of an impending lack of services in a few months without more funding, she said.

In the meantime, James is surviving day to day, using sample medications from his doctors.

"I have to pray to God that something good will happen," he said.

"When I asked [my doctor] what is happening, she said, 'You are like a ticking time bomb.'"
 
WTC Rescue Workers Attend Health Conference

http://wcbstv.com/topstories/local_story_315213452.html

11/11/2006

(AP) NEW YORK World Trade Center first responders attended a conference today on the health effects of working at the site in aftermath of the 9/11 attacks.

Doctor Jacqueline Moline of the WTC Medical Monitoring Program says she's seen a lot of patients with persistent breathing problems, sinus congestion and stomach and musculoskeletal problems, possibly from working at ground zero.

First responders gathered at the monitoring program's downtown headquarters, where they were told about services being offered, and places where they can go to treatment.

The program has already performed free medical screenings to 32,000 first responders. For the next five years, people who participate in the program receive comprehensive and confidential medical examinations at regular intervals.
 
Gathering of heroes & help at last

http://www.nydailynews.com/news/local/story/470567p-396064c.html

BY PAUL H.B. SHIN
DAILY NEWS STAFF WRITER
11/11/2006

For many World Trade Center responders who have fallen ill after toiling in the toxic haze of 9/11, getting medical care and paying those bills has been a struggle.

But hundreds of Ground Zero heroes got a helping hand yesterday at a conference that provided one-stop shopping for medical and legal services.

The gathering - a block from Ground Zero at the headquarters of DC 37, the city's biggest union - also empowers ailing workers because they realize they are not alone in their suffering, said Dr. Stephen Levin of Mount Sinai Medical Center, which has been monitoring and treating thousands of first responders.

"If it weren't for the existence of these treatment programs, many of these people wouldn't have access to care," Levin said.

Among the estimated 40,000 Ground Zero responders, thousands have been stricken, according to a landmark study unveiled by Mount Sinai in September.

Among them is Andy Scallo, 45, a heavy equipment operator who worked for three months on the smoldering pile.

Scallo now suffers from multiple sclerosis and may soon have to quit his job, he said.

"I was here to help my country. Now I'm sick," Scallo said. "My doctor tells me in two years, I won't be walking."

Rep. Jerrold Nadler (D-N.Y.) said the federal government must do more to treat Ground Zero heroes. The U.S. Department of Health and Human Services recently released the first batch of federal funds - $40 million - for treatment, not merely health monitoring.

Nadler is pushing legislation to provide medical care for responders through Medicare, "so that the heroes of 9/11 are treated like heroes and not inconvenient people to be forgotten."

Rep. Carolyn Maloney (D-N.Y.) has introduced legislation to reopen the 9/11 Victims Compensation Fund to pay for their medical bills.

With Democrats set to take over of both houses of Congress in January, "we really have an opportunity to do right by the heroes of 9/11," said Maloney's spokesman, Joe Soldevere.
 
No to Planned Guidelines on 9/11-Related Autopsies

http://www.nytimes.com/2006/11/18/n...gin&adxnnlx=1163828724-EGPPZq6BZk5b+rLB0IQqzA

By ANTHONY DePALMA
Published: November 18, 2006

The federal government has abandoned efforts to create standardized autopsy guidelines to help determine whether deaths of people who worked at ground zero during recovery operations in 2001 and 2002 can be conclusively connected to the hazardous smoke and dust they breathed there.

The guidelines were supposed to be sent to doctors nationwide to avoid the kind of confusion that resulted earlier this year after a New Jersey coroner concluded that the death of James Zadroga, a New York City police detective, had been caused by exposure to the hazardous air at ground zero, the first such official finding for anyone who worked at the site.

While Mr. Zadroga’s family and colleagues saw the autopsy report as clear proof connecting his death to the dust at the World Trade Center site, experts were troubled because certain specialized tests that might have identified material found in the detective’s lungs had not been performed. The proposed federal guidelines would have laid out methods for taking and analyzing tissue samples from workers in the New York area and across the country. The draft document also established a process for reaching a conclusion about the cause of death.

Autopsy reports often are presented as evidence in civil suits seeking to establish liability. But medical experts outside the federal government who were asked to review the proposal expressed concern that guidelines could be seen as an attempt to assess liability for diseases linked to the dust rather than an effort to find scientific answers that could lead to improved diagnosis and treatment.

They said the proposed autopsy procedures would not provide conclusive results and would be subject to inappropriate use by plaintiffs in the thousands of lawsuits filed against the city and its contractors by injured workers.

“The draft document could be misinterpreted or misapplied, hindering rather than furthering progress in addressing W.T.C. health concerns,” the National Institute for Occupational Safety and Health said in a note posted on its Web site yesterday afternoon.

In place of the proposed autopsy protocols, the federal government intends to have the New York State Departmentcupational Safety and Healthf the long-term health effects of exposure to the contaminants in the air at ground zero.

“From our evaluation of the independent reviews, it appears that other avenues are more likely to achieve our goal, and that of our partners, of reducing uncertainties in assessing W.T.C. health effects,” the note on the institute’s Web site explained.

Medical studies have shown that many of the 40,000 people who worked at ground zero are now suffering from respiratory ailments and some doctors fear they could develop more serious diseases in the future.

The institute’s director, Dr. John Howard, who is the official in charge of coordinating the federal response to ground zero-related health issues, had made the development of standard autopsy procedures a priority as he tried to establish the extent of the health risks facing those who worked on the trade center cleanup.

Dr. Howard could not be reached for comment. But his spokesman, Fred Blosser, said that although Dr. Howard had considered the guidelines a promising concept, he changed his mind after the external reviewers reported that “they didn’t believe scientifically that this would give us meaningful information to accomplish what we want to accomplish, which is to shed light on the long-term health effects of working at ground zero.”

One of those reviewers was Dr. David J. Prezant, chief medical officer of the New York City Fire Department. In a copy of his written comments to the draft guidelines, Dr. Prezant said that only a large-scale epidemiological study that analyzes the medical history of many workers would yield the kind of information Dr. Howard was seeking.

He also noted that the collection and detailed microscopic analysis of tissue samples recommended in the guidelines could only be done in specialized laboratories and pathology centers, which were not named in the draft.
 
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