Almost 10 years after the terrorist attacks of September 11th, the January 2011 passage of the James Zadroga 9/11 Health and Compensation Act created the World Trade Center (WTC) Health Program. By then, it was clear that the 9/11 attacks would have lifelong physical and mental impacts on the first responders and cleanup workers who were present in the weeks and months that followed.

LIUNA General Secretary-Treasurer and LHSFNA Labor Co-Chairman Armand E. Sabitoni
The Mount Sinai WTC Clinical Center, one of the Clinical Centers of Excellence in the federal WTC Health Program, provides medical monitoring and treatment for 9/11 responders and survivors with related health conditions, including many LIUNA members. This treatment dates back to the earliest days of the WTC Health Program, thanks to Dr. Jim Melius – the LHSFNA’s Director of Research and the administrator of the New York State Laborers’ TriFunds until his passing in 2018 – who played a major role in writing the Zadroga Act and organizing the structure and funding of the WTC Health Program. As of June 2020, over 105,000 people were enrolled in the program. Over the last decade, the program has also been responsible for conducting research into WTC-related conditions and how to improve the care and well-being of members.
“The entire LIUNA family is forever indebted to Dr. Melius for his contributions to the Zadroga Act and the World Trade Center Health Program,” says LIUNA General Secretary-Treasurer and LHSFNA Labor Co-Chairman Armand E. Sabitoni. “His dedication to the health and safety of Laborers and all 9/11 responders is why so many men and women have been able to get the treatment they deserve.”
To learn more about the WTC Health Program, we spoke to Dr. Michael Crane, Medical Director of Mount Sinai’s WTC Clinical Center, and Agata Bednarska, Outreach and Education Manager for the Selikoff Centers and the WTC Health Program at Mount Sinai. Dr. Crane has worked with WTC patients since 2001 and joined Mount Sinai in 2006, and Agata has been at Mount Sinai since 2017. Dr. Crane and his team of outreach specialists work tirelessly to help Laborers get the healthcare and services they need and deserve. LIUNA members couldn’t ask for a more passionate group of doctors and allies in the fight to protect and preserve their health, and the LHSFNA is beyond grateful for their continued service.
What’s the process like for responders and survivors enrolled in the WTCHP?
“For members we’ve seen before, there’s the regular monitoring exam about every 18 months to see if anything has changed. That includes a questionnaire, a physical, cancer screenings and other tests based on that patient’s particular illness. We also screen for mental health illnesses like post-traumatic stress disorder (PTSD), which has a much higher prevalence in this group than the general population.”
How does the information gathered during the monitoring process guide research?
“The data from the clinical care side is so important. It allows researchers to look for emerging conditions and possible new treatments at a broad level. These were by and large healthy people who risked their lives to bring the city of New York back in its time of need, and now many of them have some degree of impairment. Their altruism continues to this day because they allow their medical information to be shared with researchers, all so we can better treat other people they’ve never met and never will. These people willingly gave to New York then and they continue to give back today. We’re so grateful for that.”
Given how long it takes some of these diseases to present themselves, are you still having WTC responders come in for the first time?
“Yes, and we continue to work hard to get more responders enrolled. We estimate there are another 10,000 or so responders and cleanup workers out there who spent time at the WTC site in the six to eight months following the attacks, and several hundred thousand people who lived and worked nearby. We know there are gaps among Spanish-speaking and Polish-speaking responders, and we continue to work with Local Unions in New York to find these people, encourage them to apply to the WTC Health Program and register with the September 11th Victim Compensation Fund to preserve their rights.”
How has having both treatment and research within the WTC Health Program helped the work your team does?
“It’s been immensely helpful. The concept is really built into the structure of the Zadroga Act, and we owe that to Dr. Melius. Jim had the vision to see that if your researchers are around the doctors who are asking patients questions every day, you can really pound away at improving care. Jim’s work on Zadroga and his ability to understand how laws are passed and bridge the gap to how treatment makes its way down to patients, it was everything. He made this program a beacon to others and really laid the groundwork for what we have today.”
What does the future of research look like for WTC responders?
“Research so far has covered mental health, cancer, respiratory disease and vulnerable populations. Looking forward, more research is needed in many areas, but a particular focus is on emerging conditions, such as the long-term effects of PTSD. We’ve seen some evidence linking PTSD to increased prevalence of early cognitive impairment. There’s some evidence linking exposure to air pollutants to cognitive impairment as well. Understanding the long-term effects of these exposures and finding effective treatments is only becoming more important as this group ages, so that’s one area where more research is needed.”
What would you tell someone who thinks they might have a condition linked to the 9/11 attacks?
“Many people aren’t aware they are eligible for the WTC Health Program. Many 9/11 rescue, recovery and cleanup workers do not consider themselves responders. We often hear workers say ‘I was just there doing my job.’ That doesn’t mean they don’t deserve the same benefits as our police, EMTs and firefighters. Please, take the time to apply to the WTC Health Program and register with the Victim Compensation Fund. It’s not too late yet. Lastly, remember that the treatment and research done at Mount Sinai is contributing to the well-being of people around the world. We thank all WTC Health Program members for their sacrifice in the aftermath of the attacks, and we should keep thanking them all today.”
For more information on the eligibility and enrollment process with the WTC Health Program, visit www.cdc.gov/wtc or call 1-888-982-4748. For more information on eligibility, deadlines and registering with the September 11th Victim Compensation Fund, visit www.vcf.gov or call 855-885-1555.
[Nick Fox]