With the political season upon us, most attention on post-9/11 government reform is focused on the contentious issue of the “intelligence” agencies, but Congress is investigating other issues and options as well.

Melius’ Recommendations

  1. We need the capability for a comprehensive and rapid medical response for workers responding to terrorist incidents. We cannot afford to wait while the involved federal agencies decide which agency should bear the responsibility for providing a medical response, deciding what type of procurement is needed, arranging the funding, etc…[T]he new Department of Homeland Security should have the overall responsibility, but the expertise of federal agencies such as NIOSH should also be involved.
  2. This national program must include an immediate medical response to address acute medical issues and to ensure that toxic exposures for these workers are identified and monitored. This work site monitoring needs to be coordinated with environmental and public health agencies to ensure that the public and the involved workforce receive comprehensive and accurate information and advice…Physicians and other health personnel should be able to rapidly consult with knowledgeable authorities about diagnostic and treatment issues.
  3. We must recognize that the medical program for monitoring these workers and workers involved in future incidents must be supported for long time periods. Health effects may not occur until many years after the incidents. Workers responding to these incidents must be reassured that their long-term health concerns will be addressed…In the steering committee for the current medical monitoring program, we have struggled, especially not knowing to what extent future funding will be available, to develop a comprehensive program within the current budget limitations.
  4. The programs should include all workers exposed in the incident, and similar programs should be available for the exposed general public…[I]t is important to note that many more workers were exposed than originally estimated…People working or living in nearby buildings and students in buildings in the area were also exposed. The health needs of these people need to be addressed.
  5. Future rights for the participants need to be protected…Confidentiality and other issues are important to ensure that the rights of these workers are protected. For the participants that may develop an illness related to the WTC incident many years from now, we must be able to ensure them that their future rights to appropriate compensation are protected.
  6. We need to provide support for the treatment of workers that have developed an illness or will later become ill because of their WTC exposures…Direct funding should be made available to support treatment, and more funding should be directed to research on the treatment of these illnesses.

One important subject is the health impacts on workers who clean-up in the wake of terrorist attacks. Laborers played a major role in both the World Trade Center (WTC) clean-up and the decontamination of post offices where anthrax-tainted letters were handled. According to Dr. Jim Melius, Administrator of the New York State Laborers Health and Safety Trust Fund and Research Director at the LHSFNA, the potential medical consequences for these workers are serious and require long-term attention.

Melius testified before the House Subcommittee on National Security, Emergency Threats and International Relations of the Committee on Government Reform on September 8. He offered his assessment of 9/11 health effects and the action necessary to address these and other problems ahead.

He began by acknowledging the value of the long-term medical monitoring program, funded by Congress, that was established at New York’s Mt. Sinai Hospital to track the health problems of the workers who participated in the clean-up at the WTC site. He also praised the decision to include mental health in the monitoring program.

He then noted that long-range health tracking for Laborers who helped clean-up in the wake of the anthrax attacks is not guaranteed by any monitoring program. Thus, Melius offered several recommendations (see sidebar) to improve the existing programs and to strengthen future programs that might be established in response to similar incidents in the years ahead.

“Many of our members rushed to the World Trade Center site immediately after the building collapse to assist with rescue and recovery efforts,” Melius testified. “They continued to work long hours at the site despite the very difficult working conditions. None of them thought about the long-term health consequences. If necessary, they would do the same thing again. However, now that the incident is past, they have legitimate reasons to be concerned about their health. I believe they deserve a comprehensive, high quality, long-term medical program that addresses these concerns.”

The health impacts of clean-up work at the WTC are documented in a September 10 report issued by the Centers for Disease Control.

[Steve Clark]