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ASSESSING SEPTEMBER 11TH HEALTH
EFFECTS: WHAT SHOULD BE DONE?

TUESDAY, OCTOBER 28, 2003

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE ON NATIONAL SECURITY, EMERGING
THREATS AND INTERNATIONAL RELATIONS,

COMMITTEE ON GOVERNMENT REFORM,

New York, NY.

The subcommittee met, pursuant to notice, at 10 a.m., in the Goldwurm Auditorium of the Mount Sinai Medical Center, 1st Floor, 1425 Madison Avenue, New York, NY, Hon. Christopher Shays (chairman of the subcommittee) presiding.

Present: Representatives Shays, Turner, and Maloney.

Staff present: Lawrence Halloran, staff director and counsel; Kristine McElroy, professional staff member; Robert Briggs, clerk; and David Rapallo, minority counsel.

Mr. SHAYS. I'd like to welcome our witnesses and our guests to this congressional hearing. And to say that this is an important day and we are looking forward to the testimony from our wit

nesses.

A quorum being present, the Subcommittee on National Security, Emerging Threats and International Relations Hearing entitled, "Assessing September 11th Health Effects: What Should be Done?" is called to order.

Congresswoman Carolyn Maloney invited the National Security Subcommittee to New York City today because she understands the threat posed to the health and welfare of all Americans by terrorism and its lingering aftermath. She has been a thoughtful, hardworking partner in our bipartisan oversight of terrorism issues, and we are grateful for the opportunity to be here.

In place of the fallen towers of the World Trade Center, these two hard realities cast long shadows over our discussion today. Many first responders are the second wave of victims in a terrorist incident. And public health and disability compensation systems are not fully prepared to acknowledge the unique wounds inflicted by this all too modern war. Firefighters, police, emergency medical personnel, transit workers, construction crews and other first responders came to Ground Zero knowing there would be risks, but confident they're equipment, training and community would sustain them. But, as we will hear today, better equipment and training standards are needed to match the first responder mission to the new threats posed by catastrophic terrorism. And the dissident patchwork of Federal, State and local health support is, in many cases, not providing the care and comfort they rightfully expect.

After the 1991 war in the Persian Gulf, veterans suffered a variety of unfamiliar syndromes, faced daunting official resistance to evidence linking multiple low level toxic exposures to subsequent chronic ill health. In part, due to the work by this subcommittee, long term health registries were improved, an aggressive research agenda pursued and sick veterans now have the benefit in law of a rebuttable presumption that wartime exposures cause certain ill

nesses.

When the front line is not Baghdad but Broadway, occupational medicine and public health practitioners may have much to learn from that distant Middle East battlefield. Proper diagnoses, effective treatment and fair compensation for the delayed causalities of a toxic attack require vigilance, patience and a willingness to admit what we do not know and might never know about toxic synergies and syndromes.

Health surveillance has to be focused and sustained. New treatment approaches have to be tried now in time to restore damaged lives. In this effort to heal the wounds of September 11, 2001 and strengthened public health capacity against future attacks, the Federal Government has a central role to play. The Center for Disease Control and Prevention [CDC], and its National Institute of Occupational Health are charged to develop and implement health protocols against new workplace dangers like Anthrax and novel particulates from the fiery destruction of a building.

On our second panel of witnesses today we will hear about the work and other Federal public health agencies in treating the walking wounded of September 11th. But before we will hear from first responders and local officials on the near and long term health effects of the World Trade Center attack.

We appreciate our Federal witnesses foregoing the usual protocol of going first so that they could listen and respond to all the testimony today.

All our witnesses bring impressive expertise and unquestionable dedication to our discussion. We are grateful they could join us. We look forward to a constructive dialog on how to mend the wounds of this and other terrorist attacks.

At this time the Chair would recognize the very gentle, as they say in terms, and very knowledgeable Mrs. Maloney.

[The prepared statement of Hon. Christopher Shays follows:]

TOM DAVIS, VIRGINIA,

CHAIRMAN

DAN BURTON, INDIANA

CHRISTOPHER SHAYS, CONNECTICUT

ILEANA ROS-LEHTINEN, FLORIDA

JOHN M MCHUGH, NEW YORK

JOHNL MICA, FLORIDA

MARK E. SOUDER, INDIANA

STEVEN C. LATOURETTE, OHIO

DOUG OSE, CALIFORNIA

RON LEWIS, KENTUCKY

JO ANN DAVIS, VIRGINIA

TODO RUSSELL PLATTS, PENNSYLVANIA

CHRIS CANNON, UTAH

ADAM H. PUTNAM, FLORIDA

EDWARD L SCHROCK, VIRGINIA

JOHN J. DUNCAN, JA.. TENNESSEE
JOHN SULLIVAN, OKLAHOMA
NATHAN DEAL, GEORGIA

CANDICE MILLER, MICHIGAN
TIM MURPHY, PENNSYLVANIA
MICHAEL A. TURNER, OHIO

JOHN R. CARTER, TEXAS

WILLIAM J. JANKLOW, SOUTH DAKOTA
MARSHA BLACKBURN, TENNESSEE

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Congresswoman Carolyn Maloney invited the National Security Subcommittee to New York City today because she understands the threat posed to the health and welfare of all Americans by terrorism and its lingering aftermath. She has been a thoughtful, hard-working partner in our bi-partisan oversight of terrorism issues, and we are grateful for the opportunity to be here.

In place of the fallen towers of the World Trade Center, these two hard realities cast long shadows over our discussion today: Many first responders are the second wave of victims in a terrorism incident. And, public health and disability compensation systems are not fully prepared to acknowledge the unique wounds inflicted by this all too modern war.

Firefighters, police, emergency medical personnel, transit workers,
construction crews and other first responders came to Ground Zero knowing
there would be risks, but confident their equipment, training and community
would sustain them. But as we will hear today, better equipment and
training standards are needed to match the first responder mission to the new
threats posed by catastrophic terrorism. And the dissonant patchwork of
federal, state and local health support is in many cases not providing the care
and comfort they rightfully expect.

Page 1 of 2

Statement of Rep. Christopher Shays

October 28, 2003

Page 2 of 2

After the 1991 war in the Persian Gulf, veterans suffering a variety of unfamiliar syndromes faced daunting official resistance to evidence linking multiple, low-level toxic exposures to subsequent, chronic ill-health. In part due to work by this Subcommittee, long term health registries were improved, an aggressive research agenda pursued and sick veterans now have the benefit, in law, of a rebuttable presumption that wartime exposures cause certain illnesses.

When the front line is not Baghdad but Broadway, occupational medicine and public health practitioners may have much to learn from that distant Middle East battlefield. Proper diagnosis, effective treatment and fair compensation for the delayed casualties of a toxic attack require vigilance, patience and a willingness to admit what we don't yet know, and might never know, about toxic synergies and syndromes. Health surveillance has to be focused and sustained. New treatment approaches have to be tried now, in time to restore damaged lives.

In this effort to heal the wounds of September 11th 2001, and strengthen public health capacity against future attacks, the federal government has a central role to play. The Centers for Disease Control and Prevention (CDC), and its National Institute of Occupational Health, are charged to develop and implement health protocols against new workplace dangers like anthrax and novel particulates from the fiery destruction of a building. On our second panel of witnesses today, we will hear about the work of CDC, and other federal public health agencies, in treating the walking wounded of September 11th.

But first, appropriately, we will hear from first responders and local officials on the near and long term health effects of the World Trade Center attack. We appreciate our federal witnesses foregoing the usual protocol of going first so they could listen to all the testimony today. All our witnesses bring impressive expertise and unquestioned dedication to our discussion, and we are grateful they could join us. We look forward to a constructive dialogue on how to mend the wounds of this, and other, terrorist attacks.

Mrs. MALONEY. First of all, Chairman Shays, I want to thank you very, very much for coming to my district to hold this hearing. But I also would like to focus and comment on your long term commitment to issues of public health, including your outstanding and aggressive oversight of the response of the Federal Government to the Gulf war syndrome. In fact, many people say that the September 11 health concerns are similar to the Gulf war syndrome and that Washington is not really reacting to what is a major health crises in an appropriate way.

The primary question before us today is everything being done that could be done to help those workers and victims at September 11. And that is why I asked Chairman Shays to have this hearing.

And I regretfully expect that we will hear today that the answer is no. I have read in some testimony that over 1,800 of the firefighters have had to take early retirement because of health concerns. I have read the testimony of transit workers who called the air at Ground Zero "toxic soup" filled with asbestos and pulverized glass and concrete, and that fully half of their workers are sick.

And fully one-third, I am told by Dr. Levin and others at Mt Sinai are still experiencing long term related health problems. And, regrettably, Dr. Levin has told me that 40 percent of the people they have screened so far do not have health coverage.

There is substantial evidence of high levels of upper airway and lung problems, respiratory, digestive conditions, psychological trauma problems. And there are certainly more injured that are waiting in line to be documented. But there still seems to be no coordinated response from Washington.

Anyone looking at thousands sickened by one event would think that it would be treated as a health emergency of the highest order. But it does not seem that there has been any sense of urgency from the Federal Government.

I hope that this hearing will help sort all of this out. And I know that many of the panelists and my colleagues, I thank them for being here, have a lot of questions.

First, what is being done to actually assist the injured medically? That is what I would like to hear from the panel.

Is there a coordinated assistance for those that need help; volunteers, construction workers, residents, first responders who have injured and have not been able to work since their time at Ground Zero, many of whom have list their health insurance because they are no longer able to work?

Do those who were insured know that many can apply? Many of the injured can apply. And I want to make sure that they know that they can apply to the Victims Fund. And do they know that they must apply before the December 31st deadline of this year for assistance?

What is happening with processing of worker's compensation claims? I hear reports that is mired in difficulty.

And most importantly, are those injured receiving the proper

care?

Why has there been such reluctance on the part of the Federal Government to provide sufficient funds for monitoring and why have the funds been so slow in getting dispersed?

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