CONTENTS Page Bascetta, Cynthia A., Director, Health Care, Government Accountability Office; Ronaldo Vega, architect, city of New York, Department of De- sign and Construction; Marvin Bethea, paramedic, New York City; Stephen M. Levin, M.D., co-director, World Trade Center Worker and Volunteer Medical Screening Program, medical director, Mount Sinai Center for Occupational and Environmental Medicine, New York, NY; and Kerry J. Kelly, M.D. chief medical officer, Bureau of Health Serv- ices, FDNY, and co-director, FDNY-WTC Medical Program, New York, de Hernandez, Micki Siegel, Communications Workers of America, Dis- trict 1, New York City; Lee Clarke, American Federation of State County and Municipal Employees, District Council 37, New York City; John Romanowich, New York City Department of Design and Construc- tion; Michael Kenny, Local 375, District Council 37, New York City; and Charles Kaczorowski, Local 375, District Council 37, New York Howard, John, M.D., M.P.H., Director, National Institute for Occupa- tional Safety and Health [NIOSH), Centers for Disease Control and Prevention, U.S. Department of Health and Human Services Letters, statements, etc., submitted for the record by: Bascetta, Cynthia A., Director, Health Care, Government Accountability Bethea, Marvin, paramedic, New York City, prepared statement of Howard, John, M.D., M.P.H., Director, National Institute for Occupa- tional Safety and Health (NIOSH), Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, prepared Kelly, Kerry J., M.D. chief medical officer, Bureau of Health Services, FDNY, and co-director, FDNY-WTC Medical Program, New York, NY, Levin, Stephen M., M.D., co-director, World Trade Center Worker and Volunteer Medical Screening Program, medical director, Mount Sinai Center for Occupational and Environmental Medicine, New York, NY, Maloney, Hon. Carolyn B., a Representative in Congress from the State Vega, Ronaldo, architect, city of New York, Department of Design and 49 PROGRESS SINCE September 11th: PROTECTING PUBLIC HEALTH AND SAFETY AGAINST TERRORIST ATTACKS TUESDAY, FEBRUARY 28, 2006 HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON NATIONAL SECURITY, EMERGING THREATS, AND INTERNATIONAL RELATIONS, COMMITTEE ON GOVERNMENT REFORM, Washington, DC. The subcommittee met, pursuant to notice, at 2:06 p.m., in room 2154, Rayburn House Office Building, Hon. Chris Shays (chairman of the subcommittee) presiding. Present: Representatives Shays, Fossella, Maloney, and Van Hollen. Staff present: Lawrence Halloran, staff director and counsel; Kristine Fiorentino, professional staff member; Robert A. Briggs, clerk, and Marc LaRoche, intern; Andrew Su, minority professional staff member; and Jean Gosa, minority assistant clerk. Mr. SHAYS. A quorum being present, the Subcommittee on National Security, Emerging Threats, and International Relations hearing entitled "Progress Since September 11th: Protecting Public Health and Safety Against Terrorist Attacks" is called to order. On September 11, 2001, the World Trade Center site became the epicenter of seismic events still generating aftershocks across our entire Nation. We convene in remembrance of those lost and on behalf of those still suffering and dying as a result of the toxic terrors unleashed that day. The unfinished work of protecting public health in this dangerous era came into painful focus again last year when Hurricane Katrina washed away complacent assumptions about national readiness to deal with large-scale disasters. So we also come together to commemorate our fellow citizens who died in the storm and to ask, what more must be done to care for those who live and work in the past of cataclysmic devastation. An 18th century philosopher reached the sad conclusion, "We learn from history only that we do not learn from history. We prefer to forget." We want to get on with our lives as soon as possible to get back to where we were before disaster struck. But many suffering long-term effects from toxic exposures at Ground Zero cannot forget, nor can they be forgotten. Recent deaths and diagnosis of debilitating conditions among September 11th first responders serve as painful reminders of the enduring duty to acknowledge the wounded, ease their suffering, and learn the lessons their hard history teach. When the subcommittee convened in New York City in 2003, we heard testimony about a disjointed patchwork of Federal, State, and local health programs meant to address unique September 11th health impacts. First responders and Federal employees who answered the call were falling into bureaucratic crevices between those special programs and regular health care and workers' compensation systems ill equipped to diagnose, treat, or compensate the delayed casualties of the September 11th attacks. Today, it appears the public health approach to lingering environmental hazards remains unfocused and halting. The unquestionable need for long-term monitoring has been met with only short-term commitments. Screening and monitoring results have not been translated into timely protocols that could be used by a broader universe of treating physicians. Valuable data sets, compiled by competing programs, may atrophy as the money and vigilance to a September 11th health research wane. This unhappy history warns we are not yet prepared to do essential public health assessments after mass casualty events, natural or man-made. More recently, the lack of any baseline measurement protocols in the wake of Hurricane Katrina suggests the response to the next disaster may be yet another ruddlerless, ad hoc scramble. Last week, the White House Report on Hurricane Katrina recommended Federal agencies be prepared "to quickly gather environmental data and to provide the public and emergency responders the most accurate information available to determine whether it is safe to operate in a disaster environment or to return after evacuation.” Those charged with implementing that recommendation should study the history of the September 11th programs as a cautionary guide to lessons still unlearned and mistakes that should not be repeated. We asked our witnesses to discuss how the Federal investment in the World Trade Center Health Program has been used, how those efforts can be better coordinated and more sharply focused. We asked them to tell us what we have learned for good or ill about responding to the health effects that sustain toxic terrorism. We value their perspectives. We appreciate their expertise, and we look forward to their testimony. With that, the Chair now recognizes Mrs. Maloney, who has been leading the charge in this area, with Mr. Vito Fossella, who I will also ask at this moment for unanimous consent that he be allowed to participate, only if he joins us a little closer. Come on up here, Vito. [The prepared statement of Hon. Christopher Shays follows:] On September 11, 2001 the World Trade Center site became the tragic epicenter of a seismic event still generating aftershocks across our entire nation. We convene in remembrance of those lost, and on behalf of those still suffering, and dying, as a result of the toxic terrors unleashed that day. The unfinished work of protecting public health in this dangerous era came into painful focus again last year when Hurricane Katrina washed away complacent assumptions about national readiness to deal with large scale disasters. So we also come together to commemorate our fellow citizens who died in the storm and to ask what more must be done to care for those who live and work in the path of cataclysmic devastation. An 18th Century philosopher reached the sad conclusion we learn from history only that we do not learn from history. We prefer to forget. We want to get on with our lives as soon as possible, to get back to where we were before disaster struck. But many, suffering long-term health effects from toxic exposures at Ground Zero, cannot forget. Nor should they be forgotten. Recent deaths, and diagnoses of debilitating conditions among 9/11 first responders, serve as painful reminders of the enduring duty to acknowledge the wounded, ease their suffering and learn the lessons their hard histories teach. |