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The World Trade Center 

Health Program 

Survivors Steering Committee 

lonitoring andTreatmentj 

WTC HP Scientific/Technical Advisory 
Committee Presentation 

November 9, 2011 

Robert Spencer, Labor Co-Chair 
Kimberly Flynn, Community Co-Chair 

World Trade Center 
Survivors Steering Committee 

Created under the Zadroga Act 

Successor to the Community Advisory 
Committee of the WTC Environmental Health Ctr 

Legislative Mandate: To receive input from 
affected stakeholders and facilitate the 
coordination of initial health evaluations, 
monitoring, and treatment programs for 
screening-eligible and certified-eligible WTC 

Survivors Steering Committee 
Member Categories 

Representatives of the population of residents, 
students, and area and other workers affected 
by the 9/1 1 terrorist attacks 

Screening-eligible and certified-eligible survivors 
receiving initial health evaluations, monitoring, or 
treatment and organizations advocating on their 

Representatives of the Centers of Excellence 
providing services to screening-eligible and 
certified-eligible WTC survivors 

Representatives of New York City 

Current & Former Survivors Steering 
Committee Member Groups 

105 Duane Street Residents 
1 25 Cedar Street Residents 
9/1 1 Environmental Action 
Beyond Ground Zero Network 

- Asian American Legal Defense & 
Education Fund 

- Chinese Staff and Workers' Association, 

- Commission on the Public's Health System 

- National Mobilization against Sweatshops 

- Community Development Project of The 
Urban Justice Center 

Civil Service Employees Association 

Communications Workers of America 
District One 

Concerned Stuyvesant Community 

District Council 37 AFSCME 

Ecuadorian International Center 

Good Old Lower East Side, Inc. (GOLES) 

Henry Street Settlement 

Independence Plaza North Tenants 

Manhattan Community Board 1 

Manhattan Community Board 2 

Manhattan Community Board 3 

New York From the Ground Up 

New York Committee for Occupational 
Safety and Health (NYCOSH) 

NY State Public Employees Federation, 
AFL-CIO, (PEF) Division 199 

New York State Laborers' Union 

Organization of Staff Analysts (OSA) 

Rebuild Downtown Our Town 

Rebuild with a Spotlight on the Poor 

South Bridge Tower Residents Coalition 


Stuyvesant High School Parents' 

United Jewish Council of the East Side 

University Settlement 

World Trade Ctr Community-Labor Coalition 

World Trade Center Residents Coalition 

The Collapse Cloud Deposited 

Dust Throughout A Densely 

Populated Urban Area 

The Collapse Cloud Deposited 

Dust Throughout A Densely 

Populated Urban Area 




Fires Burned At the Site For 

Months Sending Smoke 
Throughout Lower Manhattan 


Residential Buildings Bordering 

the WTC Site 

EPA Declares Air Safe 

"Given the scope of the tragedy from last 
week, I am glad to reassure the people of 
New York... that their air is safe to breathe 
and their water is safe to drink." 

Christine Todd Whitman 

EPA Administrator 

September 18, 2001 

Severely Distorted EPA 
Risk Communications 

In 2003, the EPA Inspector General reveals that 
the White House Council on Environmental 
Quality interfered with EPA news releases 
providing guidance to downtown residents and 
workers, minimizing health concerns. 

In 201 1 , ProPublica, working from documents 
obtained under FOIA by the NY Committee on 
Occupational Safety and Health reveals just how 
far that interference went: 

Severely Distorted EPA 
Risk Communications 

"In one instance, a warning that people 
should not report to work on a busy 
thoroughfare in the financial district - 
Water Street - was rewritten and workers 
instead were urged to return to their 
offices as soon as the financial district 
opened on September 17 th ." 

NYC Department of Health 
Advisories - September, 2001 

"How should I clean the dust in my apartment 
when I move back in? The best way to remove 
dust is to use a wet rag or wet mop." 

"Do pregnant women and young children need 
to take additional precautions? No. Pregnant 
women and young children do not need to take 
additional precautions." 

"In a workplace, speak to your supervisor to see 
if there are special startup and cleaning 

Figure 3: EPA' 3 2002-2003 Indoor Clean and Test Program Boundaries In Lower 

vrc i>.itif{i 

M^ci i ov.i 

BrooKiyn r 

South of Canal St 
West Side 

South of 

Allen-Pike Sts 

East Side 

'l'^wuci bl A:i::-: '.I.J.'.L 

GAO Outlines EPA Failure to 
Implement IG & Expert Technical 
Review Panel Recommendations 

Figure 5: Key Recommendations and Additional Input Regarding EPA's Second WTC Indoor Test and Clean Program 

Key Recommendations and Additional Input 

Provided by 

Adopted by EPA 


Panel members 



Expand the list of contaminants tested for. 



Test in dust as well as in air. 



Address contamination of spaces, rather than 
re-con lamination since EPA's first program. 



Evaluate potential health risks from pollutants tor 
geographic areas north of Canal Street and in 




Test in HVACs, 



Test in inaccessible areas. 



Treat buildings as a system, rather than individual 
residential units. 



Evaluate potential health risks from pollutants in 
workplaces. 9 




Investigate a method to distinguish between 
normal urban, or background, dust and WTC dust. 



Use a method for distinguishing between normal 
and WTC dust to determine the extent of 



Source: GAO. 

Notes: Not all expert panel members made each recommendation. 

""The program allows commercial building owners to request testing, but it does not permit workers or 
employers to do so. EPA officials noted that employees who have concerns about their working 
conditions could file a complaint with OSHA or request an evaluation by HHS's National Institute of 
Occupational Safety and Health. 

World Trade Center Health Registry 


Workers at WTC Reso^ery Operiion 
[9/12-10-1 - GB0fl2) 

fe-5*. 12lh Ave &5Sth St 

MS ,.,3nj'f 


| Collapsed 
Partial Collapse 
Major Damage 

| Moderate Damage 

•& Barges 



- Pri rnary residence an /9/1 IjOI 
Student and School Staff 

- pre- K through 12th grade Enrolled on 9/11fl1 
Building Occupants, Peoplein Transit, and Pedestrians 

- employees and \isitorson 9/11j01 
Workers and Volunteers 

- st disaster site [9/1 1/01 - 6/30.02] 

WTC Health 


Chambers Street 

Building Occupants 

on 9/1 1 

Residents on 9/1 1 

Students on 9/1 1 

Workers & Volunteers 

at Site 9/1 1 -6/30/02 

Canal Street 

Residents on 9/1 1 
Students on 9/1 1 


Sro 1 Aw* & Hamilton Ae 

Manama James 

Southbridge Towers resident and parent 

Large apt complex near South St Seaport 

Member, Manhattan Community Board #1 , 
Youth and Education Committee 

On 9/1 1 , Mariama, 8 months pregnant, 
returned home covered in dust. 

Her father is caught in the dust cloud. Her 
two children return covered in dust as well. 

Collapse Cloud Approaches 
Southbridge Towers on 9/1 1 

^- m f 


. — r 


Manama James 

Dust has permeated the apartment 

Mariama and her father attempt to clean 

Without realizing the risks, she rips up a 
contaminated carpet 

City Health Department advises no 
precautions needed for pregnant women 
and young children. 

Manama James 

Manama's youngest child, born October 
2001 , is diagnosed with asthma at 10 mos 

All 3 children develop 9/1 1 -related 
aerodigestive problems for which they are 
on a host of medications. With no WTC 
program for children, Mariama seeks out a 
pediatric pulmonologist. Treatment costs 
are astronomical. 

Manama James 

Her children are now being treated at the 
WTC EHC's Pediatric Program for chronic 
asthma, sinusitis and GERD. 

The WTC Pediatric study investigating 
physical health impacts to children must 
be funded by NIOSH. 

Jo Polett 

Resident at 1 05 Duane St, 7 blocks north of the 
WTC site, a 52-story rental high rise built 1990. 

No interior source of lead or asbestos containing 
materials in its construction 

WTC dust entered through windows, apartment 
heating and air conditioning units and building- 
wide ventilation system 

Respiratory problems common for tenants 

Jo Polett 

Little visible dust, but contaminants shown 
to be present via testing 

12/3/01 : Certified Industrial Hygienist 
samples supply air defuser (hallway vent) 
on 10 th floor by micro-vac according to 
method 5755-95 published by the ASTM 
and analyzes sample by TEM for 

Jo Polett 

Sample tests positive @ 550,000 asbestos 
structures per sq. cm. 

Expected background for building without ACM 
< 1 ,000 asbestos structures per sq. cm. (Some 
studies show poorly maintained buildings in an 
urban area might have levels up to 10,000 
structures per sq. cm.) 

Either way, asbestos level found is between 50 
and 500 times expected background. 

Jo Polett 

Shows ventilation system contaminated by 
WTC asbestos. Presence of asbestos a marker 
for presence of other contaminants such as 
fibrous glass, crystalline silica, concrete, PAHs, 
ultra-fine particulates and metals. 

7/02: Sampling of entry doorframe of 5 th floor apt 
finds 123,000 asbestos structures per sq. cm. 
Shows ventilation system circulating 
contaminants through halls and into apts. 

Jo Polett 

Sampling of apt. heating/air conditioning 
unit unused post-9/1 1 : 37,000 asbestos 
structures per sq. cm. 

Sampling of apt. heating/air conditioning 
unit run post-9/1 1 according to NYC DOH 
guidance: 16,700 asbestos structures per 
sq. cm. 

Jo Polett 

5/03: EPA lead wipe sample of bedroom floor: 
127 micrograms per sq ft - 5 times EPA's health 
based benchmark of 25 micrograms per sq ft 

EPA antimony wipe sample: 1090 micrograms 
per sq ft. EPA health-based benchmark for 
antimony 627 micrograms per sq ft 

Of 8 apartments sampled for heavy metals and 
dioxin, four exceeded EPA health-based 
benchmark for lead 

Gail Benzman 

9/1 1 : not in the immediate area of the WTC 

Works for the NYC Comptroller in the Municipal 
Bldg (Chambers & Centre Sts) 

Mayor orders non-essential city workers not to 
return to work 

9/18: EPA Administrator Whitman issues "air is 
safe" advisory 

9/20: Gail and thousands of other city workers 
ordered back to work 

Gail Benzman 

On her return, outdoor air is full of smoke; 
dust is resuspended and coating surfaces 

She experiences breathing problems 
almost immediately 

9/25: Reports health effects to Deputy 
Comptroller - coughing, sore throat, sinus 
pain, headaches, pressure in chest, nose 

Gail Benzman 

Told to go home if she feels sick. Air is safe 

10/17: first of many medical appointments; 
prescribed many medications 

Increasing absences due to illness 

Her employer arranges visit to Mt. Sinai's Irving 
J. Selikoff Occupational and Environmental 
Clinic. Diagnosed with new onset RADS and 
asthma, then GERD, chronic sinusitis. 

Gail Benzman 

Considers disability, files workers compensation 

Attorneys mostly refuse to accept her case since 
she had not worked on the "pile." 

Workers Comp Board reimburses for prior 
medical expenses, as well as lifetime medical 

2007: Snag in workers comp case leaves her 
paying for all meds out of pocket that her 
primary insurance does not cover. 

Gail Benzman 

Retires to Florida in 2010. 

RADS, chest pain, sinusitis, GERD, etc. remain; 
fewer attacks. 

Finds Florida doctors have little expertise in 9/1 1 
health issues although 1 700 9/1 1 affected 
people live in the state. 

Not eligible for the WTC Health Registry since 
she was not at work below Chambers St on 9/1 1 

Recently examined at WTC Environmental 
Health Center. 

Lillian Bermudez 

Lower East Side resident (above Canal Street) 

Parent of two children: Mitch and Amanda 

Senior Police Administrative Aide with the New 
York Police Department. 

On 9/1 1 , Mitch was 12, Amanda was 9. No prior 
health problems. 

Fumes, burning smell is intense and constant, 
beginning after 9/1 1 . 

Dismissed worries about health risks of 
breathing fumes because authorities said 'air is 

Lillian Bermudez 

Late October 2001 , Mitch comes down with a cold & 

ER visit: Mitch is hospitalized in Bellevue's ICU for 3 
days, then 5 more days as he is stabilized/monitored 

Mitch given new diagnosis of asthma and prescribed 

Continues to have crises - at least 4 require 

Lillian Bermudez 

In 2002, Amanda is diagnosed with 
sinusitis; has recurrences every time she 
gets a cold. 

Because of where they live, the children 
did not qualify for the Health Registry. 

In 2007, both children first treated at the 
WTC EHC and are now "doing great." 

Lila Nordstrom 

Student on 9/1 1 at Stuyvesant High 
School, at Chambers Street and West 

Patient at WTC Environmental Health Ctr 

Founder of StuyHealth advocacy group for 
9/1 1 health issues of former Stuyvesant 

Lila Nordstrom 

School engulfed in dust cloud 

Reoccupancy before full remediation 

Debris barge outside school for months 

Alumni now widely dispersed 

Lila Nordstrom 

Health conditions heavily reported among 
student body include respiratory and 
gastrointestinal disorders. Reports of 
cancer and autoimmune disorders. 

Amit Friedlander's statement: Significant 
dust and debris exposure. 4 years post- 
9/1 1 diagnosed with Hodgkin's lymphoma 

Dust Cloud About to Reach 
Stuyvesant High School on 9/1 1 

tuyvesant is 
he building 
enter right in 
ihoto, just 
iast the 
Hudson River 
pier inlet" 
ower right 

Debris Truck Passing Stuyvesant 
HS & BMCC on West Street 



JJ / 

Dust often 
became airborne 
from debris trucks 
traveling from the 
"pile" to the Pier 
26 barge site