Testimony of
Joel Shufro, Executive Director
New York Committee for Occupational Safety and Health

April 19, 2007
New York City Council Civil Service and Labor Committee

My name is Joel Shufro. I am the executive Director of the New York Committee for Occupational Safety and Health (NYCOSH) a coalition of approximately 200 local unions in the New York metropolitan area and 300 individuals--safety and health activists, health and safety, legal, medical and public health professionals, community, environmental and public interest organizations. NYCOSH is a non-governmental, non-profit organization that has provided technical assistance and comprehensive training in occupational safety and health to unions, employers, government agencies, and community organizations for over twenty five years.

We are here to support the resolution before the council supporting the "9/11 Heroes Health Improvement Act of 2007, (S.201) introduced by Senator Hillary Clinton.

Since the tragic events of September 11, 2001 and continuing to this day, NYCOSH, in partnership with the National Disaster Ministries of the United Church of Christ, has worked closely with unions, employers, and non-profit, immigrant, community, and tenant organizations at Ground Zero and throughout Lower Manhattan. This work has included outdoor and indoor environmental sampling, assessment of the safety and healthfulness of affected workplaces and residences, help with design and evaluation of sampling, cleanup, and re-occupancy protocols, and technical assistance with building ventilation and filtration issues. NYCOSH, in collaboration with the Queens College Center for the Biology of Natural Systems and the Latin American Workers Project, operated a mobile medical unit near Ground Zero which provided medical screenings to hundreds os immigrant day laborers engaged in the cleanup of contaminated offices and residences. We also provided respirators to these cleanup workers, along with change-out filter cartridges, fit-testing, and training in proper respirator use. In addition, NYCOSH has trained additional hundreds of Lower Manhattan workers about 9/11-related occupational and environmental health issues. Finally, NYCOSH has worked closely with health care providers and with unions, employers, and tenant and community organizations to ensure that their constituents are informed about and have access to appropriate medical care for 9/11 health conditions.

The incidence and persistence of 9/11-induced respiratory illness among thousands of response workers and area workers are by now well-established and extensively documented in the scientific literature, including among rescue, recovery, and service workers, firefighters , transit workers and immigrant day laborer cleanup workers at buildings outside Ground Zero. Although there is no question that, in general, those working on the pile experienced more severe exposures and health impacts than did community residents, students, and workers, comparable respiratory impacts among these latter groups are also extensively documented in the scientific literature. This week, the Daily News reported that according to the New York State Health Department over 100 individuals have died as a result of exposure.

Broadly categorized, there are three categories of adverse physical health outcomes associated with exposure to 9/11-derived contaminants:

1. acute, short-term, reversible respiratory and skin irritant and allergenic symptoms and illnesses (e.g., upper airway cough syndrome and allergic and irritant-induced rhinitis);

2. onset of new, or exacerbation of existing, chronic illness (e.g., reactive airways dysfunction syndrome and chronic rhino-sinusitis); and

3. development of chronic, catastrophic illnesses with long latency periods (e.g., asbestos-related cancers and interstitial lung diseases).

4. Because Ground Zero workers and other exposure populations may have been exposed at varying levels to a robust array of carcinogens, including asbestos, dioxins, silica, benzene, PAHs, and PCBs, there is concern for the potential development of late-emerging cancers. It is as yet unknown whether or when 9/11-derived exposures will produce late-emerging diseases, but it is prudent and scientifically appropriate to anticipate the possibility.

The risk of adverse health impact is dependent on the intensity and duration or frequency of the exposures and the toxicity of the substances, there are multiple and distinct exposure populations. The two best known are persons caught in the dust cloud on 9/11 and workers and volunteers at Ground Zero and at the associated debris removal and waste transfer operations.

However, other groups also had, and may still have, potential for exposure and for adverse health effects. These include:

1. immigrant day laborers and building maintenance personnel who engaged on a regular basis in cleanup of WTC dust and debris at commercial and residential buildings outside Ground Zero;

2. workers involved in the restoration of essential services at and beyond Ground Zero (e.g., telecommunications, electrical, water, sanitation, transit, and other workers) and/or workers who continue to engage in disturbance activities in spaces that have not been tested or cleaned, such as telecommunications workers in manholes, vaults, basements, and cable chases;

3. workers engaged in the demolition of 9/11-contaminated buildings; and

4. residents, workers, and students who remained in or returned contaminated indoor spaces.

Unfortunately, funding to deal with the emerging health crisis has not been forthcoming from the federal government. Although the congressional delegation was able to get an appropriation to establish medical monitoring and screening programs for rescue and recovery workers, the funding is inadequate. And, until recently, no federal money was available for medical treatment.

The consequence has been that workers, volunteers and residents have been unable to get needed health care. There are numerous obstacles. Workers who have tried to get health care and wage replacement benefits from workers compensation have had their cases contested; others who have attempted to file have been time barred. Some workers who have become sick and cannot work have lost their health insurance; others with health insurance have found the co-pays and deductibles a disincentive. Other workers, as well as volunteers and residents, have not health insurance.

Recently, the U.S. Department of Health and Human Services announced that $58 million dollars would be allocated for the medical treatment of World Trade Center responders to be administered by the World Trade Center Medical Treatment Consortium and the Fire Department of New York. However, these funds are estimated to last only until July 2007. Additional funding of $25 million has been included in the Bush Administration’s proposed 2008 budget request – an amount which is totally insufficient to meet the growing health care crisis resulting from this national tragedy.

Worse, there are recent reports that the federal government may withdraw or reduce its support of the medical centers of excellence and instead require 9/11 health victims to pursue treatment on their own in the health care market. This would have dire consequences for the thousands of people who have or who may develop 9/11-related illnesses and would be a grave error in public health policy.

The high level of expertise in diagnosing environmentally induced symptoms and illnesses, associating them with environmental exposures, and rendering effective treatment through access to broad institutional resources that these hospital- and clinic-based centers provide could not be duplicated were 9/11 health victims forced to rely on a market-based health care model. It is also essential to maintain the medical centers of excellence because they are capable, as individual health care providers in a fragmented market are not, of engaging in targeted outreach and public health education, appropriate long-term medical monitoring, identification of disease trends, and collection and sharing of data to inform clinical practice and public health policy.

The "9/11 Heroes Health Improvement Act of 2007, (S.201) introduced by Senator Hillary Clinton takes an important first step in providing the necessary resources for “medical and mental health monitoring, tracking, and treatment to individuals whose health has been directly impacted as a result of the attacks on New York City and at the Pentagon on September 11, 2001, by providing by grants to organizations, such as the Worker and Volunteer World Trade Center Medical Treatment Program and entities throughout the country who can provide assistance to those who came, in our country’s hour of need, to work at or around the site.

We do raise two concerns. First, we believe while we are concerned that individuals get appropriate medical care, it is essential that those whose earning capacity has been adversely affected by exposure to the toxic substances released by the collapse of the World Trade Center be appropriately compensated. Second, we also do not believe that the costs of medical treatment should be borne by those who have insurance. This will place a heavy and unfair burden on union administered funds. This was a national tragedy whose costs should be borne uniformly by the federal government.

Thank you.