WTC - Medical Monitoring Unit

[Guest guest]

NYer of the Week: Volunteers For WTC Mobile Medical Monitoring Unit

NY 1 News

January 21, 2002

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Our New Yorkers of the Week are nurses and doctors who volunteer their time

near the World Trade Center site. They are making sure undocumented immigrant

workers are getting the care they need. Spitz introduces us.

Dr. Ekaterina Malievskaia isn't working in her normal office these days and

Lucio Solis isn't one of her usual patients.

Solis is a day laborer who spent weeks cleaning buildings around the World

Trade Center site. For about two months he's been feeling sick. He gets

dizzy, feels short of breath and has constant headaches.

Now Solis is being cared for, free of charge, in the Medical Monitoring Unit

- a van parked on the corner of Broadway and Barclay near the World Trade

Center site. It's the brainchild of health and labor activists and doctors

from Queens College.

" We sat down a couple of months ago and we said we want to do something

related to the World Trade Center because we're all in this field of

occupational and environmental medicine, and we've got to be there, " says Dr.

Malievskaia.

Many of the patients coming to the Medical Monitoring Unit are illegal

immigrants, and before the van arrived, most of were afraid to come forward

for help.

Henriquez of the New York Committee for Occupational Safety and Health

coordinated a massive outreach.

" No one should have fear, " Henriquez says. " Whether you're undocumented or

not, you have rights by law, you have rights according to the United Nations

and you have rights by the fact that you're a human being. "

Jesus Palomino worked for six weeks, unprotected and off the books. He says

he never got paid and now he's paying a price. He says he has a throat

irritation from the dust at the site.

Inside the van, more volunteers pitch in translating for the patients and the

doctors.

" We're realizing that a lot of these people don't have regular medical care,

and even seeing a physician just once is really helpful for them, " says

volunteer Nora Rosenberg.

Everyone who comes in is checked out by a doctor. Even though many have

already been exposed, they also get a lesson from a volunteer nurse on how to

use masks to protect themselves.

The program is subsidized by the September 11th Fund. The demand is great,

but the unit can only afford to be there until the end of the month. The goal

is to see as many people as possible.

" It feels great, " Dr. Malievskaia says. " We're very busy. I don't think we

concentrate on this feeling, we don't dwell on it, but still it's very

rewarding. "

So, for taking care of those in need, the volunteers at the Medical

Monitoring Unit are our New Yorkers of the Week.

The van will be at Broadway and Barclay Street weekdays between 8 a.m. and 8

p.m. until the end of the month. Exams are by appointment.

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Track Their Health Now, to Protect Others Later

By Q. Stranahan

WASHINGTON POST

January 20, 2002

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Twenty years from now, will the World Trade Center disaster continue to claim

victims? Will the tragedy be compounded by a loss of life that had less to do

with terrorism than with ignorance? In the haste to return Lower Manhattan to

a sense of normalcy, have additional lives been put at risk?

Nobody can answer those questions. But the issue of long-term health

implications for all those at or near Ground Zero since the catastrophe must

not be swept away along with the million tons of twisted steel and rubble.

Sure, several small studies have begun, most focusing on discrete groups of

the population, but none has the funding or capacity to match the scale of

the disaster.

Consider the tip of Manhattan an ideal laboratory and all who worked or lived

there in the days and weeks after Sept. 11 as prime candidates for a massive

health study that may finally prove what we don't know: How resilient the

human body is when bombarded with a plethora of natural and man-made

chemicals.

There is real reason for concern. Many of the air-quality standards used by

the Environmental Protection Agency, the Occupational Safety and Health

Administration and others date to the 1970s and measure a specific substance,

such as benzene, lead or PCBs. As a result, they fail to take into account a

far more likely scenario: Exposure to a chemical " soup " such as the one that

was given off when the contents of the World Trade Center burned. " They keep

saying that almost all of these contaminants are below levels of concern, "

says Monona Rossol, an industrial hygienist who lives and works near the

World Trade Center. " But they're not looking at the incredible number of

plasticizers, fire retardants, fillers. You had 210 floors of carpets,

wallboard, furniture and computers burning. We have no idea what this will

do. "

Over the past two decades, anecdotal evidence has mounted that such chemical

exposures take a toll. Having spent several years gathering health data on

more than 200 firefighters and emergency workers who fought a 1978 hazardous

waste fire in Chester, Pa., I am well aware of how little is known about the

long-term effects. In that case, no fire or rescue workers were killed at the

time of the fire, but eventually more than 40 of the people at the scene were

stricken with serious diseases, including cancer; of that group, 28 are dead.

No one can say with certainty that the cause was the chemicals they

encountered, but their fate -- and the uncertainty of what will happen to the

thousands of professionals and civilians who raced to the World Trade Center

-- cries out for investigation.

The study of those exposed in Manhattan must be started immediately and

continued for the two decades or more it takes for certain diseases, notably

cancer, to develop. Perhaps it will turn up nothing. But it must be

undertaken, if only to reassure all Americans that the existing framework of

environmental and occupational regulations protecting their everyday lives is

performing as intended. " Out of the billions of dollars devoted to recovery

efforts, there should be money put aside to find, register and clinically

assess these people, " says M. Levin, medical director of the Mount

Sinai-Irving J. Selikoff Center for Occupational and Environmental Medicine

in New York.

From the beginning, Levin and his colleagues saw evidence of health problems

among responders and residents living near Ground Zero. Many people have

suffered from coughs, nosebleeds and respiratory ailments, triggered by the

massive amounts of dust and debris in the air. Some of these are probably

temporary irritations; others may be far more serious. " This wasn't [about]

breathing dust, " said Levin, referring to the size of the particlesin the

air. " It was breathing chunks of material. " In recent weeks, concern has

grown about levels of asbestos permeating the air of Lower Manhattan, and

about repeated assurances by the Environmental Protection Agency that the air

is safe. The EPA's handling of air-quality data isthe subject of an internal

investigation, launched by agency ombudsman J. .

Some have accused city, state and federal officials of playing down the

possible health hazards near Ground Zero, encouraging residents to return and

businesses to reopen. " There was a concern to get life back to normal at all

costs, " said A. Shufro, executive director of the New York Committee for

Occupational Safety and Health, a coalition of 250 labor unions whose members

include secretaries, teachers, government employees, construction workers and

others who work near the World Trade Center. Officials " were frightened to

death of the economic consequences of shutting down Lower Manhattan, said

Shufro. " Rather than explaining the risks, they worked to reassure people. "

As a result, he worries, " we'll turn heroes into martyrs. "

The studies that are underway will certainly provide some useful data. In

October, a team from the s Hopkins Bloomberg School of Public Health

began a survey that will follow at least 200 construction workers at Ground

Zero, according to Alison Geyh, an assistant scientist at the university.

Although by the time the study started workers were wearing sophisticated

protective equipment, including respirators, Geyh says " we don't have a clue

what the long-term [health] consequences will or will not be. "

Another survey, undertaken jointly by Columbia University's School of Public

Health and the Mount Sinai School of Medicine, will attempt to locate all

pregnant women living or working near Ground Zero to ascertain what effect,

if any, prenatal stress or environmental contaminants may have on their

babies.

A third, launched by Shufro's group and the City University of New York, is

attempting to identify hundreds of day laborers who were hired to clean

office buildings and residences. The structures were often heavily

contaminated with asbestos,yet few of the workers -- many of them illegal

immigrants -- were provided with adequate protective equipment.

These small surveys, while helpful to segments of the affected population,

cannot take the place of a large study and a tracking program that

encompasses everyone who was at the scene. " I think it is incredibly valuable

to do that, " says Geyh, echoing the views of many experts.

If any city is equipped to oversee such a program it would be New York. " New

York has a public health infrastructure unlike any other in the country, "

says Shufro, " and a concentration of people concerned with environmental and

occupational health. It is unique in that way. The city is a ready-made

laboratory for investigation. "

Yet, to date, no one has stepped forward to offer the critical element:

Money. That must come from Washington, for this is a national public health

issue that goes far beyond the fate of thousands of firefighters, police,

rescue workers and well-intentioned volunteers who converged on the

smoldering rubble. These are matters of concern to every worker who labors in

a chemical-filled job site. They are critical to the 14 million Americans who

live within a mile of the nation's 1,500 federal Superfund sites still

awaiting cleanup, whose air and drinking water may be tainted by chemical

residues. And they are of significance to every parent whose child faces a

lifetime of exposures to chemicals in food, air and water, at homes, schools

and playgrounds. If the disaster has a legacy, let it be that the rules meant

to protect us do exactly that.

Stranahan is a freelance journalist who has written about environmental

and occupational health issues for more than two decades.

© 2002 The Washington Post Company

------------------------------------------------------------------------

Some See N.Y. Air as a Hidden Menace: Many believe EPA cited safety too

quickly. Pollutants indoors a key worry.

By Josh Getlin

LOS ANGELES TIMES

January 18, 2002

http://www.latimes.com/news/nationworld/nation/la-011802air.story

NEW YORK -- As New Yorkers choked and gagged under a cloud of smoky dust

after the World Trade Center attacks, the Environmental Protection Agency

constantly assured them that the air did not pose a major health risk.

" EPA is greatly relieved to learn that there appears to be no significant

levels of asbestos in the air in New York City, " said Administrator Christie

Whitman in a Sept. 13 message repeated many times.

But now, amid growing scientific evidence of high asbestos levels in homes

and other potentially serious air quality problems related to the attacks,

many New Yorkers believe the EPA misled them and was perhaps too eager to

promote the return to business as usual in lower Manhattan.

" The assurances we got from the EPA came from ignorance, and we do not want

to pay a terrible price in death and sickness down the road, " Rep. Jerrold

Nadler (D-New York) said Thursday, joining federal, state and local officials

in a call for the EPA to clean up contaminants inside New York homes and

businesses.

" Federal officials have only tested the air outside, " he added. " They

couldn't possibly know if the city is really safe now. "

It was the latest outburst in an escalating debate over New York's

environmental health after Sept. 11. EPA officials deny they have overlooked

health needs, and in a statement Thursday the agency said it has used " sound

science " to chart the problem and " has undertaken an unprecedented response

to the terrorist attack on the World Trade Center. "

Yet the criticism mounts.

Ever since the fires and smoke at the trade center site disappeared, there

has been less concern over outdoor air quality and an increasing focus on

indoor contaminants. The agency's independent ombudsman has called for a

probe of Whitman's reassuring statements about air quality. And a senior EPA

chemist has charged that asbestos levels in New York homes pose a health risk

equal to that of Libby, Mont., a mining town so contaminated it has been

declared a U.S. Superfund site.

Meanwhile, parents are rebelling against Board of Education orders to return

their children in three weeks to public elementary schools near ground zero,

saying they won't go back until they are convinced the air is safe.

An unprecedented study has been launched to test pregnant women who were

exposed to the clouds of gas and smoke at the World Trade Center, and health

testing has also begun for hundreds of day laborers who have been working at

the site without adequate respiratory protection.

While there is no hard scientific evidence that New Yorkers are in danger

from contamination, many observers say federal officials failed to properly

communicate the level of medical risk to the city.

" All along, the EPA and other departments have been assuring people in New

York City that things were fine, but things were not fine, " said Dr.

Levin, medical director of Mount Sinai Hospital's Center for Occupational and

Environmental Medicine. " There was a great desire to resume business as usual

here, and I do mean business, because there's a great push to commercially

redevelop the [World Trade Center] site. "

Much of the controversy has focused on asbestos testing. When the World Trade

Center towers collapsed, a large but still undetermined amount of asbestos

used in the original building construction rained down on Manhattan. The site

was only partially lined with the cancer-causing fireproofing material,

because New York outlawed its use in 1971 while the buildings were under

construction.

Many experts believe that the force of the airplane blast pulverized the

asbestos into particles smaller than those normally identified by detection

equipment. And while rigorous EPA tests suggest the outside air at the site

is free of dangerous contamination, several private studies using more

sophisticated technology have shown higher levels of asbestos and other

contaminants in the smaller dust particles that blew into homes and offices

near the World Trade Center.

The tests, by HP Environmental Inc. of Herndon, Va., and Chatfield Technical

Consulting, a Canadian firm, could not determine whether those exposed to the

minute particles would develop any potentially fatal diseases. Typically,

individuals must be exposed to asbestos for long periods of time, and the

disease may not appear for 20 years or more.

" We found conditions that EPA inspectors may not have suspected, " said Hugh

Granger, who directed the HP Environmental study. " And we don't want to alarm

people, but this kind of information should be widely known. "

Under EPA guidelines, 70 fibers of asbestos per square millimeter calls for

decontamination procedures in schools. In the HP study, several indoor

samples showed more than 300 fibers per square millimeter.

EPA officials have said they do not regulate the interior of people's homes,

and that the responsibility for enforcing such cleanup rests mainly with the

city's health department. But the health department has come under heavy fire

for advising people to clean up potentially dangerous particles of airborne

asbestos with wet rags, mops and other crude home equipment, instead of the

costly and more effective vacuums used at other sites.

Amid the debate, Levin and other experts urge calm. While he said there had

been an " unexpectedly high " number of respiratory complaints from New

Yorkers, especially among office workers and people who lived near the site,

he believes health dangers are greatly abating.

" The fires at the site are out and the risks are diminishing, " he told

parents from Public School 150 at a meeting this week to decide whether they

should return to the school, six blocks from the World Trade Center site. The

school and several others were evacuated after the attacks.

Levin pointed to recent air quality tests at the school, indicating that

levels of asbestos, lead and other contaminants did not pose a danger to

students. Given all the information that is now available, he said he would

not have a problem sending his children back to school near the disaster

site.

Yet some parents were not convinced and asked pointed questions: Is there an

air quality problem caused by trucks filled with trade center debris that

rumble past the school? Is it safe for youngsters to play outside for 45

minutes at recess so close to the site? And what about the contaminated dust

particles that may be tracked into the school by children playing outside?

By the end of the meeting, parents were still wrestling with the question,

but they clearly resented the Board of Education's edict that their children

and students of other schools had to return to their original campuses by

Feb. 4. Earlier, parents at nearby Public School 89, citing health concerns,

voted against returning.

" You just don't know who to believe in the government anymore, " said one

angry mother, preparing to leave the meeting in the cafeteria of the

Greenwich Village school where Public School 150 students have been

temporarily housed since the attacks. " I don't think federal people told us

the truth. "

Those concerns prompted J. , the EPA's national ombudsman, to

call for an inquiry into Whitman's assurances about air quality. , who

has called for 35 investigations into EPA actions over the years, is waging a

court battle against Whitman's effort to dissolve his job at the agency.

" We felt there was something rotten in Denmark, " said Hugh Kauffman, 's

chief investigator. " I don't want anyone to be scared [about asbestos

levels], but we need to find out what exactly she [Whitman] knew when she

made these comments, and how forthcoming the agency was. "

Yet another charge has been lodged by Cate , an EPA chemist, who has

performed a risk assessment study of reported asbestos levels in New York

homes, and found the city has a level comparable to that of Libby, Mont.,

where hundreds of people died of asbestos poisoning from nearby mines.

She cautioned, however, that her analogy to Libby is a projection. It is not

based on epidemiological studies, which rely on medical histories to chart

the onset of diseases and the conditions that caused them.

" If EPA doesn't call for uniform, proper cleanups in these Manhattan homes,

the risks will be very high down the line for people, " she said.

Elsewhere, researchers at Columbia University's School of Public Health and

the Mount Sinai School of Medicine are launching a study that will track the

effect of the terrorist attacks on 300 pregnant women. They want to know what

chemicals and metals these individuals were exposed to, and whether they

contribute to any health problems in the mothers or their children.

Newman, an industrial hygienist with the New York Committee for

Occupational Safety and Health, said, " We need to make it clear that not

everybody will get ill in New York or has been exposed to something bad.

" But people get concerned, sometimes to the point of hysteria, if we don't

have a coordinated governmental response to the problem and what people

should do. In New York, that's been sorely missing. "