It is approaching the 7th anniversary of the horrific events of the terrorist attack on the World Trade Center and the medical benefit and compensation program remains fragmented. The aftermath of the event leaves a cloud of smoke of the complex workers’ compensation issues. Many workers and volunteers throughout the United States lack treatment or compensation for past and potentially future compensable conditions as they struggle to identify a system under which to seek redress.Dr. Robin Herbert, co-director of the World Trade Center Medical Monitoring Program at Mount Sinai Hospital, New York, has reported that significant medical findings have been identified in these workers. Over 70% of the first responders examined had respiratory problems while they were working on the World Trade Center site. The problems persisted in 60% of the workers. Over one-third of the workers had abnormal spirometry tests. Of the non-smokers examined the abnormal rates were five times that in a normal population. Mental health consequences, such as depression and post traumatic stress disorders, were observed in 40% of those who had physical findings.
It is anticipated that there will be two or three “waves” of disease cause by the exposure to the pulverized substances that composed the World Trade Center buildings. The building burnt at very high temperatures because of the 91,000 liters of jet fuel that cause a micronization of a million tons of building materials. The initial health acute respiratory problems were caused by the exposure to the irritations of the cement on the respiratory systems. They are now begining to identify higher rates of interstitial lung disease which has been designated as a second wave of disease. They are concerned about a third wave of disease, cancers. The pulverized materials contained a mix of known carcinogens such as: asbestos (estimated 400+ tons of sprayed on fiber alone), dioxin and other products which had synergistic effects upon the workers. Self-reported cancers of the blood and lymphatic systems, are being watched carefully.
The number of occupational exposures were enormous. The population of workers includes all those who were caught in the 9/11 dust cloud; workers and volunteers at Ground Zero, waste transfer operations, Staten Island landfill and Medical Examiners office; immigrant day laborers and building maintenance personnel; workers restoring essential services at and beyond Ground Zero; workers demolishing 9/11 contaminated buildings and workers and volunteers remaining in or returning to Lower Manhattan and exposed to primary and/or secondary sources of contamination.
The demographics of the population were national as volunteers and workers swarmed in throughout the United State to work and lend a helping hand. While the exposure was geographically in the State of New York, many employees were hired outside of New York State and the employers were out-of-state employers. Multiple state workers’ compensation systems have jurisdiction over the benefit delivery process. Therefore, workers and volunteers are required to meet the rules and regulations of possibly multiple jurisdiction that will govern the various and dissimilar benefits programs available.
The process to obtain benefits for injured workers and volunteers remains chaotic. Federal legislation, H.R. 3543 is pending to nationalize medical monitoring of 9/11 exposure through the National Institute for Occupational Safety and Health (NIOSH). Specific State programs have varying restrictions, limitations, requirements and different benefit structures. The State of New York requires registration by August 13, 2008. There remains no universal co-ordination of benefit programs or any unified guidance for injured workers and volunteers to obtain compensation benefits.
It has been 7 long years since the 9/11 tragedy and injured workers and volunteers are still without a co-ordinated national system for compensation. It is time to recognize that workers and volunteers of the 9/11 events should not be left in the dust. For a workers’ compensation program to be effective and credible it is essential that a co-ordinated system be established on a national level to adequately direct the injured workers and volunteers of the 9/11 tragedy for medical monitoring, treatment and compensation.
