Next week marks the anniversary of the terrorist attacks on the United States including the World Trade Center. The program for medical surveillance and compensation continues to proceed to benefit first responders and those in the immediate area of the New York City attack on 9-11.
Today's post is shared from cdc.gov
The World Trade Center (WTC) Health Program was established by the
James Zadroga 9/11 Health and Compensation Act of 2010 (Act), and is administered by the National Institute for Occupational Safety and Health (NIOSH). The Program provides medical monitoring and treatment at no cost for enrolled responders at the WTC and related sites in New York City, Pentagon, and Shanksville, PA. It also provides services for enrolled survivors who were in the New York City disaster area. Health conditions, such as types of cancer, can be added to
the list of WTC-related covered conditions after a valid petition has been received and the scientific evidence for causation by exposures at the attack sites is analyzed.
In September of 2011, the Administrator of the WTC Health Program, Dr. John Howard, received a petition from nine New York members of Congress asking him to consider adding cancer to the List. The Administrator reviewed the petition and requested the advice of the WTC Scientific/Technical Advisory Committee (STAC), which provided recommendations to add specific types of cancer. After reviewing the STAC’s recommendation, evaluating the available science, and considering public comment on a proposed rule, in 2012 the Administrator published a
final rule which added certain types of cancer to the List and explained the approach used to add the types of cancer.
Recently, the U.S. Government Accountability Office (GAO) evaluated the
World Trade Center Health Program’s approach to adding cancers to the List [see:
http://www.gao.gov/products/GAO-14-606
]. The GAO found that the Administrator used a hazard-based, multiple-method approach to determine whether to add cancers to the WTCHP list of covered conditions for which treatment may be provided. Experts who participated in a meeting held by GAO indicated that the Administrator’s approach was reasonable but could be improved. The GAO reports:
- According to these experts, a hazard-based approach focuses on identifying whether particular “hazards”—sources of potential harm—are associated with certain health conditions, and does not attempt to quantify the risks of developing those health conditions. The Administrator’s approach used four methods to determine whether there was an association between a September 11 exposure and a specific cancer, and thus, whether to add that cancer to the list.
- The experts considered the approach reasonable given the WTCHP certification process for enrollees to obtain coverage for treatment for a condition on the list, the lack of data related to exposure levels and risks, and the use of similar approaches by previous federal compensation programs.
- The experts indicated the approach could have been communicated more clearly. For example, the description of the approach in rulemaking did not clearly articulate how decisions would be made when evidence under one method supported adding a cancer type to the list, and evidence under a different method did not. The Administrator noted that this omission was an oversight. Since the Administrator plans to use the same approach in future cancer-related decision making, the absence of a clear description can lead to questions about the credibility and equity of the program.
- According to the experts, an independent peer review process similar to that used in other federal compensation programs could improve the approach. According to the Administrator, this was not feasible due to time constraints imposed by law. A process through which an independent party assesses the validity of the information upon which decisions are being made and that rationales for decisions are clearly described could help ensure the credibility of the Administrator’s approach.
, the long-range weather forecast predicts chillier temperatures than average in January and February in the Southern Plains and the Southeast. Cold weather can bring on health emergencies for people who may be susceptible as a result of their working environment, such as those who work outdoors or in an area that is poorly insulated or without heat.
