City Releases Guidelines for Treating Trade Center-Related Illnesses

By JILL GARDINER, Staff Reporter of the Sun
September 1, 2006

Mayor Bloomberg has opposed legislation to automatically expand medical benefits to emergency workers who participated in the recovery effort after the World Trade Center attacks if they become sick. Yesterday, his health department released its most comprehensive set of medical guidelines to date acknowledging that many average New Yorkers who breathed in the dust and debris have become sick.

The health department said it would mail its new guidelines to doctors on how to treat and diagnose patients who have fallen ill because of exposure to toxins after the attacks. In the past, its guidelines have included only information about depression, posttraumatic stress, and chemical dependency.

"Five years after the World Trade Center attacks, many New Yorkers have disaster-associated physical and mental health conditions," the health commissioner, Dr. Thomas Frieden, said.

The announcement comes just a few weeks after Mr. Bloomberg declared his opposition to a bill signed by Governor Pataki that expands medical benefits to emergency responders who participated in the recovery effort at ground zero and become sick. That legislation and another law passed last year will cost the city $550 million over the next decade, Mr. Bloomberg says.

The chairman of the New York State Public Employee Conference Peter Meringolo said the updated clinical report is long overdue. He said it was intriguing given the mayor's attempt to block the Albany legislation.

"Whether or not this contradicts the mayor, I don't know, but it does recognize that there are a lot of people with health problems," Mr. Meringolo said. "That only seems to support what the governor is saying."

Health professionals said they were happy to have the updated information.

"I think it's clear to virtually everyone that the exposure is having serious medical consequences for more and more people," the director of the National Center for Disaster Preparedness at Columbia University's Mailman School of Public Health, Dr. Irwin Redlener, said.

Mr. Redlener — who last week released a book called "Americans At Risk: Why We're Not Prepared for MegaDisaters and What We Can Do" — said that while there will always be gray areas in determining the exact cause of an illness, it is better to provide care.

The chief medical officer at Downtown Hospital, Dr. Warren Licht, said many of his patients who live or work in Lower Manhattan have had health conditions flare up since September 11, 2001. "I think it's fantastic," he said of the new report.

The deputy commissioner for epidemiology at the health department, Dr. Lorna Thorpe, said the city has been working on the updated guidelines for a year and that its release had nothing to do with the state legislation.

In opposing the Albany legislation and publicly taking on Mr. Pataki, the mayor argued that it was unfair for the state to stick the city with an unfunded mandate that would cost hundreds of millions of dollars. He said he did not object to the intent of providing medical care to first responders, but that it would nearly impossible to determine whether conditions were actually caused from exposure to the dust and not something else.

Mr. Bloomberg also said that if the city were forced to come up with the money to fund the two new laws, it would have to cut back services or raise taxes.

A spokesman for the mayor, Stuart Loeser, said yesterday that the new guidelines do not contradict the mayor's past position.

"He believes that the city and the taxpayers have inherently limited resources and we should be supporting people with demonstrable medical links."