9/11 health problems widen

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September 4, 2006

Mariama James is neither a firefighter nor an emergency medical technician, and after the World Trade Center attacks, she spent no time working on the pile as a volunteer responder. The 35-year-old mother of three is a bookkeeper who lives at 90 Gold St., four blocks east and one block north of Ground Zero.

But right after Sept. 11, when a thick layer of dust from downtown blew in through her windows, James, who was eight months pregnant at the time, said she started feeling pain in the middle of her chest. Then came the cysts that appeared from her face to her groin, and "really horrific" allergies and respiratory problems that she said affect both her and her children, who are now 14, 20 and 4. She said her husband, who was out of town for months before and after 9/11, suffers from none of these ailments.

Last week, the city's Department of Health issued some long-awaited guidelines to help doctors diagnose and treat Ground Zero-related illnesses. But advocates say the guidelines suggest that only those who had acute and prolonged exposure to conditions at Ground Zero, such as first responders and volunteers, are affected. They say the guidelines ignore a health threat to people who simply live and work in lower Manhattan, and whose homes, schools and workplaces were also contaminated.

"People are hurting and they want medical help," says Kimberly Flynn, co-coordinator of 9/11 Environmental Action, a group that advocates for downtown residents and office workers such as James, who claim health problems from Ground Zero exposure. But Flynn said the medical guidelines read as if the only people whose health is at risk were those who had acute and prolonged exposure at the pile or whose homes or offices were severely damaged and full of dust and debris.

"That is completely misleading," Flynn said.

In past columns, I've called on the city to issue the guidelines, since many Ground Zero responders and volunteers who are now sick were initially misdiagnosed and received the wrong treatment, their doctors say. But while Mount Sinai Medical Center posted medical guidelines on its Web site in early 2002, city health officials say there was no consensus among physicians until now about what illnesses were caused by exposure to the toxic stew at Ground Zero.

The health problems of firefighters, police officers, emergency technicians and volunteers who worked at Ground Zero have received the lion's share of publicity. But the illnesses of people such as Mariama James and her children may be the next big public health problem that city and federal officials will have to address.

"I'm very angry today," said Jonathan Bennett, a spokesman for the New York Committee for Occupational Safety and Health, a private group that works on workplace safety issues.

"It's perfectly reasonable for the guidelines to focus a great deal on the people who had the heaviest exposure, but there's no reason to ignore people who had lighter exposure," Bennett told me.

He said he doubted that a physician who read the guidelines, and then treated a patient who lives on Duane Street who's having problems breathing, would ever suspect there was a link to Ground Zero.

While Bellevue Hospital Center operates a World Trade Center screening and treatment program for lower Manhattan residents and workers, advocates say there should be a medical program right in lower Manhattan, closer to those who might be affected. And there have been repeated calls for the federal government to test the inside of apartment buildings and offices for contaminants that might pose a health threat. After 9/11 the feds cleaned only residences below Canal Street, Bennett said.

By producing the medical guidelines, city officials have finally acknowledged, after years of denial, that the conditions at Ground Zero have made a lot of Ground Zero responders sick, and the full dimensions of that public health problem still aren't known.

But it's time that city and federal officials also recognized the health problems of people like Mariama James and her children, who could be feeling the effects of 9/11 for years to come.