Fred Mogul, Reporter, WNYC News
Fred Mogul has been covering healthcare and medicine for WNYC since 2002.
A federal panel charged with examining the link between World Trade Center dust says the evidence is strong enough that the government should begin covering cancer.
Under the James Zadroga 9/11 Health Law, individuals with lung, skin and other conditions are eligible for health coverage and compensation, but those with cancer are not.
Lawmakers who passed the bill in 2010, said then that the evidence wasn't strong enough to include cancer — but also said that could change, if scientific evidence emerged.
"I think there's a reasonable likelihood that cancer has or will result from World Trade Center exposures," said Dr. Steven Markowitz, director of the Center for the Biology of Natural Systems at Queens College.
The reasons he listed included the number of carcinogens present at the site, the extent to which people there inhaled materials, and historical evidence that for some materials and some cancers, even brief exposures can have long-term consequences.
Another panelist, Guillermina Mejia, a safety and health coordinator for the municipal workers union DC 37, acknowledged "there are many gaps in the data," but said, "we shouldn't hold this against the workers."
The 17-member Scientific and Technical Advisory Committee was convened last fall to assess the latest research and make and recommend whether cancer should be added to a list of illnesses that includes various lung, digestive and skin conditions.
Discussion focused not just on the published literature, but on the nature of proving cause and effect, with something as complicated as cancer. It took decades to confirm the connection between a relatively simple exposure, smoking, and one type of cancer; at the World Trade Center, there were myriads of substances, and types and durations of exposures, and many different kinds of cancer that may or may not have anything to do with the post-9/11 experience.
This complexity was part of the reason cancer was left out of the James Zadroga 9/11 Health Law. When Congress passed the law late in 2010, evidence of a link to WTC exposure was considered insufficient, but it allowed for "periodic review" of scientific research to modify the list, based on new findings.
There have been some new findings in the last 13 months. An FDNY study last fall showed firefighters exposed to the WTC site were at least 19 percent more likely to develop cancer than their non-exposed colleagues and up to 10 percent more likely than a similar sample from the general population.
Mt. Sinai Medical Center, which has been monitoring and treating Ground Zero workers other than FDNY, says a recent study with similar results has been submitted for publication.
Dr. Philip Landrigan, head of the Mt. Sinai program, told the panel that while epidemiologists would like to have 95 percent certainty, before declaring cause-and-effect between an exposure and an illness, the complexity of cancer and the long time it would take for patterns to emerge suggest the need for a different, and more humane, standard - one more like 51 percent certainty that there's a "substantial likelihood" of connection.
Landrigan said that confidence came from combining the epidemiological evidence, with established knowledge about the carcinogens at the site, and "biological plausibility," the reasonable assumptions that could be made about how certain body tissues react with those carcinogens.
The panel - which has 12 people with MD's or Ph.D's and five advocates representing the FDNY, NYPD, local community and other groups - agreed not to cover all cancers, but to develop a list of specific cancers, based on the substances present at Ground Zero.
On Wednesday and Thursday, the panel held its main meeting in Lower Manhattan.
The committee's recommendation is due by March 2. Its advice can then either be accepted or rejected by the administrator of the health program.
With the Associated Press