PUBLIC HEALTH:

Could 9/11 health bill's fate hold toxic echoes for the Gulf?

The parallel is grim enough to have caused a stir when President Obama drew it broadly in an interview. But the similarities between the Sept. 11, 2001, terrorist attacks and this year's Gulf of Mexico oil gusher -- specifically, the common thread of environmental health risks -- are back in the spotlight on Capitol Hill this week.

Ten days after unified Senate GOP opposition stalled a $7.4 billion aid package for 9/11 responders, Democrats are vowing a second try at passage before the new year, perhaps as soon as Wednesday. And some of the bill's most passionate backers warn that an inability to pass federal help for sickened Ground Zero workers does not bode well for any future assistance needed by their Gulf Coast counterparts.

"It sets a very bad precedent," said Rep. Eliot Engel (D-N.Y.) in a recent interview. The potential failure of the 9/11 health care aid bill, he added, could mean that responders to disasters of all stripes are "going to have to, in the future, look towards protecting themselves rather than not thinking about themselves."

Sen. Robert Menendez (D-N.J.), one of the upper chamber's champions of the 9/11 bill, sounded a similar note. Asked whether the uncertain prospects for the legislation signals a shrinking political space for aid to Gulf Coast workers, he said: "If you take the proposition that people who respond to the nation's challenges are on their own, that they inherit their own risk -- absolutely, that's a problem."

The causes of the two catastrophes could not be more different. But some of the same toxins encountered by responders to the World Trade Center attacks were flagged by occupational health experts in the wake of the Gulf spill: polycyclic aromatic hydrocarbons and the pollution cocktail known as particulate matter.

Those byproducts of the fires that raged in Lower Manhattan in 2001 also were generated by this year's gushing crude and the controlled burns performed by idled fishermen hired by BP PLC's "vessels of opportunity" program to help contain the oil. On the issue of environmental health, Engel said, "you can sure as hell draw a bit of a parallel to the Gulf spill, where workers exposed themselves to unsafe conditions."

The House-passed version of the 9/11 health bill, named for the late New York City police detective James Zadroga, would set aside $3.2 billion for long-term medical monitoring and treatment of ill rescue workers. No outcry for federal funding of Gulf oil spill responders' care has materialized on Capitol Hill, though the National Institute of Environmental Health Sciences (NIEHS) has a first-year commitment of more than $17 million to study the physical and mental health of as many as 50,000 workers who fought the gusher (Greenwire, Aug. 19).

It is far from certain, then, that Gulf workers could make the eventual case for even a fraction of the government assistance envisioned by the Zadroga bill. "The toxic levels in New York City were much greater" than those experienced during the BP spill, said Sen. Mary Landrieu (D-La.), a strong backer of the 9/11 health care measure.

"There may be problems, but it's not going to be nearly as significant as what happened in New York City," Landrieu added, describing "our problem" in the region as "not toxicity, pollution in the water, health issues" but "the lack of economic activity" linked to the Obama administration's moratorium on deepwater drilling.

Yet even if the environmental health consequences of the oil leak prove much smaller in scale than those of 9/11, Rep. Frank Pallone (D-N.J.) said, the failure of the Zadroga legislation still could deprive the Gulf of research into the connection between chemical exposures and human wellness.

"It is a bad sign, because part of what these clinics do, they also do research," Pallone said of the facilities that would benefit from the stalled 9/11 bill. "[A]s the people come in who have been impacted by these diseases or disorders, they begin to discover new things they didn't see before."

New York Committee for Occupational Safety and Health industrial hygienist David Newman, who served on a U.S. EPA expert panel that evaluated lingering public health risks after 9/11, said that a comprehensive investigation of the toxicological risks and medical needs of disaster responders cannot "happen effectively without a well-funded, expertly staffed, government-directed assessment."

"It can't happen at a university level, it can't happen at a community or individual physician level," Newman said in an interview. "You need to have an overarching public health infrastructure."

Bigger scale, similar problems

Natural Resources Defense Council environmental justice attorney Al Huang noted that Ground Zero responders were more open to discussing symptoms they connected to the disaster than oil-spill workers -- a difference he attributed in part to the active union membership shared by many of the workers and first responders at the World Trade Center but not by residents of right-to-work states along the Gulf Coast.

Unionization provided "a way to organize these workers together to call for protection," said Huang, who visited the Gulf during the gusher to advocate for affected locals and said very few fishermen hired by BP or other low-wage cleanup workers publicly shared their fears of exposure. "The reason why is, they were afraid of losing their job."

Another major difference between the environmental health risks of the two disasters, Huang pointed out, was their sheer scale. Compared with the several square city blocks of Ground Zero, "the BP oil spill was the entire coastal region," he said. And while U.S. EPA monitored air quality near the shoreline, he said, "a lot of the work was happening out in the open ocean. ... BP was self-collecting that data."

BP and federal health officials have said on numerous occasions that the chemicals generated by the oil spill did not result in a significantly greater health risk for workers in the Gulf.

Health professionals hailed the NIEHS Gulf worker study as a potentially major addition to the body of scientific literature on the human toll of oil spills. NIEHS officials acknowledged early on that sickened Gulf responders could need help finding care, but one leading player in the post-9/11 care process observed early in the process that treating those workers would be difficult without money from Washington.

Physician Stephen Levin, principal investigator for the monitoring program that the Zadroga bill would expand, warned NIEHS during an August meeting that until federal funds came through in 2006, "we had no resources for identifying" ill workers whose symptoms could be tied to the disaster.

"It was extremely frustrating, to them and to us, to be in the position of identifying a problem and not being able to make sure there were financial resources as well as clinical resources," said Levin, an associate professor at Mount Sinai School of Medicine in New York.

Filibuster's end?

Senate Majority Leader Harry Reid (D-Nev.) last week said he would call another vote on the Zadroga bill before adjourning the 111th Congress. The measure's supporters were further buoyed yesterday when New York's two Democratic senators said that in order to marshal enough GOP support they would modify the spending offsets included to pay for the medical monitoring.

"I believe we now have more than enough votes to pass this legislation," Sen. Kirsten Gillibrand (D-N.Y.) said in a statement yesterday. Gillibrand also said in a brief interview last week that a defeat of the bill could reverberate for other disaster-response health care debates.

The revised Zadroga bill crafted by Gillibrand and Sen. Chuck Schumer (D-N.Y.) would remove language in the House-passed measure that pays for the responders' care by closing a loophole allowing foreign corporations to avoid tax bills for their U.S. income -- an offset that had raised concerns among Republican senators. The New York senators instead propose to pay for the responder monitoring, which is now estimated to carry a slightly lower price tag of $6.2 billion, by levying a 2 percent fee on foreign corporations that are awarded U.S. government contracts.

But it remains to be seen whether the House would have time to vote again on the tweaked legislation before the 111th Congress comes to a close -- and whether potential GOP objections could require the upper chamber to burn more floor time before a final verdict. The Senate's No. 2 Republican leader, Jon Kyl of Arizona, yesterday suggested his party might not be ready to sign off on the bill in the waning hours of 2010.

"It's one thing to make an emotional appeal to say we need to take care of people, but it's another to do in a sensible way," Kyl told Fox News. "You bring it up in lame-duck session with no opportunity to amend it and you'll probably make bad legislation."

Reporter Sarah Abruzzese contributed.

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