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CONTINUATION OF 9/11 HEALTH EFFECTS:

ENVIRONMENTAL IMPACTS FOR RESIDENTS

AND RESPONDERS

HEARING

BEFORE THE

SUBCOMMITTEE ON GOVERNMENT MANAGEMENT,

ORGANIZATION, AND PROCUREMENT

OF THE

COMMITTEE ON OVERSIGHT

AND GOVERNMENT REFORM

HOUSE OF REPRESENTATIVES

ONE HUNDRED TENTH CONGRESS

FIRST SESSION

APRIL 23, 2007

Serial No. 110–45

Printed for the use of the Committee on Oversight and Government Reform

(

Available via the World Wide Web: http://www.gpoaccess.gov/congress/index.html

http://www.oversight.house.gov

(II)

COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM

HENRY A. WAXMAN, California, Chairman

TOM LANTOS, California

EDOLPHUS TOWNS, New York

PAUL E. KANJORSKI, Pennsylvania

CAROLYN B. MALONEY, New York

ELIJAH E. CUMMINGS, Maryland

DENNIS J. KUCINICH, Ohio

DANNY K. DAVIS, Illinois

JOHN F. TIERNEY, Massachusetts

WM. LACY CLAY, Missouri

DIANE E. WATSON, California

STEPHEN F. LYNCH, Massachusetts

BRIAN HIGGINS, New York

JOHN A. YARMUTH, Kentucky

BRUCE L. BRALEY, Iowa

ELEANOR HOLMES NORTON, District of

Columbia

BETTY MCCOLLUM, Minnesota

JIM COOPER, Tennessee

CHRIS VAN HOLLEN, Maryland

PAUL W. HODES, New Hampshire

CHRISTOPHER S. MURPHY, Connecticut

JOHN P. SARBANES, Maryland

PETER WELCH, Vermont

TOM DAVIS, Virginia

DAN BURTON, Indiana

CHRISTOPHER SHAYS, Connecticut

JOHN M. MCHUGH, New York

JOHN L. MICA, Florida

MARK E. SOUDER, Indiana

TODD RUSSELL PLATTS, Pennsylvania

CHRIS CANNON, Utah

JOHN J. DUNCAN, JR., Tennessee

MICHAEL R. TURNER, Ohio

DARRELL E. ISSA, California

KENNY MARCHANT, Texas

LYNN A. WESTMORELAND, Georgia

PATRICK T. MCHENRY, North Carolina

VIRGINIA FOXX, North Carolina

BRIAN P. BILBRAY, California

BILL SALI, Idaho

——— ———

PHIL SCHILIRO, Chief of Staff

PHIL BARNETT, Staff Director

EARLEY GREEN, Chief Clerk

DAVID MARIN, Minority Staff Director

SUBCOMMITTEE ON GOVERNMENT MANAGEMENT, ORGANIZATION, AND PROCUREMENT

EDOLPHUS TOWNS, New York, Chairman

PAUL E. KANJORSKI, Pennsylvania

CHRISTOPHER S. MURPHY, Connecticut

PETER WELCH, Vermont

CAROLYN B. MALONEY, New York

BRIAN P. BILBRAY, California

TODD RUSSELL PLATTS, Pennsylvania,

JOHN J. DUNCAN, JR., Tennessee

MICHAEL MCCARTHY, Staff Director

(III)

C O N T E N T S

Page

Hearing held on April 23, 2007 .............................................................................. 1

Statement of:

Chan, Kwai-Cheong, former Assistant Inspector General for Program

Evaluation, Environmental Protection Agency; David M. Newman, industrial hygienist, New York Committee for Occupational Safety and

Health; Patrick Roohan, director, Bureau of Program Quality, Information and Evaluation, New York State Department of Health; Dr. Anthony Szema, assistant professor of medicine, Suny-Stony Brook School

of Medicine; Suzanne Y. Mattei, executive director, Sierra Club of New

York City; and Peter Gudaitis, executive director, New York Disaster

Interfaith Services ........................................................................................ 31

Chan, Kwai-Cheong .................................................................................. 31

Gudaitis, Peter ........................................................................................... 37

Mattei, Suzanne Y. .................................................................................... 85

Newman, David M. .................................................................................... 49

Roohan, Patrick ......................................................................................... 61

Szema, Dr. Anthony .................................................................................. 79

Graham, Yvonne, deputy Brooklyn Borough president ................................. 20

Letters, statements, etc., submitted for the record by:

Chan, Kwai-Cheong, former Assistant Inspector General for Program

Evaluation, Environmental Protection Agency, prepared statement of ... 33

Fossella, Hon. Vito, a Representative in Congress from the State of

New York, prepared statement of ................................................................ 110

Graham, Yvonne, deputy Brooklyn Borough president, prepared statement of ........................................................................................................... 23

Gudaitis, Peter, executive director, New York Disaster Interfaith Services, prepared statement of .......................................................................... 40

Maloney, Hon. Carolyn B., a Representative in Congress from the State

of New York, prepared statement of ........................................................... 8

Mattei, Suzanne Y., executive director, Sierra Club of New York City,

prepared statement of ................................................................................... 88

Nadler, Hon. Jerrold, a Representative in Congress from the State of

New York, prepared statement of ................................................................ 15

Newman, David M., industrial hygienist, New York Committee for Occupational Safety and Health, prepared statement of ................................... 52

Roohan, Patrick, director, Bureau of Program Quality, Information and

Evaluation, New York State Department of Health, prepared statement

of ..................................................................................................................... 63

Shays, Hon. Christopher, a Representative in Congress from the State

of Connecticut, prepared statement of ........................................................ 107

Szema, Dr. Anthony, assistant professor of medicine, Suny-Stony Brook

School of Medicine, prepared statement of ................................................. 82

(1)

CONTINUATION OF 9/11 HEALTH EFFECTS:

ENVIRONMENTAL IMPACTS FOR RESIDENTS

AND RESPONDERS

MONDAY, APRIL 23, 2007

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE ON GOVERNMENT MANAGEMENT,

ORGANIZATION, AND PROCUREMENT,

COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM,

Brooklyn, NY.

The subcommittee met, pursuant to notice, at 10 a.m., in Brooklyn Borough Hall, 209 Joralemon Street, Brooklyn, NY, Hon.

Edolphus Towns (chairman of the subcommittee) presiding.

Present: Representatives Towns, Murphy, Maloney, and Platts.

Also present: Representatives Weiner and Nadler.

Staff present: Michael McCarthy, staff director; Rick Blake, professional staff member; Cecelia Morton, clerk; and John Cuaderes,

minority senior investigator and policy advisor.

Mr. TOWNS. The subcommittee will come to order. Before starting

our proceedings today, I just want to say two words about one of

our colleagues who passed away. Juanita Millender-McDonald

passed away yesterday, who happened to be my next door neighbor

in the Rayburn Building in Washington, DC.

Her office is right next to my office. We served together for many

years. And she, of course, chaired the House Administration Committee and has done a fantastic job in that regard.

So we will miss Congresswoman McDonald. And I would just like

for you to just pause for a moment of silence.

[Pause.]

Mr. TOWNS. Thank you.

We are in the borough presidents—of course, Marty Markowitz

has made it possible for us to come in. And I was sort of looking

for him to ask him to bring greetings today, but I do not see the

borough president. Oh, he is on his way upstairs? OK.

Well, we will just pause a moment to ask him to bring greetings,

of course. And if he can’t bring greetings, we will have to ask the

deputy borough president to bring greetings because we want to

thank you for allowing us to come in and hold the congressional

hearing.

While we are waiting on him, let me just sort of introduce the

members on the panel here in terms of our Congressmembers.

First, we have the ranking—actually, the former chairman of this

subcommittee before, as you know, the House did a little switch.

And he was the Chair. Of course, I was ranking at the time he was

2

chair. And he did a marvelous job. I enjoyed working with him.

And, of course, he hails from Pennsylvania, Representative Platts

from Pennsylvania, whom you will be hearing from a little bit later

on in his statement.

Then, of course, we have with us Congressman Nadler, who also

represents a portion of Brooklyn. So he is at home here, of course.

And then, of course, you have Carolyn Maloney from Manhattan,

who has been very involved in this issue as well.

So we will pause at this point to ask the borough president of

Brooklyn, the Honorable Marty Markowitz, to bring greetings to us

and to thank him for allowing us to come in to Borough Hall, a

place that I am very, very familiar with.

Borough President Marty Markowitz.

Mr. MARKOWITZ. You sure are. And, remember, mi casa es su

casa.

Thank you very, very much. It is so good to see you. Jerry Nadler, who serves Brooklyn with tremendous distinction;

Congressmember Platts, welcome to where New York State begins,

Brooklyn; Carolyn Maloney, who is an outstanding Member of the

Congress from our outer borough, Manhattan—and thank you all

for your personnel; I mean it, Carolyn—and Chairman Ed Towns.

It is a pleasure to call you Chair. And you should always be chair

for all the days to come. And I mean that.

Mr. TOWNS. Thank you.

Mr. MARKOWITZ. Let me say good morning to the Subcommittee

on Government Management, Organization, and Procurement,

Committee on Oversight and Government Reform. Welcome to

what we call Brooklyn City Hall.

I want to thank everyone here for making yourselves available

to talk about the health concerns of Brooklynites, especially as they

relate to the devastating attacks on 9/11. The single most important thing to any human being, as we all know, is his or her

health.

I’m sorry. Congressman Weiner, welcome. Welcome. Congressman Weiner serves Brooklyn and Queens superbly. And the only

word I have to say about him, he’s too thin. That’s the only thing.

I have tried since I’ve known him to fatten him up. Obviously I get

fatter as I talk about it. Congressman Weiner, thank you very

much.

Mr. WEINER. Keep those Junior’s cheesecakes coming.

Mr. MARKOWITZ. Right past me to you. I know. And so it goes

without saying that as elected officials, our No. 1 priority is doing

everything in our power to ensure that our residents get the treatment and care they need and deserve.

That is why I along with all of our residents am profoundly

grateful to our colleagues at the Federal level who have introduced

in both the House and the Senate the 9/11 Heroes Health Improvement Act of 2007. This bill would provide $1.9 billion in Federal

funding for medical and mental health screening, testing, and

treatment grants to health care institutions that care for those affected by the 9/11 attacks.

We applaud Congressmen Towns, Nadler, Engel, Weiner, Platts,

and Maloney for taking action. We urge Congress to pass this legislation quickly.

3

The heartbreak that Brooklynites experienced on 9/11, the days

and months afterwards, and even to this day, as you know, is as

searing and complete as that of any New Yorker or any American.

Three Brooklyn police officers perished in the rescue efforts, and 82

of New York’s bravest from Brooklyn firehouses died on the scene.

According to the World Trade Center health registry, at least

8,000 Brooklynites were in the downtown area during the towers’

collapse. Countless numbers of our residents breathe in contaminated air from the smoke plume that drifted to Brooklyn on that

terrible day.

Finding out how our residents’ health may have been impacted

and getting them the treatment that is denied them is the right

thing to do, as you know.

I thank you for holding this important hearing in Brooklyn.

Many Brooklynites are still waiting to be compensated and cared

for. No one knows better than all of us here in Brooklyn how tough

Brooklynites are and the tremendous attitude they bring to every

challenge. But the heartbreak of 9/11 will always front our collective memories.

The least we can do is to get our residents the treatment and

care they need so that the health conditions that resulted from the

9/11 tragedy are a thing of the past.

Thank you and good morning. And I know that our deputy borough president, Yvonne Graham, will get into much greater depth

on this. Thank you very, very much for being here.

Mr. TOWNS. Thank you very much, Mr. President.

Mr. MARKOWITZ. My pleasure.

Mr. TOWNS. Thank you very much for allowing us to come in.

And thank you for your welcome.

Mr. MARKOWITZ. Welcome home, by the way.

Mr. TOWNS. Thank you. Thank you. And I also thank you for

calling me chairman.

Mr. MARKOWITZ. I love that title.

Mr. TOWNS. Let me ask unanimous consent that these members

of the New York City delegation be allowed to participate in today’s

hearings. That’s Congressman Weiner and, of course, Congressman

Nadler and Congresswoman Maloney. Without hearing any objection, it is so ordered.

I would also like to welcome those seated in the audience who

are either first responders or who belong to a trade union and

other organizations who represent these heroes. You are the primary reason we are holding this hearing today.

I recognize that on the day of 9/11, that there was a dark cloud

in the sky moving in this direction, moving toward Brooklyn. And

there is no doubt in my mind that Brooklyn was affected by that

because it landed somewhere in our borough. And, of course, since

that time, we have had many residents to come forward and say

that they had respiratory problems and all kinds of things occurred.

I think that we cannot afford the luxury of just ignoring this,

that we must listen to it. And, of course, I said that this committee

will address that issue and see what we can do in terms of to be

able to correct it.

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We feel that not only is the city involved in it, but I think that

the Federal Government has an obligation and responsibility as

well to come up with a Federal fix because we do not want to discourage people from volunteering. We do not want to discourage

people from helping each other. And the only way we can do that

is to make certain we are fair to them when something like this

happens.

So I want to thank my colleagues today for coming to be a part

of this hearing and to say I look forward to hearing from the witnesses.

So at this point in time I would like to pause and ask Representative Platts for his opening statement. And then we’ll just move

right along to the other Members.

Mr. PLATTS. Thank you, Mr. Chairman. It is great to be back

here in Brooklyn, I think my third visit here with you. And while

I enjoyed the title of chairman in the past, I am delighted to now

have the privilege of serving with you as chair of this important

subcommittee.

I also want to add my words of condolences to our Congresswoman’s family in her passing and that we keep her and her family in our thoughts and prayers in this difficult time.

I want to comment my fellow colleagues that are here and especially the New York delegation in total for your great leadership on

this very important issue and your continuing the important oversight through this committee’s work.

I believe this is the committee’s sixth hearing on the health problems caused by al-Qaeda’s attack on New York City 51⁄2 years ago.

Members share a commitment to ensuring that the Federal Government, the State of New York, this wonderful city, and other

public and private organizations are properly organized and funded

to identify, assess, and treat those emergency personnel, workers,

volunteers, and residents who are physically or emotionally harmed

by the collapse of the World Trade Center and the subsequent

cleanup.

The 2001 terrorist attacks caused destruction on an unprecedented scale. When al-Qaeda struck the World Trade Center buildings with fuel-laden jet aircraft amidst one of the world’s most

densely populated cities, the resulting collapse of the World Trade

Center Twin Towers and other buildings was unimaginable.

Thousands of firefighters, police officers, and others raced immediately to provide assistance at the scene. Thousands more arrived

in subsequent days and weeks to fight persistent fires and to remove rubble and begin the arduous task of rebuilding.

Now it seems apparent that these brave individuals inhaled a

toxic mixture of concrete dust and smoke made up with the byproducts of incinerated building materials. Every American harmed

physically and mentally by the 9/11 attacks in New York; Washington, DC; and those with loved ones on flight 93 deserve our assistance.

Today, we will hear from several people who are representatives

of a much larger number of victims of that day. I look forward also

to hearing from city officials and learning about the government’s

current arrangements and future plans to assist those in need.

5

The President has included $25 million in his current budget for

the coming fiscal year as what has been called a placeholder in the

Nation’s spending plan. I’m eager to hear assessment about how

this seemingly modest amount will be allocated and estimates on

the scope of further assistance that will be needed in the months

and years to come.

It’s also essential to learn from the 2001 attacks so that our government is prepared for natural and manmade emergencies in the

future. I look forward to hearing what lasting changes and arrangements have been made in light of the experiences here in

New York.

Finally, no doubt there will be some disagreements about whether in hindsight every agency of government responded adequately

to the health issues caused by the unprecedented attack on September 11th. Let us not, however, lose sight of the forces and individuals which struck the blow which spurred this and the preceding hearings.

We must correct dysfunctional or unresponsive bureaucracies.

We must allocate the necessary funds to aid those harmed. And,

most importantly, we must work together as a nation to ensure

that we are prepared to handle any emergencies that we are likely

to face as we continue to fight the war on terror.

Thank you again, Mr. Chairman, for allowing me to be here with

you today and for your important and great leadership on this

issue.

Mr. TOWNS. Thank you very much. I really appreciate your being

here and also the work that you have been doing, not only now but

even in the past.

The next person we call on, a very outstanding member of the

committee from Manhattan, Representative Carolyn Maloney.

Ms. MALONEY. Thank you so much, Mr. Chairman. I also represent Queens. And I really want to thank you for holding this very

important hearing on 9/11 health effects.

This is the second hearing that Chairman Towns has called on

the health problems that our citizens confront. It is the sixth in a

series of hearings that have been held by this committee in Congress. And I want to thank the chairman for his outstanding leadership in calling us together with yet the sixth hearing on this

issue.

As many in this room know all too well, the collapse of the World

Trade towers released a giant dust plume containing thousands of

tons of pollutants, which exposed thousands of first responders and

residents to pulverized cement dust, glass fibers, asbestos, lead,

acid, and other toxins. But what many across the country still do

not understand is the impact that dust cloud had on both responders and residents and, as today’s hearing will show, how that dust

cloud traveled from ground zero across the East River and into

Brooklyn.

Like the environmental and health effects on those who live near

the 9/11 site, the environmental and health effects in Brooklyn are

far from understood.

One reason we know so little about the impacts in Brooklyn is

that we still have so much to learn about the impact of 9/11 on everyone affected because the current administration did not want to

6

ask questions, let alone find the answers. The truth of the matter

is that the New York delegation has had to fight very, very hard

to achieve medical monitoring and treatment for the responders.

But we cannot forget the residents, area workers, school children

that were exposed and may continue to be exposed to toxins in the

homes, offices, and schools. And currently there is really not any

Federal funding available to monitor and treat them. And we need

to change that.

Worse, the administration has not even come up with a plan to

help the residents who lived through the dust cloud or the responders who risked their lives in the aftermath of 9/11.

Time and again, we have asked the administration to come up

with a comprehensive long-term plan to medically monitor everyone who is exposed to the deadly toxins. And everyone who was exposed should be treated. And time and again they have not acted.

Experts have testified to this committee that the health effects

of 9/11 are persistent and long-term and will be prevalent, even 30

years from now in the future, when cancers begin to occur.

To adequately address the 9/11 health crisis, we need a longterm plan that takes into account everyone exposed to the toxins:

responders, rescue workers, cleanup workers, area residents, school

children, residents, including the residents of Brooklyn.

And I know that the new majority in Congress will be looking

at these issues, as is evident from today’s hearing, and that they

will work in a bipartisan way to address the problem.

Along with many of my colleagues, I have introduced a comprehensive Federal response called a James Zadroga plan, the 9/11

Health and Compensation Act to ensure that everyone exposed is

medically monitored and everyone who is sick is treated.

The bill is named after New York police detective James

Zadroga, who was among the first to die from respiratory illness

related to his work at ground zero. It’s drafted to continue, expand,

and improve the Federal Government’s response to the health effects of 9/11, providing for long-term medical monitoring and treatment.

James Zadroga came down with something called pulmonary fibrosis. And we are going to hear more and more about it. The particulates are breathed in. The skin grows over it. And your lung becomes like an iron lung. You can’t breathe. And you die. The only

treatment so far is a lung transplant. And many of our first responders have come down with this deadly disease.

With the work of the committee, we have been successful in securing $90 million for a monitoring program at Mount Sinai. Incredibly, the administration took $125 million out of the budget for

Workers’ Compensation. We had to work very hard to put that

back into the budget for treatment and other concerns.

We recently got a $25 million line item, budget item, in the

President’s budget for 25 million. He has promised and his people

have promised to increase that to what the need is for treatment.

We need to document that.

Health professionals are telling us that for this 2-year term of

Congress, it will cost roughly $256 million to treat those who are

sick. We have written and met with Mr. Obey to put that in the

7

budget. So we are working hard. We are making progress but not

enough.

Thank you very much.

[The prepared statement of Hon. Carolyn B. Maloney follows:]

8

9

10

Mr. TOWNS. Thank you. Thank you very much.

We are also delighted to have with us, of course, Congressman

Murphy, who is also a member of the committee from Connecticut.

So, Congressman Murphy?

Mr. MURPHY. Thank you very much.

Mr. Chairman, this is the second opportunity that I have had to

sit with you on a hearing on this subject in my first term. I have

been drawn to this issue, not just by your leadership but also leadership of Congresswoman Maloney, Congressman Nadler, and Congressman Weiner. This is an important day to be here. And I am

glad that I could join you from Connecticut.

You know, we were all struck, those of us who watched the

events of September 11th unfold on television and on the news. I

was not a Member of Congress at the time, but we were all obviously struck by the bravery of those first responders and those people that rushed down to the site of the September 11th tragedy.

They didn’t wait for any bureaucracy. They didn’t fill out any questionnaires. There was no red tape. They asked no questions. They

responded because their country was in need.

And it has struck me in the hearings that we have done that our

government has not acted with the same expediency that those

first responders acted. In fact, they have been met with bureaucracy, with red tape, and questions after questions after questions.

Those people that responded to the tragedy in New York came

largely from this metropolitan area, but we also know that they

came from Connecticut, from the Fifth District. They came from

New Jersey. They came from Representative Platts’ area in Pennsylvania.

I have had the great privilege over the course of the last couple

of months of getting to know some of those brave men and women

in the course of these hearings. And in my private life in Connecticut, I also have struggled with a family member who is dealing

with the issue of pulmonary fibrosis. And for any family that has

gone through that ordeal, you wouldn’t wish it on your loved ones,

on your friends, on anyone that you come in contact with.

It is a terrible ordeal for a person, a family to go through. And

to think that there are so many of our neighbors and our friends

in the New York metropolitan area who responded to that crisis,

perhaps people in the greater metropolitan area who may have

been exposed to the debris and to the pollution that emanated from

that site that may be at risk for a disease as terrible as that is one

that should make us all shudder.

Mr. Towns, this is an important hearing today. I am so glad to

be able to come down and join you. I hope that this is yet just another piece in the puzzle that begins to prompt this administration,

that begins to prompt our fellow Members of Congress to put not

just the money behind this effort but to also put the expediency behind it that those brave men and women came through as they descended upon the World Trade Center site on that day and the

days following.

Thank you, Mr. Chairman.

Mr. TOWNS. Thank you very much, Congressman Murphy.

The person who—immediately after the incident happened, he

started talking about the fact that the government has not budgVerDate 11-MAY-2000 14:33 Apr 29, 2008 Jkt 000000 PO 00000 Frm 00014 Fmt 6633 Sfmt 6633 C:\DOCS\40872.TXT HGOVREF1 PsN: HGOVREF1
11

eted the kind of funds needed to give us all the facts. He talked

about the fact that there are environmental issues that must be addressed. And he has been saying it over and over again to anyone

and everyone that will listen. Ladies and gentlemen, Congressman

Nadler.

Mr. NADLER. Thank you very much, Chairman Towns. I would

like to thank you for holding this very important field hearing

today in Brooklyn and for inviting me to hear testimony on the impact of the September 11th attacks on the health of area residents,

workers, and students. I thank you for letting me make these opening remarks.

Mr. Chairman, I represent the district where the World Trade

Center once stood, the site of the tragic events of September 11,

2001, as well as, of course, representing large areas of Brooklyn.

Like you, I represent many constituents who have suffered adverse

health effects as a result of the horrible environmental impacts of

the collapse of the World Trade Center towers.

I have spent the better part of the last 5 years in public life cajoling the Federal Government to tell the truth to its citizens about

9/11 air quality, insisting there must be a full and proper cleanup

of the 9/11 environmental toxins that to this day are still poisoning

New Yorkers and for those already sick, be they first responders

or area residents, workers, or school children, demanding that the

government provide long-term comprehensive health care.

Unfortunately, every time I think we are making a bit of

progress on this issue, I find myself shocked at the Federal Government’s response. I know, Mr. Chairman, that you are as utterly

dismayed as I was to hear at your February 28th hearing that the

Department of Health and Human Services had absolutely no intent of including area residents, workers, and school children in the

plan it is ostensibly developing to provide health care to victims of

the post-9/11 environmental contamination.

HHS officials say that this outrageous and arbitrary decision to

limit the health response to first responders but not to area residents, workers, and school children was based on their belief that

there does not exist sufficient data indicating that residents, workers, and students have, in fact, suffered negative health effects

from 9/11. Of course, that is not true. We have a growing body of

data, both anecdotal and otherwise, that I’m sure will be recounted

here today.

This decision, of course, is nothing more than a continuation of

the Federal policy that has completely ignored the needs of these

non-responder exposed populations. I by no means intend to imply

that this administration has treated our first responder heroes

well. They certainly have not. But there were other unnecessarily

exposed populations as well because of the continuing misdeeds of

the Federal Government.

Let me be utterly clear. Given the Federal Government’s reckless

negligence and ongoing malicious actions, all affected residents,

workers, and school children, no matter where they live, must be

given relief by the Federal Government. There must be a comprehensive and scientifically sound indoor cleanup program implemented. And these affected individuals must be provided proper

health care.

12

As is now common knowledge, then EPA Administrator Christine

Todd Whitman told New Yorkers shortly after September 11th that

the air was safe to breathe. This statement, which she repeated

often and did not qualify, has since been shown by the EPA’s own

Inspector General, among others, to have been misleading, false,

and politically motivated. But the administration stood by it and

still does.

And, as a result, countless first responders and, yes, also residents, workers, and students are sick and some are dead as a direct result of the foul deeds of EPA and the Federal Government.

These statements, in effect, we were attacked first by the terrorists and then by our own government. These statements lulled

Americans into a dangerous sense of false safety, engaged government decisionmakers the cover to take extremely perilous shortcuts.

Federal Judge Deborah Batts put it well in a case brought

against EPA by area residents, workers, and school children, ‘‘No

reasonable person would have thought that telling thousands of

people that it was safe to return to lower Manhattan while knowing that such return could pose long-term health risks and other

dire consequences was conduct sanctioned by our laws.’’ She found,

in fact, that the actions taken were so bad that they shocked the

conscience.

While most Americans understand that those caught in the initial collapse of the towers and those first responders who toiled

away in the pile for months were subject to a heavy acute dose of

outdoor toxins, most people do not know that the environmental

disaster still continues to exist today indoors.

Like the debris, office furniture, steel beams, and human remains that have been found recently in buildings throughout lower

Manhattan, dangerous contaminants such as lead, asbestos, mercury today remain in indoor spaces, such as apartments, workspaces, and schools in Manhattan, in Brooklyn, and possibly farther afield.

Whereas nature cleans the outdoor air, it does not clean the indoor air. Toxins remain in carpets and drapes and porous wood

surfaces and the HVAC systems of buildings.

In April 2002, 5 years ago, I released a white paper, which is still

available on my Web site, that meticulously details how the EPA’s

unfounded and misleading statements followed by the EPA’s unlawful complete dereliction of responsibility resulted in totally inadequate hazardous materials testing and remediation inside residential, public, and commercial buildings downtown and in Brooklyn, putting the public’s health at grave risk.

The EPA illegally delegated its responsibility for indoor environmental quality and reoccupation of contaminated buildings and

areas to the city environmental officials, who had no ability to handle such a situation, and endorsed the city’s illegal and dangerous

advice to area residents and workers to ‘‘use a wet mop and a wet

rag’’ to clean their contaminated spaces, all in the service of continuing to cover up the original lies told by Ms. Whitman.

In May of that year, after months of dodges, finger pointing, excuses, and a tremendous amount of pressure, EPA offered finally

13

an indoor cleanup program. It was very soon clear to me and others

that the plan was a sham.

Not only was there no scientific basis to the plan. EPA actually

asserted at the time that there was no need for a real cleanup program as there were, in fact, no real post-9/11 air quality problems

indoors. The program they said was designed merely to reassure

the public. In other words, it was pure public relations.

This initial cleanup plan was voluntary and included only residences, not workspaces, or schools. They failed to treat buildings as

a whole, which allowed for recontamination of some spaces and

buildings that were not cleaned. It tested only for asbestos, even

though it was known that the dust contained other harmful toxins,

including heavy metals, glass, fibers, mercury, and lead.

The program was arbitrarily geographically limited. Only buildings in Manhattan south of Canal Street and west of Allen and

Pike Streets were eligible, even though physical inspection identified dust in locations outside of this area.

Because of this, Brooklyn, for example, was and continues to be

completely ignored in all of the EPA’s program. To this day, EPA

officials would like us to believe that there was a 30,000-foot-high

wall or perhaps a Star Trek-type force field magically stopping the

plume and its toxins from going north of Canal Street or across the

East River to Brooklyn.

Despite EPA’s repeated assurances to me at that time that they

would ‘‘expand the program where necessary’’ to places like downtown and Brownstone and Brooklyn and Borough Park and Williamsburg that had numerous accounts of interior contamination,

no such expansion ever occurred.

A year later, in August 2003, after much public outcry, EPA’s

own Inspector General found that this original so-called testing and

cleanup plan was indeed improperly limited in scope in terms of

both what it was to look for and where it was to look for it deeply

flawed in methodology and ‘‘failed to utilize standard health-based

benchmarks.’’

The same report documented White House interference in EPA

press releases post-9/11, resulting in important cautionary sentences being deleted. The report notably stated that the delay in

providing a proper government-organized cleanup may have contributed to unnecessary additional exposures to hazardous toxins.

The IG’s ultimate conclusion, EPA must——

Mr. TOWNS. Will the gentleman yield?

Mr. NADLER. Yes.

Mr. TOWNS. Will the gentleman please summarize?

Mr. NADLER. OK. EPA must engage in a real comprehensive and

scientifically based testing and cleanup program to address 9/11

contamination wherever it is found. Of course, to date, the EPA has

done no such thing. In the last 2 years, they have had scientific

panels set up to design proper cleanup programs and dissolved

when the EPA started hearing things they didn’t want. They are

now proceeding with a new phony cleanup plan, just as phony as

the original one.

As you know, it has taken years of painstaking work on the part

of the New York congressional delegation to get what little moneys

we have for federally mandated 9/11 health response. But even

14

that is mostly for the first responders. And there is plenty of data

why we need all the funds.

Because the administration continues to fail to act, I have introduced two key pieces of legislation that I believe will help provide

relief. The 9/11 Comprehensive Health Benefits Act provides a sensible, easy to access, and cost-effective way to give comprehensive

medical treatment to all individuals. The 9/11 Heroes Health Improvement Act will provide more than $1.9 billion in Federal funding for mental and medical health screening testing, monitoring,

and treatment grants. Senators Clinton, Schumer, Kennedy, and

Menendez have introduced companion legislation in the Senate.

This bill would provide a necessary continued and expanded

funding mechanism for the institutions that Mayor Bloomberg has

called the World Trade Center Centers of Excellence.

The Federal Government is culpable for recklessly allowing tens

of thousands of people to be unnecessarily exposed to dangerous environmental toxins. It must take responsibility for two things. Most

of the discussion has focused on the first. And that is responding

to the health needs of the 9/11 first responders, and we must respond to that. But the second is to undo that second coverup. There

were two coverups. The first of the impacts on 9/11 responders,

that coverup was unraveled. And we are now trying to respond to

it.

The second coverup is still covered up. And that is the fact that

people in Manhattan, Brooklyn, Jersey City, Queens are still being

poisoned daily because the indoor spaces were never properly tested and cleaned and the EPA Inspector General’s recommendations

of August 2003 as to how to properly inspect and clean up all of

the areas that may be necessary to clean up must be implemented

so that people do not continue to be poisoned and so that future

cases of cancer, mesothelioma, do not continue to be germinated by

our deliberate negligence and malfeasance.

Thank you, Mr. Chairman.

[The prepared statement of Hon. Jerrold Nadler follows:]

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Mr. TOWNS. Thank you. Thank you very much.

Now I yield 5 minutes to Congressman Weiner, who represents

Queens and Brooklyn. I yield 5 minutes.

Mr. WEINER. Thank you, Mr. Chairman.

I won’t take my full 5 minutes, and I want to express my gratitude to you and Mr. Platts for obliging those of us from the New

York delegation who have so much to say about this. I think you

are building a record that someday will be reviewed and will strike

many as, frankly, intuitive that on an attack of this magnitude, the

Federal Government bears the responsibility for taking care of

those who instinctively, as Representative Murphy said, responded

as good citizens would.

I think there are two things that are going to emerge. But first

I want to say thank you to Carolyn Maloney and to Jerry Nadler,

who have, just like you, Mr. Chairman, been beating the drum on

this issue.

It has been, frankly, after months and months of many of us not

being quite sure what to think of the responsibility and where it

lies. The record that been established by Mr. Nadler and Ms.

Maloney makes it crystal clear.

The EPA bears the responsibility for saying to us clearly and

loudly shortly after September 11th that it was safe to return to

your homes, it was safe to return to ground zero. It is my view that

this is fundamentally and wholly a Federal responsibility that has

to be absorbed by the EPA, the Department of Health and Human

Services, and those of us in Congress.

But lest this be viewed as a simply lower Manhattan or a downtown Brooklyn problem, all of us have stories about where we were

on September 11th. I, like so many New Yorkers, was here in New

York because it was primary day. After traveling around to Polls

and trying to find as many citizens as I could, I returned to my office.

And, as you know, Mr. Towns, my office at the time was in the

Lundy’s Building in Sheepshead Bay, 1901 Emmons Avenue, about

as far south as you can go and almost as far as you can go in

Brooklyn away from ground zero. I had at the time a doorway to

my office that led to a little balcony right by the Bell Parkway

down by Sheepshead Bay in Manhattan Beach.

There were scraps of paper, not sediment, not invisible soot, but

scraps of paper from the explosion, from the collapse of the buildings, and from that terrible day that were settling on my terrace

in Sheepshead Bay.

If you think that this was a problem that only affected those

were within a stone’s throw of ground zero, you clearly don’t understand what many New Yorkers and many residents of Brooklyn

and Queens and all five boroughs in Jersey know because they

were there that day. If there were carcinogens, if there were elements of asbestos, if there were disease-carrying elements in the

air, they were all over our area. And I think this is another step

in accepting responsibility for that.

And it could well mean that we are vigilance in this for a generation. And it could well mean that this is going to be a problem we

are going to have to wrestle with a long-term comprehensive health

care plan. But one thing I think we all agree upon is that this is

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a responsibility that those of us in the Federal Government have

to accept.

I yield back the balance of my time.

Mr. TOWNS. Thank you very much, Congressman Weiner.

At this time we would like to call to the witness desk Yvonne

Graham, the Deputy Borough President of Brooklyn.

Ms. GRAHAM. Thank you very much.

Mr. TOWNS. You know, just before you start, first of all, let me

just tell you a little bit about her. A native of Jamaica, West Indies,

Deputy Borough President Yvonne Graham has been a pioneer in

the arena of public health for more than two decades. As Brooklyn’s deputy borough president, Ms. Graham oversees health care

policy and all human services for the borough president.

Ms. Graham has many publications. She has received numerous

national and local awards. I am delighted that she is with us today.

But before we start, it is the policy of this committee that we

swear witnesses in. So will you please stand and raise your right

hands?

[Witness sworn.]

Mr. TOWNS. Let the record reflect that she has responded in the

affirmative.

You may be seated, and you may begin.

STATEMENT OF YVONNE GRAHAM, DEPUTY BROOKLYN

BOROUGH PRESIDENT

Ms. GRAHAM. Good morning, Chairman Towns and distinguished

members of the Subcommittee on Government Management, Organization, and Procurement. I want to thank you for spearheading

this important dialog on the health and environmental impacts of

9/11, particularly as it relates to Brooklyn residents and businesses. My name is Yvonne Graham, deputy borough president,

here to read the following testimony.

Both our president, Marty Markowitz, and I are extremely grateful to our colleagues from the New York delegation, Congressmen

Towns, Nadler, Engel, and Weiner, for introducing the 9/11 Heroes

Health Improvement Act of 2007.

It is critically important that Brooklyn is included in research,

surveys, testing, and health services and that we receive our fair

share of funding so that health care resources can reach the victims of 9/11.

We know that on September 11, 2001, the plumes of smoke that

resulted from the devastating attacks on the World Trade Center

drifted across the East River to downtown Brooklyn, Brooklyn

Heights, Carroll Gardens, Cobble Hill, and Red Oak. These Brooklyn communities were impacted by the smoke as well as the film

of dust that later settled on our parks, streets, homes, and businesses across the borough.

I was living in Fort Green at the time and experienced this directly since for days after the attack, my window sills were coated

with dust.

We also know that debris from the site continued to burn and release contaminants into the air for an additional 3 months. The

U.S. Environmental Protection Agency’s Web site now indicates

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that contaminants such as concrete, glass, fiberglass, asbestos, and

other toxic chemicals were present.

Despite the fact that Brooklyn was in the direct line of the

plume, our borough has been nearly excluded from testing and

completely excluded from cleanup services.

The test results for asbestos and white samples provided on the

EPA Web site only reflect lower Manhattan. Although it may be too

late to determine the level of contaminants that blanketed Brooklyn communities, it is not too late to address the short and longterm health effects that may have resulted.

Of the 38,937 New Yorkers who enrolled in the World Trade

Center health registry, which was created to track the health of

residents and those directly exposed to the World Trade Center collapse, 8,202 cite Brooklyn as their home, more than 20 percent.

But respondents to this survey had to be living south of Canal

Street in Manhattan or have been directly involved with the World

Trade Center site or surrounding area to take the survey. That

means that those who live in the Brooklyn neighborhoods that experienced the direct path of the smoke plume but were not in the

downtown area during the attack could not take part in this important health analysis.

Nearly half of the register’s individuals who were measured in

the survey have reported new or worsened sinus, breathing, or respiratory problems. So it is safe to assume that exposure to the initial plume of smoke and the debris smoke that continued until December would also have negative health impacts.

Although Brooklyn was in the direct path of the smoke plume, we received a far smaller share of the $140 million that the U.S.

Department of Health and Human Services awarded to health care

organizations following the attacks. Brooklyn received just over $51⁄2 million compared to Manhat- tan’s $106 million. The Bronx received $91⁄2 million of funding,

nearly double the allocation that Brooklyn received.

As elected officials, our No. 1 priority is ensuring the health and

well-being of our residents. Elected officials, government agencies,

health care providers, and community-based organizations must

work together to protect our residents’ health and come up with

comprehensive health solutions to existing challenges.

Despite the errors or failures of the past, our call to action

should be making sure that Brooklynites who continue to suffer

from health complications as a result of the attacks get the health

care and services they need and deserve.

In addition, securing long-term funding for research and treatment so that all victims can be accommodated and compensated is

our mandate. Our colleagues in the House and Senate are to be

congratulated for your tireless efforts.

The phrase ‘‘Never forget’’ was ubiquitous after 9/11, referring to

those we lost. We honor their memory, of course, but we must also

never forget those who selflessly responded to the tragedy and survived. It may only be through the continuing momentum and action from our legislators that we will fulfill our government’s duty

to first responders and others who have already sacrificed so much.

We are grateful to Congressman Towns and the members of the

Subcommittee on Government Management, Organization, and

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Procurement for shining a light on this issue and for asking how

we can work together to respond to the health and environmental

impacts of the 9/11 disaster. Thank you all for refusing to forget.

[The prepared statement of Ms. Graham follows:]

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Mr. TOWNS. Thank you very much, Deputy Borough President

Graham, for your testimony. We thank you for it.

Let me begin with some questions. You know, I represent Brooklyn. I’m not like Nadler and Weiner and Carolyn Maloney. They

represent other boroughs. But I only represent Brooklyn.

So my concern, of course, in this instance, the primary concern

would be Brooklyn. I’m concerned about people everywhere in all

places, but I must admit that my district is the one that I am fighting for.

What can we do to create a comprehensive plan? Because I would

not want to have Queens and Staten Island and, of course, Manhattan and the Bronx fighting us as we move forward, but we need

to have a plan, I think, that will help everybody. And also we have

some folks who came in as volunteers and, of course, to help us.

And now they have problems.

So I think it requires a Federal fix, but I don’t want to start a

fight. So what can we do?

Ms. GRAHAM. First of all, Mr. Chairman, I know that the Office

of Emergency Management has been doing a fantastic job in terms

of raising awareness about how to be prepared in the event of future disasters.

I also know that the New York disaster interfaith services have

been working with our faith-based institutions to come up with a

plan of helping people to understand where to go and what to do

in the event of disasters.

But I think a comprehensive plan that includes all of our government agencies, all of our schools and colleges and community-based

organizations as well as our health services organizations is critical

to coming up with a comprehensive plan, particularly, as you know,

that Brooklyn has a large percentage of immigrants. And sometimes it’s very difficult to reach into immigrant communities.

So community-based organizations have a particularly important

role to play in this comprehensive plan, but it is only through

working together that we can truly come up with a comprehensive

plan to address the problems that we have now and to prepare for

the event of any future disasters.

Mr. TOWNS. Do you have any special suggestions or comments

above and beyond that you would like to make to this subcommittee in terms of what we might be able to do that would further put

some light on it? And the other part of the question would be, have

you had anyone to come in to talk to you or to say to you that ‘‘I

have a problem because of 9/11?’’

Ms. GRAHAM. We have not had anyone in particular who have

come in, but I think also that many people may not attribute new

or worsening symptoms to 9/11. I believe that one particular recommendation is to ensure that all of our physicians in our health

care institutions receive special training to ask people when they

conduct an assessment about symptoms that may have some kind

of correlation to this disaster so that they can get further testing

and treatment.

Mr. TOWNS. Thank you very much.

And that is the reason why I am so happy to see a physician in

the room, Dr. Frank Focus, in the room, who is a physician, of

course, and has done a lot of work in this area. And the person that

26

had a lot to do with this hearing being here today is Rabbi

Niederman, who down through the years has complained about the

fact that we are not paying enough attention to the Williamsburg

section and areas that we know that really were hit.

So I want to thank them both for their support and coming out

and being with us today. I also want to thank you for all the work

that you have done in health care because when it comes to health

care, there is no doubt about it. You always are in the forefront.

And we really, really appreciate your involvement on behalf of the

folks of Brooklyn. Thank you so much.

Now, I would like to yield to the ranking member, Representative Platts.

Mr. PLATTS. Thank you, Mr. Chairman. And, Madam Vice President, thanks for your testimony and your service here in Brooklyn.

One of the issues you mentioned is the dollar amount that has

been distributed thus far and how it was distributed in an inequitable fashion as far as the different boroughs. As we move forward

and the clear need for additional assistance, including from the

Federal Government, one of the issues is going to be not just how

much but how to distribute it and to avoid perhaps the inequities

ideally that we saw in the past.

I think as a followup to the chairman’s question, is there a position on yourself or on behalf of the borough that you suggest as a

more appropriate manner for distributing whatever dollar amount

is going to be available to the various boroughs for the recovery effort formula or perhaps the commission established Federal, State,

and local officials to try to get to what I think you are after, which

is everybody being treated fairly and, as the chairman said, not pitting one borough and its residents against another but that everybody is fairly treated.

Ms. GRAHAM. Absolutely. I think that, first, funding should be

commensurate with need. We also mentioned that over 20 percent

of those who participated in the survey cited that they lived in

Brooklyn. That’s No. 1.

And, No. 2, when we look at the proximity, you know, downtown

Brooklyn is only about a mile away from the World Trade Center.

And the Bronx is almost 12 miles away. And, yet, Bronx received

a far greater amount. And I’m not sure how they came up with this

formula, but clearly Brooklyn was under-represented in funding.

Mr. PLATTS. Was there any direct contact from the borough officials to HHS or EPA, any of the Federal agencies, about that distribution?

Ms. GRAHAM. We did not make any direct contact about the distribution. What we did try to find out was when they came up with

the World Trade Center health registry to ensure that Brooklynites

who lived in downtown Brooklyn should participate in it.

But clearly when the instructions came out, you had to be in

Manhattan at the time. Even if you lived in Brooklyn, you had to

be in Manhattan at the time to participate. But we did try to reach

out to make sure that more Brooklynites were included.

Mr. PLATTS. And that is part of the misguided directions from

the Federal Government early on of that even if you resided here,

you should participate or should have been included in that participation.

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I again thank you for your leadership. I had the pleasure last

evening my first dinner at Junior’s and then to walk the neighborhood of Carroll Garden. I have cousins who live on Carroll Street

and got to visit with them. And just standing and looking from

their rooftop back of seeing——

Ms. GRAHAM. Sure.

Mr. PLATTS. How direct a flow that plume would have been on

9/11 and how evident the need to make sure that not just those

who live here and went to the site but who live here are assisted.

And we certainly will continue and are honored to work with your

New York delegation on this issue.

So thank you for your testimony.

Ms. GRAHAM. Thank you, too.

Mr. TOWNS. Thank you very much, Mr. Platts.

Now I would like to yield to Congresswoman Maloney.

Ms. MALONEY. Thank you. And thank you, Madam Deputy Borough President, for your testimony and for your concern.

Many of my questions were answered by the chairman and the

ranking member. Just very briefly, can you think of anything else

that we should be doing to help the people of Brooklyn that is not

being done today?

Ms. GRAHAM. As I mentioned before, Brooklyn has a large number of immigrants. And my sense is that a great majority of people

from Brooklyn who volunteered at the World Trade Center site

were immigrants. Some of them might have been undocumented.

We don’t know. But it is very difficult to tell of those people how

many of them do not have health care coverage and insurance and

may be experiencing symptoms that we are not sure whether they

are directly related to their participation.

And so, again, we need to ensure that our health care workers

or health care providers are in tune with those new and worsening

symptoms and really look to see whether they may be affected.

Ms. MALONEY. Thank you very much.

Mr. TOWNS. Now I yield to Congressman Murphy of Connecticut.

Mr. MURPHY. Thank you very much, Mr. Chairman. Welcome,

Ms. Graham.

One of the things that greatly concerns me is that when we have

been visited by national tragedies, whether they be September 11th

or the disaster on the Gulf Coast, the administration will sort of

swoop in on the days following and make very broad promises that

this is a Federal issue the Federal Government is going to come in

and take care of, and make all sorts of promises and commitments

to make a community whole.

And then in the months and years following, the rhetoric coming

from some of the administration officials starts to get seeped with

cost sharing, that this has to be now a Federal and State or Federal and municipality dual commitment. And we certainly heard

that in our hearing in Washington, DC.

And my question to you is this and to the extent that you have

the information or can get it following this hearing. Do we have an

idea up until now of what kind of resources toward this problem

have had to have been committed by the borough or, in addition

to or in the alternative, if we don’t have the proper Federal funding

going forward what kind of commitment from the borough we

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should expect going forward in the absence of a Federal commitment to identify the problem, identify the victims of that pollution,

and then treat them?

Do we have any handle on how much we have spent here at the

borough level and how much we may have to spend going forward

if we don’t do the right thing at the Federal level?

Ms. GRAHAM. We looked at the $140 million that was provided

by Health and Human Services. And that was when we recognized

that Brooklyn was seriously under-represented in terms of the

funding that is available.

Right now we want to thank the committee for keeping the spotlight on this issue and so from this moment on, we will make sure

that we keep a handle on it so that Brooklyn gets its fair share of

funding.

Mr. MURPHY. And part of the frustration is that no one knows

the extent of this problem.

Ms. GRAHAM. Sure.

Mr. MURPHY. And so the exposure for a municipal health system

or a regional health system is potentially unquantifiable, which is

one of the problems with having the responsibility for it lie at a

local level.

Thank you very much, Mr. Chairman.

Mr. TOWNS. Let me further add on that point that our hospitals

have indicated that there has been an increase in terms of people

coming in and, of course, complaining about respiratory problems

and that the doctors and nurses in these various medical facilities

are saying that it has to be associated with 9/11, which means that

is additional cost as well because these are people that would not

be in the system if it had not been for 9/11.

And so the outcry now is that we need to have a Federal fix and

we need to have a Federal fix for a lot of reasons because that even

volunteers, we don’t want to discourage them. We want them to

continue to volunteer. If we walk away from them and ignore them,

ignore their complaints, and not do anything about it, and hope

that there was never another crisis, but if there is one, then people

will not respond. So that is the reason why I think that we need

to come up with a Federal fix.

On that note, I yield to Congressman Nadler. Congressman Nadler.

Mr. NADLER. Thank you. And thank you for your testimony,

Madam Deputy Borough President.

As I mentioned in my testimony, I have always maintained that

there were two coverups at work here, one of which was the coverup of the impact, of the health impact, of 9/11 on the first responders, one people who were caught in the plume, and then people who

worked at the site. And that coverup has been unraveled, largely

by the work done at Mount Sinai and some other places and by the

Daily News. It took 5 years, but people finally acknowledged the

problem there.

The second coverup, which is still under cover, is the impact of

the fact that we have never properly cleaned up indoor spaces and

that people are probably still being poisoned and cancers incubated

today, which we will find about 15 years from now.

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Now, the EPA announced a cleanup, what was characterized by

myself and then by the Inspector General as a phony cleanup back

in 2002 in lower Manhattan only and again recently again only for

lower Manhattan.

Has there been any discussion, to your knowledge, with EPA

about inspection of indoor spaces in Brooklyn or cleanup, decontamination of indoor spaces, residents, schools, workplaces in

Brooklyn?

Ms. GRAHAM. Not to my knowledge, but I believe that there is

a need for additional funding for continued research and surveys

and testing so that we can come up with that information because

right now we can only assume.

Mr. NADLER. Now, we know, do we not, that much of Brooklyn

was in the path of the plume? And, as Congressman Weiner said,

things fell all over at Lundy’s and Borough Park and in Park Slope

and Williamsburg, all over the place. And we know that nature

cleans up the outdoor air but that it doesn’t clean up the indoor

air.

So it’s safe to assume that there is a lot of indoor pollution still

existing in Brooklyn?

Ms. GRAHAM. Absolutely. And we know that there are contaminants. Mercury, for example, could be in the cracks, in the floors,

could be in the carpet, could be in the curtains for many, many

years.

Mr. NADLER. And the EPA has never spoken to you or to, to your

knowledge, to anybody in the city government about doing inspections to find out the extent of contamination in Brooklyn?

Ms. GRAHAM. Not to my knowledge. And you are also aware that

Brooklyn is not a city by itself, as it once was. And so whatever

discussions take place——

Mr. NADLER. City Hall also seems oblivious to the contamination

of Brooklyn, does it not?

Ms. GRAHAM. Well——

Mr. NADLER. Well, let me put it this way. Has City Hall, to your

knowledge, ever asked EPA to undertake any kind of examination

in Brooklyn?

Ms. GRAHAM. Not to my knowledge.

Mr. NADLER. Has City Hall ever offered the city of New York to

do such an examination in Brooklyn?

Ms. GRAHAM. Not to my knowledge.

Mr. NADLER. Has City Hall ever asked anyone else to do such an

examination in Brooklyn?

Ms. GRAHAM. Not to my knowledge.

Mr. NADLER. Let me ask you one further thing. The Inspector

General back in August 2003 in his report said that the only proper way to find out the extent of the indoor contamination was to

select several hundred randomly selected indoor spaces, apartments, workplaces, schools, whatever, in concentric circles going

out from the World Trade Center, concentric circles without regard

to borough boundaries or rivers or anything else, and test several

hundred such sites and that you might find out that in one direction, the problem extended for three blocks and in another direction for 3 miles.

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Has anyone, to your knowledge, ever suggested, other than the

EPA Inspector General and other than me and some other individuals, has anybody in the executive branch of government ever suggested, doing such random testing and mapping of the contamination?

Ms. GRAHAM. Not to my knowledge.

Mr. NADLER. Do you think it necessary?

Ms. GRAHAM. Absolutely.

Mr. NADLER. Thank you.

[Applause.]

Mr. TOWNS. Thank you. Thank you very much. Thank you very

much for your testimony. We look forward to working with you in

the days and months ahead to make certain that Brooklyn gets its

fair share. Thank you very much, Deputy Borough President.

And now we will call our next panel. Mr. Cheong Chan, former

Assistant Inspector General for Program Evaluation, please come

forward, Environmental Protection Agency. Mr. David Newman, industrial hygienist, New York Committee for Occupational Safety

and Health, please come forward. Mr. Patrick Roohan, please come

forward, director of Bureau of Program Quality, Information and

Evaluation, New York State Department of Health. Anthony

Szema, assistant professor of medicine, Stony Brook College of

Medicine; Suzanne Mattei, executive director of Sierra Club of New

York City, please come forward. And Peter Gudaitis, executive director of New York Disaster Interfaith Services, please come forward.

It is a longstanding tradition of this committee that we swear

our witnesses in. So would you please stand and raise your right

hands?

[Witnesses sworn.]

Mr. TOWNS. Thank you. You may be seated. Let the record reflect

they all indicated in the affirmative.

Let me begin with you, Ms. Mattei, and come right down the

line.

Ms. MATTEI. All right. We have a PowerPoint.

Mr. TOWNS. A PowerPoint? OK.

Ms. MATTEI. Good day. My name is——

Mr. TOWNS. Why don’t we start with Mr. Chan, then, and come

down to you? You don’t have a PowerPoint, right?

Mr. CHAN. No, I don’t.

Mr. TOWNS. We’ll start with you, then. Save the PowerPoint.

Mr. CHAN. OK.

31

STATEMENTS OF KWAI-CHEONG CHAN, FORMER ASSISTANT

INSPECTOR GENERAL FOR PROGRAM EVALUATION, ENVIRONMENTAL PROTECTION AGENCY; DAVID M. NEWMAN, INDUSTRIAL HYGIENIST, NEW YORK COMMITTEE FOR OCCUPATIONAL SAFETY AND HEALTH; PATRICK ROOHAN, DIRECTOR, BUREAU OF PROGRAM QUALITY, INFORMATION AND

EVALUATION, NEW YORK STATE DEPARTMENT OF HEALTH;

DR. ANTHONY SZEMA, ASSISTANT PROFESSOR OF MEDICINE, SUNY-STONY BROOK SCHOOL OF MEDICINE; SUZANNE

Y. MATTEI, EXECUTIVE DIRECTOR, SIERRA CLUB OF NEW

YORK CITY; AND PETER GUDAITIS, EXECUTIVE DIRECTOR,

NEW YORK DISASTER INTERFAITH SERVICES

STATEMENT OF KWAI-CHEONG CHAN

Mr. CHAN. Good morning, Chairman Towns, Congressmen Platts,

Nadler, Murphy, Weiner, and Congresswoman Maloney. My name

is Kwai Chan. I am the former Assistant Inspector General for Program Evaluation.

I appreciate the opportunity to appear before you today to discuss the work that we did in the Office of Inspector General on the

most important subject.

While many of the data and findings are taken from the two reports that were done under my direction in EPA, the opinions, findings, and conclusions expressed in my testimony are solely that of

my own and do not represent those of the OIG and the EPA or any

other government agencies. Allow me just to summarize a few

points I would like to make.

EPA’s early statement following the collapse of the World Trade

Center tower reassured the public regarding the safety of the air

outside the ground zero area. However, when EPA administrator

announced on September 18, 2001 that the air was ‘‘safe’’ to

breathe, it did not have sufficient data and analysis to make such

a blanket statement.

While the statement did not have any qualifications in it, in fact,

when you look behind it, what they really meant was that the

statement only applies to asbestos and not other pollutants; longterm health effects and not short-term; the general public and not

the ground zero workers; outdoor air and not indoor air; and, finally, health adults and not sensitive subpopulations, such as children and the elderly.

Furthermore, the White House Council on Environmental Quality influenced the information that EPA communicate to the public

through its early press releases when it convinced EPA to add reassurance statements and delete cautionary ones.

Regarding indoor air cleanup, evidence indicates that government communication was not very effective in persuading the public to take the recommended cleanup practices. So, as a result, we

recommend that the cleanup should be considered, both indoor and

outdoor together, and also building as a single system. That means

you clean up from the outside and go all the way in as well as look

at the HVAC.

We also recommend that the EPA should sample beyond lower

Manhattan, moving in concentric circles from ground zero and out,

and see the degree of deposits.

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Given these communication and exposure concerns, my office decided to conduct our own survey of New York City residents. The

survey also was designed to determine if contamination from the

dust and smoke spread into the homes of residents located beyond

lower Manhattan, the zone designated as eligible for the EPA lead

testing and cleanup programs.

Although the survey response has a much lower response rate

than what we expected, nevertheless, it is instructive to present

some of the data. Let me summarize.

Overall, the majority of respondents want more information regarding outdoor and indoor air quality, wanted this information in

a more timely manner, and did not believe the information they received from the government. For every respondent who was satisfied, there were three to six respondents who were dissatisfied with

the government information.

Further, data indicated that contamination from the collapse of

the World Trade Center towers spread into the homes of respondents located beyond lower Manhattan.

About 9 out of every 10 respondents were concerned about the

short-term health effects associated with outdoor air. And 7 out of

every 10 were concerned about long-term health effects. For indoor

air, more than 7 out of 10 were concerned about short-term health

effects and more than 5 out of 10 the long-term effects.

In lower Manhattan, half of the respondents reported that their

residents had been contaminated with dust and/or debris due to

the collapse. In Brooklyn, about a quarter responded and reported

their residence had been contaminated. And for the residents of

Manhattan, over 10 percent reported contamination.

Only about 1 out of 10 respondents knew about EPA’s response

to September 11th Web site. And about half of those who knew the

Web site visited it. And the reason we did that is because the administrator asked us specifically to ask these questions to see how

effective they were in reaching out to the public through the Web

site.

The majority, 6 out of 10, respondents, however, were aware of

key World Trade Center-related information, such as EPA’s recommendation to have contaminated homes professionally cleaned

and EPA lead testing cleanup program in the eligible area of Manhattan. Despite this awareness, relatively few respondents with

home contamination had their homes tested for asbestos or had

their homes professionally cleaned.

In closing, overriding lessons learned was that EPA needs to be

prepared to assert its opinion and judgment with data and with

some science on matters that impact on human health and the environment.

Although many organizations were involved in addressing air

quality from the World Trade Center collapse, subsequent events

have demonstrated that ultimately the public, the Congress, and

others expect EPA to monitor and resolve environmental issues.

This is the case, even when EPA may not have the overall responsibility to resolve these issues or the necessary resources to address

them.

This ends my statement. Thank you.

[The prepared statement of Mr. Chan follows:]

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Mr. TOWNS. Thank you very much for your testimony.

Mr. Gudaitis.

Mr. GUDAITIS. Thank you, Mr. Chairman.

STATEMENT OF PETER GUDAITIS

Mr. GUDAITIS. Thank you for your invitation, Mr. Chairman, and

to your colleagues, particularly to Representative Maloney, who has

been such a tireless advocate for our work and that of my staff.

My name is Peter Gudaitis. I am the executive director of New

York Disaster Interfaith Services [NYDIS]. NYDIS is a 501(c)(3)

federation of approximately 30 faith-based human service providers

and philanthropies who work in partnership to provide secular disaster readiness response and recovery services in New York City.

As it pertains to 9/11, NYDIS has six full-time recovery workers

who manage a variety of advocacy and recovery programs for

human service caregivers, religious leaders, direct victims, and

residents, including specifically the New York City 9/11 Unmet

Needs Roundtable. Since 2002, the roundtable has distributed approximately $6 million to over 2,500 direct victims and injured recovery workers.

Our target clients are under-served and under-resourced direct

victims and health-impacted recovery workers and residents. Assistance is provided by application of a qualified caseworker on behalf of their client and must fund an emergency need or secure a

client’s sustainable recovery.

The roundtable has been a collaboration of over 80 human service providers and 18 donors over the past 6 years since it was established by the faith community in 2002. The roundtable has provided case management resources, peer review, and referral services to caseworkers.

As of 2006, with the support of the American Red Cross Liberty

Fund and Episcopal Relief and Development, NYDIS has also been

the sole provider of case management coordination, caseworker

training, and the primary funder of case managers for the New

York City recovery community.

Currently the only remaining donors are the Lutheran Disaster

Response of New York, NYDIS, and Safe Horizon. Sadly, all current roundtable funding of about $2.3 million a year, terminates in

December 2007.

9/11 resulted in a prolonged airborne dissemination of a smoke

plume throughout lower Manhattan that moved over Brooklyn.

And I can attest to this as a lower Manhattan resident. At the time

of 9/11, I lived across the street from St. Paul’s Chapel and lost my

living room windows and lived in New Jersey for 3 months, an exciting adventure.

As hundreds of thousands of Brooklynites and lower Manhattan

residents witnessed on 9/11, they also reported physical, psychological, and economic impact immediately following the attack but

were told their injuries or losses were not a direct result of the disaster as designated by the government or aid agencies that concentrated their resources in lower Manhattan.

It has been our experience that many Brooklyn residents expressed anxiety about the effects of the dust plume, which I expect

my colleagues will discuss in their testimonies. Those effects have

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since surfaced as serious health threats to the residents and recovery workers, many of whom continue to struggle as they attempt

to recover from the emotional, medical, and economic impacts.

In order to discuss the impact of 9/11 on people, we need to answer three questions: where have we been, where are we now, and

where we will go from here.

In the early days of 9/11, during that 10-month period following

the cleanup, the attention of larger relief agencies was focused on

lower Manhattan workers and residents below Canal Street.

From 2002 to 2004, 1,612 people were assisted by the roundtable.

Approximately 30 percent were from Brooklyn. Of those, the vast

majority of individuals receiving financial assistance were dislocated workers in industries affected by 9/11.

Since individuals affected outside of lower Manhattan and south

of Canal Street as a whole were not eligible for FEMA’s 18 months’

mortgage and rental assistance nor Red Cross September 11 Fund

moneys, the roundtable’s assistance to clients focused about 56 percent on rent, about 12 percent on utilities, and then other basic

human needs.

The ethnic demographics of the roundtable clients during those

years were 42 percent Hispanic; 21 African American; 21 Caucasian; 6 percent Arab, Persian; and 4 percent Asian.

Coinciding with the close of the United Services Group in 2004

and over the past 2 years, we have seen a 200 percent increase in

cases. For the residents that were impacted psychologically and especially those who have not been eligible for large amounts of aid

due to geographic eligibility restrictions, recovery has been more

complicated. And there continue to be needs that surface even

today.

Currently NYDIS receives an average of 15 calls a month from

new impacted residents or clients who are seeking case management assistance. In 2006, NYDIS saw an 80 percent increase in clients over 2005 in terms of the number of impacted individuals

seeking assistance.

Currently 20 percent of that 2,900 are residents of Brooklyn. Of

these, about 88 percent were either recovery workers or lower Manhattan workers. The other 11 percent or so are impacted residents.

Ethnically these residents are 32 percent Caucasian; 24 percent

Hispanic; 16 percent African American; 15 percent Arab, Persian;

6 percent Polish; and 4 percent Asian.

We are now facing a crisis in human services as hundreds of new

cases of 9/11-impacted people come forward. Clients are now forced

to wait as long as 2 or 3 months to seek case management assistance or medical screening.

Currently an average of 60 percent of the 332 ill recovery workers seen monthly at Mount Sinai seek case management services.

About 17 percent of those are Brooklyn residents.

Where do we go from here? Increasing numbers of health-impacted people are coming forward for critically needed services. In

some cases, services will save clients from hopelessness or dying

with dignity. Medical treatment for ill people, psychologically or

physically, is critical. But these services do not address the difficulties of 9/11 health impacted clients without case management services.

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At a minimum, 9/11 clients that we are assisting today deserve

the same level of services that was given to victims in the first few

years after 9/11. They deserve continuity of services, coordinated

assistant, and treatment, unmet needs assistance, and timely access to care. And they deserve case managers with manageable

case loads.

Currently caseworkers have an average of 220 cases per caseworker. During 9/11’s height under the USG, there were 60 clients

per caseworker.

Last, if we leave these health-impacted people without support,

it could impair our ability to mobilize people to keep our residents

safe following the next disasters. Our workers and volunteers deserve better from us from the help they gave in rebuilding our community.

The sad fact of the matter is Federal assistance was used to hire

the undocumented and Federal assistance was not given to mandate protection. And we owe these people a debt of gratitude and

the ability to support them as they continue to struggle to recover

or die with dignity.

[The prepared statement of Mr. Gudaitis follows:]

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Mr. TOWNS. Thank you very much for your testimony.

Mr. Newman.

Mr. NEWMAN. Thank you.

STATEMENT OF DAVID NEWMAN

Mr. NEWMAN. Good morning, Chairman Towns, members of the

subcommittee, and Representatives Maloney and Nadler. My name

is David Newman. I am a Brooklyn resident. I am an industrial hygienist with the New York Committee for Occupational Safety and

Health [NYCOSH].

I had the privilege of serving as a member of the EPA, as a nongovernmental member of the EPA, World Trade Center expert technical review panel and as a member of the exposure assessment

working group of the World Trade Center worker and volunteer

medical screening program. I currently serve on other 9/11-related

advisory boards at the World Trade Center register and at the

Bellevue Hospital World Trade Center Environmental Health Center.

The 9/11 attacks produced two primary sources of environmental

contamination, lower right. The 9/11 attacks produced two primary

sources of environmental contamination: particulate matter from

the dust cloud generated by the collapse of the World Trade Center; and, second, the plume of combustion byproducts from the fires

that burned from three to 5 months. Here you see the dust cloud.

In addition, there were and still are several secondary sources of

contamination. That is, 9/11 exposure may be ongoing. These secondary exposure sources include, next one, particulates resuspended in contaminated indoor spaces and particulates from ongoing demolitions of 9/11 contaminated high risk buildings in lower

Manhattan.

World Trade Center dust was dispersed throughout much of

lower Manhattan and adjacent parts of Brooklyn. It may also have

been disbursed over a larger geographic area.

Many of the hundreds of contaminants identified in outdoor and

indoor air dust and bulk samples are known to be toxic or carcinogenic. These include asbestos, polychlorinated biphenyls, polycyclic

aromatic hydrocarbons, manmade vitreous fibers, dioxins, violative

organic compounds, crystalline silica, pulverized glass shards, highly alkaline concrete dust, and lead, mercury, and other heavy metals.

Here you see EPA, Office of Research and Development plume

modeling clearing showing and acknowledging the bloom at varying

concentrations over Brooklyn.

Despite exhaustive efforts outdoor sampling by Government

agencies was neither coordinated nor comprehensive, nor targeted.

In addition, sampling at and around ground zero began late and

was conducted only on a limited basis. Therefore, our knowledge of

the nature and scope of 9/11 contamination remains limited.

There has been no comprehensive, systematic investigation of indoor spaces even though particulates that infiltrate indoor spaces

persist over time unless they received targeted environmental

cleanup. Government activities to assess or cleanup indoor contamination have been scientifically flawed.

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Government efforts were also inappropriately limited in scope.

Geographic areas known to have been impacted such as Chinatown

and parts of Brooklyn were excluded from testing and cleanup, as

were all industrial and commercial spaces and schools, and Government buildings. Here we see photographs from EPA reports documenting from space visible dust on the shore of Brooklyn. The

black and the yellow dots in the lower right hand corner. And, of

course, we’re concerned not solely about visible dust but about invisible dust. The visible dust will tend to fall out of the air at shorter distances than the more microscopic and less visible particulates

which could travel longer distances, potentially.

As a result, the environmental data for lower Manhattan are of

limited scientific utility and the data for Brooklyn are nonexistent.

Thus, it is not possible even at this late date to characterize the

level, composition or geographic scope of initial or residual 9/11 derived contamination. Nor is it possible to characterize prior exposure or risk or current exposure or risk. Nevertheless, there are

credible data that indicate the possibility that 9/11 derived toxic

substances were widely distributed: In some cases at levels of concern.

The satellite photos that you’ve seen clearly shown the combustion plume over much of Brooklyn on 9/11 and on other dates. My

Flatbush neighborhood, as other people have commented, were

blanketed with charred documents from the World Trade Center.

Nevertheless, there are no data by which to assess the presence or

absence of contaminants.

A large and increasing number of people who were exposed to 9/

11 contaminates, primarily rescue and recovery workers but also

area workers and residents, are now suffering serious and persistent adverse health outcomes which are extensively documented in

the scientific literature. Although those working on the pile generally experienced the most severe exposures and the most severe

health impacts, comparable respiratory impacts among community

residents, students and workers are also well documented in the

scientific literature.

Because 9/11 contaminates include numerous carcinogens there

is concern about late emerging cancers. Whether or when these diseases will manifest is unknown, but it is prudent and scientifically

appropriate to anticipate the possibility.

Moreover, neither environmental nor occupational health regulations were enforced at or around ground zero. This failure to implement legally regulated protective measures, legally required protective measures is likely to have contributed to the high incidents of

9/11 related illness. The current EPA sampling plan, which was implemented despite its rejection by the EPA WTC Expert Technical

Review Panel, repeats many of the flaws of the earlier efforts, including the exclusion of Brooklyn.

The current testing program should be replaced with a comprehensive scientifically sound effort to identify and quantify residual contaminates, if any, in indoor spaces and to provide effective

environmental cleanup if and where warranted. Businesses, schools

and Government spaces as well as residences must be included.

Testing should concentrate on indoor spaces closest to ground

zero and proceed outward, as Congressman Nadler pointed out,

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outward in concentric circles until measurements indicate that contaminates do not exceed background levels or health-based benchmarks. The goal should be to identify and remove residual resources, if any, of ongoing or potential exposure.

Here we see an EPA from an earlier plan that the EPA presented to the panel. They proposed sampling of Brooklyn. As recommended by the panel, this proposal to sample in Brooklyn was

withdrawn by EPA.

A comprehensive approach is also needed to identify, treat and

tract 9/11 related illness of rescue and recovery workers and also

of area workers, residents and students.

It is essential that the Federal Government support and adequately fund over the long term the three medical centers of excellence: The World Trade Center Medical Monitoring Program and

its affiliated clinics; the Fire Department of New York Medical Program, and; the World Trade Center Environmental Health Clinic

of Bellevue Hospital. Reportedly, the Federal Government may

withdraw its support of these medical centers and instead require

9/11 health victims to pursue treatment on their own in the health

care market. This would have dire consequences for the thousands

of people who have or who may develop 9/11 related illnesses, and

it would be a grave error in public health policy.

These hospitals and clinic-based centers provide a high level of

expertise in diagnosing environmentally induced symptoms and illnesses and in rendering effective treatment—and I’m finishing up

here—through access to broad institutional resources. These could

not be duplicated if 9/11 health victims were forced to rely on a

market-based health care model. The centers of excellence are also

capable, as individual health care providers are not, of targeted

outreach, public health education, long term medical monitoring,

identification of disease trends and collection and sharing of data

to inform clinical practice and public health policy.

Thank you very much for this opportunity to present my views.

[The prepared statement of Mr. Newman follows:]

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Mr. TOWNS. Thank you very much for your testimony, Mr. Newman.

Mr. Roohan.

STATEMENT OF PATRICK ROOHAN

Mr. ROOHAN. Thank you. Thank you, Chairman Towns and members of the subcommittee to allow me to present the findings from

our study entitled, ‘‘Asman Medicaid Managed Care: Enrollees Residing in New York City Results from a Post-World Trade Center

Disaster Survey.’’

My name is Patrick Roohan. I’m the director of the Bureau of

Program Quality, Information and Evaluation in the New York

State Department of Health.

Our Bureau’s role is to monitor the quality of care and also to

evaluate programs in Medicaid managed care as well as the Medicaid program overall.

My testimony is a summary of our study, which has been published in the Journal of Urban Health on 2005.

The collapse of the World Trade Center on September 11, 2001

created a plume of smoke and dust that covered much of lower

Manhattan before moving east to Brooklyn. The New York State

Department of Health is charged with administering the State’s

Medicaid program and has oversight responsibility for the 18

health plans that provide services to over 1 million recipients enrolled in Medicaid Managed Care in New York to assess the Asman

status of Medicaid Managed Care enrollees who may have been exposed the New York State Department of Health Office of Managed

Care conducted a mail survey among enrolls residing in New York

City.

A total of 16,629 enrollees aged 5 to 56 with persistent asthma

prior to September 11, 2001 were surveyed during the summer of

2002. 3,557 completed surveys were available for analysis. Administrative health service utilization data from the Medicaid Encounter Data System, MEDS, were also used to validate and supplement survey responses.

Multivariant logistic regression models were developed to examine factors associated with self reported worsened asthma post September 11, 2001, and with emergency department in-patient hospitalizations related to asthma from September 11, 2001 through

December 31, 2001.

Forty-five percent of survey respondents reported worsened asthma post 9/11. Approximately half of these, 46 percent, indicated

that their asthma was still bad at the time of the survey. Respondents most commonly cited: Dust 63 percent; emotional stress 42

percent, and; and cold weather 37 percent as the reason for the

worsened asthma.

MEDS data were used to validate self reported change in asthma

status. Respondents reported worsened asthma post 9/11 were significantly more likely p less than 0.05 to have at least one professional service visit, a specialty visit, an emergency department visit

and an in-patient hospitalization with a diagnoses of asthma. Also

they were significantly more likely P less than 0.05 to have filled

a prescription for asthma medication, had a service with a behavVerDate 11-MAY-2000 14:33 Apr 29, 2008 Jkt 000000 PO 00000 Frm 00065 Fmt 6633 Sfmt 6633 C:\DOCS\40872.TXT HGOVREF1 PsN: HGOVREF1
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ioral health diagnosis and filled a prescription for a psychoactive

medication.

Residents in both lower Manhattan with an adjusted odds ratio

of 2.28 and western Brooklyn with an adjusted odds ratio of 2.4

were associated with self reported worsened asthma compared to

the rest of New York City. Significant differences were also observed by days of weeks in lower Manhattan: One to three odds ration of 1.95, 4 more days 2.43. However, only residents of western

Brooklyn had elevated odds ratios for emergency department in-patient hospitalizations with a diagnosis of asthma post 9/11. And

that adjusted odds ratio is 1.52.

Worsened asthma was reported by significant proportion of this

low income largely minority population and was associated with location of residence.

Results from this study provide guidance to health care organizations and the development of plans to ensure that the health of

persons with asthma during disaster situations.

Thank you.

[The prepared statement of Mr. Roohan follows:]

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Mr. TOWNS. Thank you very much.

Dr. Szema.

STATEMENT OF ANTHONY SZEMA

Dr. SZEMA. Thank you, Chairman Towns.

I have a 1-minute video and 5 minutes of written testimony.

I thank Representatives Nadler and Platts.

This 1 minute video will show that it is plausible that exposure

to the inhalation energy from the World Trade Center could reasonably lead to a worsening asthma exacerbation.

[Video shown].

Dr. SZEMA. We’ve been following children with asthma in the

largest ethically homogeneous neighborhood proximal to the World

Trade Center since 1997. After September 11, 2001 serendipity presented us with a control population to study pre and post the

World Trade Center disaster.

We had two hypotheses. No. 1: Pediatric asthma patients exposed to the World Trade Center disaster may experience increased

asthma severity. No. 2: Some previously healthy children may be

newly diagnosed with asthma after September 11, 2001.

The study population comprised Chinese American pediatric

asthma patients who lived in New York City. They all received

medical care at the Charles B. Wang Community Health Center,

1.5 miles from the WTC. The closest border of Chinatown to ground

zero is three blocks.

Eligible subjects included patients younger than 18 years of age

as of September 11, 2001 who had established asthma and enrolled

in an asthma registry by Dr. Debra H. Lynn, chief of allergy at the

CBWCHC prior to 9/11. All patients included in the study were

given a diagnosis of asthma by Dr. Lynn, who is a pediatric allergist. Patients younger than 6 years of age were given a diagnosis

of asthma if they had two or more episodes of wheezing or coughing

within a 12 month period and symptoms improved after asthma

medication in the clinic. Children older than 6 years of age were

given a diagnosis of asthma if they had wheezing, cough on at least

two occasions and symptoms and physical signs and peak flow

rates improved after bronchial dilator therapy.

We only included subjects who had at least one clinic visit for

asthma between September 11, 2001 and September 10, 2002, and

also had at least one clinic visit between September 11, 2001 and

September 10, 2002.

This was a retrospective chart review. 205 pediatric patients

with established asthma from the clinic were studied. Clinical data

obtained for the 12 months before and after September 11, 2001.

Seven physicians trained in internal medicine or pediatrics reviewed 319 patient charts from the asthma registry. 205 patients

met the inclusion criteria, which required them to have at least

nine of ten variables studied.

We studied: The number of visits to the MD for asthma; number

of asthma medication prescriptions; use of oral cordic steroids;

number of weekly doses of rescue inhaler, peak expiratory flow

rates measured in liters per minute as air leaves the lung. A low

number means an asthma attack; age, height and weight 3 months

pre and post 9/11 and sex; doctors were blinded to the residential

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zip code; for PEFR the best value of three trials was recorded at

each visit. PEFRs were obtained from all patients who were able

to consistently perform the maneuver.

Demographic characteristics of Chinese American patients were

as follows: Average age, 8 years; 34 percent female, 66 percent

male; height 48 inches, weight 63 pounds.

We further characterized patients as those living within 5 miles

of the World Trade Center and those living further away.

I have two tables which show that these groups were appropriately matched. There was no statistical difference between the

two groups with regard to age, sex, height and weight.

The number of clinic visits for asthma increased from 3.79 visits

in the 12 months prior to 9/11 to 4.69 visits in the 12 months after

9/11.

The number of asthma prescriptions per child increased from 2

to 2.3 during the same period. The number of rescue inhaler doses

per week and oral steroid uses did not differ.

I have a map of ground zero. On the left we have zip codes of

residents of kids with asthma who lived within 5 miles of the

World Trade Center. In blue are those zip codes, those asthmatic

children who live greater than 5 miles away, which includes Brooklyn.

The number of clinic visits for children in Region 1 within 5

miles increased after 9/11 along with the number of asthma prescriptions. There are no differences in the number of rescue inhaler

doses or oral steroid use.

In Region 2 greater than 5 miles, although the average number

of clinic visits and asthma prescriptions increased after 9/11, these

increases were not statistically significant.

Now, for the entire clinic population we tracked the number of

children with a diagnosis of asthma. The number of children of

asthma increased 66 percent and pediatric asthma visits increased

48.8 percent.

I have a bar chart which shows the increase in pediatric asthma

patients in Chinatown increased from 306 to 510. The number of

pediatric asthma visits increased from 1,044 to 1,544. In comparison, a control group children with asthma treated in Flushing

Queens, 11.9 miles from ground zero, by the same physicians in

Manhattan using the same standards showed children with asthma

decreased 10.9 percent and the number of pediatric asthma visits

decreased 13.6 percent. Mean percent predicted peak flow rates decreased below 80 percent of predicated in children living within 5

miles of ground zero. The decrease lasted for 6 months.

In summary. Exposure to the World Trade Center disaster led to

increased asthma severity. Children living within 5 miles of ground

zero had more asthma clinic visits after September 11, 2001. These

children received more prescriptions for asthma medications. The

increase in visits for asthmatic children living further than 5 miles

from ground zero was not percent. Mean percent predicated peak

expiratory flow rates decreased solely for those patients living

within 5 miles of ground zero after September 11, 2001.

In conclusion. Asthma severity worsened after September 11,

2001 in pediatric asthmatic patients living near ground zero. ResiVerDate 11-MAY-2000 14:33 Apr 29, 2008 Jkt 000000 PO 00000 Frm 00084 Fmt 6633 Sfmt 6633 C:\DOCS\40872.TXT HGOVREF1 PsN: HGOVREF1
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dential proximity to ground zero was predictive of the degree of decreased in asthma health.

I’d like to acknowledge my colleagues which include fellows from

SUNY-Stony Brook and Dr. Debra Lynn from the Charles B. Wang

Community Health Center. Our epidemiologist is Dr. Francis Mary

Maduna from the University of Pittsburgh. And our statistician is

Dr. Hong Chu Chin from Harvard Medical School.

Thank you.

[The prepared statement of Dr. Szema follows:]

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Mr. TOWNS. Thank you. Thank you very, very much. Thank you.

STATEMENT OF SUZANNE MATTEI

Ms. MATTEI. Good day. Thank you for allowing me to testify

today, Chairman Towns, and members of the panel.

My name is Suzanne Mattei. I am the New York City executive

for the Sierra Club, a national environmental group.

My testimony will describe information that the Sierra Club has

obtained regarding the extent to which the contamination from the

World Trade Center disaster travel eastward into the borough of

Brooklyn and looking at various neighborhoods trying to answer

the question did that dust become deposited at the ground level,

did it enter buildings.

So, thank you.

You know, obviously when you have a significant release of hazardous substances you want an answer to two questions. What’s in

it and where did it go? Neither of these questions were answered

for the ground zero pollution source.

We already have discussed the problems with EPA; bad equipment, failing to test for the proper parameters, failing to test systematically, falling to do proper indoor testing and completely ignoring Brooklyn.

We’ve already talked about this. The original residential program

and the current one completely ignored Brooklyn.

Despite the Inspector General’s criticism, despite advocacy from

residents, I want to particularly acknowledge Gena Orkin who is

a Brooklyn resident who advocated very vociferously for testing in

Brooklyn. They just continue to completely ignore the borough.

So what are the information sources about what happened in

Brooklyn? You’ve seen the aerial photographs. There were also

some newspaper accounts where people talked about readable papers being deposited in Brooklyn. There was also the Inspector

General’s survey, which was discussed just a little bit before. I’ll

get into the specifics relevant to Brooklyn. We did our own informal supplementary survey, and you’ve heard about some of the

health studies that have been done.

The NASA aerial photographs showed it moving in a southeasterly direction across Manhattan. You already saw that picture.

The Newsday article described seeing people seeing readable addresses, readable papers in Brooklyn Heights, Carroll Gardens and

also Red Hook.

In 2003, the EPA Inspector General did conduct that survey of

residents. The interesting thing is that they did not limit their survey to Manhattan residents. They did include people in other boroughs. There were about 204 residents from Brooklyn who responded. One of the questions was whether or not the resident was

aware of their own home having been invaded by World Trade Center contamination. It was really quite stark that about a quarter

of the 200 some residents who responded from Brooklyn said yes,

that there was either visible dust or debris in their homes. The interesting thing is that information came out and then nothing happened. Nobody did any further testing. EPA didn’t take any further

action.

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So the three most significant reporting neighborhoods in terms

of how many reported and the percentage that said their homes

had been contaminated where Carroll Gardens, Cobble Hill, Brooklyn Heights Cobble Hill. They did it by zip code. So we had to look

at what the neighborhoods were, and Park Slope.

So the Sierra Club New York City Group didn’t have any particular funding to look at this. But just decided well we want to see

if this was just a fluke. Did people really see dust in their homes

and in what neighborhoods did they see it. And so we just did it

in a very sloppy way. We set up card tables outside of grocery

stores. And when people came shopping, we asked them where they

lived and did they remember what they saw in their neighborhoods

or in their homes at the time of September 11, 2001.

I got to tell you, people’s memories of that day are crystal clear.

It’s like do you remember where you were when you learned that

President Kennedy was shot. It is that kind of clarity. They remember everything about that day.

So we focused on three highest reporting neighborhoods in the

Inspector General’s survey, and then based on the newspaper accounts about Red Hook, we went into Red Hook as well.

We got a little bit of information from other boroughs just because people started emailing our survey around. So I will talk

about a little bit of information from other neighborhoods as well.

But Brooklyn Heights, people who saw dust in their neighborhoods,

67 percent. It’s a small survey. But it was really quite telling.

A lot in Brooklyn Heights. A lot in Cobble Hill. Red Hook, a

smaller amount but still really very significant, almost a third of

the people. And in Park Slope a very high percentage of the people

who responded said yes, we saw dust in our neighborhood.

And then we went to the next question, which was did you smell

odors inside your home or see World Trade Center dust inside your

home. And, again, the numbers were really pretty high. The percentages were pretty high. More than half in Brooklyn Heights and

Cobble Hill, about a third again in Red Hook and about a quarter

in Park Slope.

You may remember that September 11th was a stunningly beautiful day. The air was really clear and beautiful. It was the first

really nice day after a string of bad weather. A lot of people had

their windows open, and that definitely put them at greater risk

of contamination. Seventy percent of the people who saw or smelled

9/11 pollution in their homes had their windows open that day.

Now it is open to recognize that even with windows closed you

could still have infiltration. It is also important to recognize that

you did not have to see the dust for the dust to be there. You could

have very fine, essentially invisible dust in your home or dust that

you would not even notice. We know that people in Manhattan who

did not have visible dust when they had chemical analysis with

dust wipe tests, they found the kinds of heavy metals and other

materials that were associated with World Trade Center dust contamination.

So what we are looking at is what people saw. We did not have

people to go in and do scientific tests. This is not perfect. And probably a lot of people who said I did not see anything or smell anything, may still have had contamination in their home.

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A lot of reports of smell in Dumbo, Williamsburgh, Greenpoint,

and Fort Green, we did not get much in the line of dust reports

from there. Although today we just heard from the Deputy Borough

President that she saw dust in her Fort Green home. So these

areas need to be investigated.

Areas from which we received only a few surveys, but they indicated some neighborhood contamination that really should be investigated further are listed up here. Downtown Brooklyn, Sunset

Park, Ocean Parkway. Sheepshead Bay, which Congressman

Weiner mentioned. We had one person who mentioned that she had

completely painted her steps, her front steps and her railing. And

when she came home that evening they were covered this sort of

grayish dust.

So what we have here are colored markings for the areas where

the red square indicate where we had a significant amount of surveys—well, you know, more than 10 surveys and then we have in

orange the areas where we think ought to be further investigated

where we got a fewer number of surveys.

And this is not scientific. I want to emphasize. This is only preliminary information designed to try to spur people to do more. But

it sure does follow the dust cloud. So I do not think we are too far

off in identifying where the worst contamination was. It really

looks as though central and southern Brooklyn were hit harder

than the northern parts of Brooklyn. And a lot of neighborhoods

were contaminated.

You know, 5 out of 10 people that we talked to in Coney Island

saw dust. So it really traveled.

The conclusion is really the dust cloud did not just go over

Brooklyn, it went through Brooklyn. And EPA really must conduct

a proper testing program, and this program must include Brooklyn.

[The prepared statement of Ms. Mattei follows:]

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Mr. TOWNS. Thank you very much, Ms. Mattei.

I mean to do all of that without being funded, I mean I just can

imagine what you had been able to do if you had funds to do it.

I think that is a marvelous job.

I want to thank you for your testimony.

Now I would like to move into the question period. Let me begin

with you, Mr. Chan. During your tenure to your knowledge did the

Office of the IG experience any direct or indirect pressure from any

sources in the administration to soften its evaluation of EPA’s conduct or any work concerning the testing and cleanup of 9/11? Do

you know of any?

Mr. CHAN. I don’t have any evidence like that personally. One of

the great things about working for the Inspector General’s Office

is that I know whatever evidence we gathered. However they wish

to change it, the evidence will be there. So every single report that

I have done have been through FOIA have been exposed. So all the

documents are there. So in that sense I never worry about it. I do

not feel that pressure at all in my position.

Mr. TOWNS. You do not feel the pressure?

Mr. CHAN. No, sir.

Mr. TOWNS. All right. Let me go just right down the line on a

very simple question, but I think it is a very important question.

Let me just go right down the line. I will probably start with you

on this side.

Is there scientific evidence of health problems and contamination

in Brooklyn or any other boroughs, scientific?

Let us go right down the line.

Ms. MATTEI. Well, I think you have heard at this table the best

information that those of us who were called to this hearing could

pull together. I think that Dr. Szema’s study is scientific evidence.

I think that the health officials study is scientific evidence. But

what they are is evidence, they are an indication of a problem. But

what our Government failed to do was followup and do the comprehensive testing that is required.

Dr. SZEMA. I’m going to show you a slide which shows zip codes

of children with asthma who were in the hot zone or the red zone

within 5 miles of the World Trade Center who had worsened asthma.

Keep in mind, however, that even though the numbers were not

statistically significant for children who lived outside of the red

zone, the numbers were also increased. And we were limited by

sample size, even though it was statistically significant. But you

will see that a variety of zip codes in Brooklyn had worsened asthma.

So the answer is, yes, that there is scientific evidence which

shows that children who lived in parts of Brooklyn were worse

after 9/11.

Mr. TOWNS. Thank you.

Mr. ROOHAN. Our studies showed that were elevated persons

with asthma where their asthma worsened in Brooklyn. Again,

similar to the study in Chinatown, our sample size was small but

still statistically significant. So when I presented the results over

twice as likely to have significant worse asthma, two and a half

times worse asthma, compared to the rest of New York City.

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Mr. TOWNS. So the answer is yes?

Mr. ROOHAN. Yes.

Mr. TOWNS. Thank you.

Mr. NEWMAN. Well, I have a two part answer to that question.

First, we have EPA photos, one of which I projected earlier that

clearly show that visible particulate matter was dispersed and deposited, at least on the northwestern edges of Brooklyn. And again,

as I mentioned earlier, we have a much higher level of concern for

the particulate matter that we don’t see. So that the presence of

visible particulates is an indication that there are microscopic invisible particulates that have the potential to be present, and also

to travel further.

Second, we have the photographs and the plume dispersion

model from the Office of Research and Development at EPA. So we

have well documented indications that there’s a high possibility for

contamination in Brooklyn. What we do not have is data. And, you

know, data does not fall from the sky like particulates do. We do

not have data because data is a result of investigation. Essentially

there has been no investigation, there has been no site characterization, there has been no effort by EPA or any other Government

agency to accumulate that data and assess it.

So on the one hand we have an absence of data, on the other

hand, the absence of data is not indicative and cannot be used to

indicate safety. We just do not have the data to indicate either

safety or risk.

Finally, I would like to note two things. No. 1, that the EPA

World Trade Center Expert Technical Review Panel strongly recommended that sampling be done in Brooklyn, and that recommendation was not accepted by EPA.

Second of all, another reason for the absence of data is the Centers of Excellence, the medical programs for which people who are

symptomatic or concerned about 9/11 exposure and related health

efforts until very recently with the opening of the Bellevue Clinic

on January 1st of this year, Brooklyn residents, Brooklyn workers

unless they worked at ground zero were not eligible for those programs, and therefore there is no data available for people from

Brooklyn.

Mr. TOWNS. All right. So the answer is a yes?

Mr. NEWMAN. The answer to that is the data that we have indicate a problem, but we have very little data and we need a lot more

data in order to find out what we are actually dealing with, yes.

Mr. TOWNS. OK. Thank you.

Mr. Gudaitis.

Mr. GUDAITIS. Of the client we have in order for them to make

a successful application they have to have medical documentation

of their illness. So in our case the answer would be yes as well.

Mr. CHAN. My answer is that clearly there are indications of

that, but I would answer in a different way. My answer to you is

that I don’t think that all the debris can be healthy to me.

Mr. TOWNS. I did not hear the answer.

Mr. CHAN. I do not think the debris is healthy to me.

Mr. TOWNS. Yes.

Mr. CHAN. So that is the beginning.

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I think EPA with its authority with concerns in terms of protecting the human health as well as environment, it is their job to determine if, in fact, what is released in the environment could be

harmful to the environment and the health of its citizens.

Mr. TOWNS. Right.

Mr. CHAN. I do not think they have done their job.

Mr. TOWNS. Right. Thank you.

Congressman Platts from the great State of Pennsylvania.

Mr. PLATTS. Thank you, Mr. Chairman. And our colleague, Representative Fossella could not be with us today, but I know he has

asked permission, unanimous consent to submit a written statement for the record.

Mr. TOWNS. Without object, so ordered.

Mr. PLATTS. Thank you, Mr. Chairman.

Mr. Newman, I want to followup on your testimony and your

service on the Expert Technical Review Panel. First, can you give

me a little background of the makeup of the panel. You state local,

you know Federal officials. Who all were involved?

Mr. NEWMAN. The EPA Expert Technical Review Panel was an

appointed panel. It was an unusual configuration. It initially consisted, I believe, of seven representatives of Government agencies

such as EPA, FEMA, OSHA, New York City Department of Health,

etc., and seven nongovernmental experts, of whom I was one.

The panel was charged broadly speaking with three tasks. One

was to characterize any remaining exposure and risks, second was

to identify unmet public health needs, and the third was to recommend any steps to further minimize the risks associated with

the aftermath of the World Trade Center attacks.

Mr. PLATTS. And that panel met, my understanding, about a

dozen times in over about a 2-year period and issued a report in

late 2005.

Mr. NEWMAN. The panel did not issue a report.

Mr. PLATTS. OK. The report referenced, Mr. Chan, I believe—OK.

The objection I guess——

Mr. NEWMAN. I think you’re probably referring to the Inspector

General’s report.

Mr. PLATTS. OK.

Mr. NEWMAN. No. EPA subsequent to the dismissal of the panel

prior to the expiration of its term went ahead and implemented, I

believe, it is in December 2006, a new sampling program which is

currently underway. That sampling program was rejected by the

panel. Our rejection and our concerns were ignored in EPA, they

went ahead an issued a new program.

Mr. PLATTS. So it was not a written report rejecting that? It was

an expression?

Mr. NEWMAN. No. No. The panel was an advisory body. It was

plagued by a number of procedural concerns, one of which was a

lack of clear process for memorializing the panel’s input. So there

was no final report issued by the panel.

Mr. PLATTS. But the current EPA plan was one that the panel

looked at and rejected as again insufficient?

Mr. NEWMAN. Correct.

Mr. PLATTS. Are you aware of the rationale of the EPA for appointing you and the others to the panel but then not adhering to

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the expert testimony and knowledge? Was there any formal response from EPA why they were not following the lead of the

panel?

Mr. NEWMAN. No.

Mr. PLATTS. No?

Mr. Chan, you left EPA late 2005, correct?

Mr. CHAN. Yes, sir.

Mr. PLATTS. Are you aware of any in your work in the Inspector

General’s Office of any EPA response internally to the panel and

how it reviewed it and the seriousness with which EPA took the

findings of the panel?

Mr. CHAN. The findings, our recommendation and their response

are in the report and they accept a lot of our recommendations and

the ideas looking into the indoor air, I believe, that is something

that they initiated together with, I believe, Senator Clinton and

Senator Lieberman pushed to do that.

We were in fact hopeful that they would follow through on some

of these recommendations. We are so disappointed in terms of what

happened since then.

Mr. PLATTS. OK. But thus far they have not really followed the

recommendations you made?

Mr. CHAN. I can give you a short answer and a long answer. The

answer is no. The short one, yes.

Mr. PLATTS. My understanding was that in February 2006 that

there was a report issued by the panel, by your panel? No.

Mr. NEWMAN. No.

Mr. PLATTS. OK. Give me one moment here.

Mr. Chan, one of the things of learning lessons here is my understanding in the initial months following 9/11 that the city of New

York took the lead not EPA. Are you aware or can you give us any

information on how that decision came to be between the city and

the Federal Government? And then what spurred in early 2002 the

decision the EPA would take over the effort?

Mr. CHAN. This may be difficult for me to answer because it appears to be still a legal issue.

I believe that city itself under the circumstance can, in fact, decide to do the cleanup themselves. You know, the EPA’s obligation

is to make sure that it is done. And I believe also that the event

that occurred afterwards that there were a lot of complaints about

the effort. And if I recall correctly around February 2002 EPA

stepped in and decided to begin the cleanup for the indoor air.

Mr. PLATTS. Mr. Chairman, if I could squeeze in a quick followup? Real quick.

Mr. TOWNS. Sure.

Mr. PLATTS. To all the panelists, are any of you aware of the

interaction between the city and EPA and the initial decision for

the city to take the lead and then EPA in early 2002 saying, no,

we are going to take the lead? And even if you do not have that

knowledge, a recommendation for learning from this experience

should it be mandatory of EPA coming in and being more the lead

entity from the get-go and not having that discretion at the local

level?

Mr. Newman.

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Mr. NEWMAN. Yes. My understanding is that the EPA initially

denied that it had legal responsibility to assessing or addressing indoor environmental contamination, and thus it defaulted to New

York City agencies. And in turn, New York City agencies essentially in the real world defaulted to building owners and employers

whose efforts, you know, ran the gambit from testing an appropriate cleanup to not, depending upon their level of technical expertise depending on their financial capabilities. And most importantly, depending upon guidance from the Government. And as we

know, guidance from the Government, you know, tended to indicate

or allege that there was no problem and therefore it was a

disinsentive to clean up.

Mr. PLATTS. Right. And opinion as far as whether that should be

more clear in the law and perhaps mandatory as far as EPA versus

the local?

Mr. NEWMAN. Well, I think it’s fundamentally clear that it was

and is EPA’s responsibility period to assume—EPA fundamentally

has clear legal responsibility for environmental and public health

from contamination.

Mr. PLATTS. Yes?

Ms. MATTEI. Right. I would just add to that. And I think that

some of this was defined very clearly for everyone by Congressman

Nadler’s white paper that really looked into the issue of responsibility. But fundamentally the Environmental Protection Agency

has the authority to respond to any significant release of a hazardous substance. They can do that no matter what the cause of that

hazardous substance release. And that is under what is known as

the Super Fund Law. They have that authority. They do not have

to declare the site a Super Fund site to get in there and do the

analysis. They can go indoor as well as outdoor. That statute does

not differentiate.

Also because this was a terrorist attack, there was a Presidential

Directive in place that specifically mandated that the Environmental Protection Agency should take action.

So actually the law was in place and the agency clearly had the

responsibility and the duty, but it chose not to do so. So we had

a major failure in implementation of an existing law. It was an administrative failure.

Mr. PLATTS. Right. So not that the law is flawed, but it was not

properly implemented?

Ms. MATTEI. That’s right. That’s correct. It was irresponsible behavior on the agency’s part.

Mr. PLATTS. OK. Thank you, Mr. Chairman.

Mr. TOWNS. Thank you. Thank you very much.

And I will now yield to Congressman Murphy of Connecticut.

Mr. MURPHY. Thank you, Mr. Chairman.

A month or so ago when we had a committee hearing on this

subject in Washington, DC, we had Dr. Howard and Dr. Agwunobi

before us. And I left there at least with some fear that their strategy was to study this to death and to basically require going forward, that each person potentially present their own personal

white paper to prove that their illness was a direct result of their

exposure to the contaminates in and around the site. So I want to

talk for a second or ask some questions for a moment on the limits

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of data going forward and to try to get a better understanding of

what our expectations are going to be from data that we may be

able to receive.

Maybe I’ll direct the first question to Dr. Szema as the one doctor

I believe on the panel.

Let us take your specific study on asthma. What are the expectations going forward on this case study, at the very least, that we

would have any ability going forward to examine which patients

had an increased level of asthma or an increased exposure to asthma due to their exposure to contaminates through September 11th

or to what extent is this simply very important aggregate data that

we may not be able to distill down to determine the actual cause

of the increased level of asthma?

Dr. SZEMA. The clinic population, the population in Chinatown is

relatively stable. So I would say that since this is a good yard stick

or gold standard, I would want to resurvey and restudy it on a

more broader scale and move out in concentric circles.

We have already made a computerized questionnaire similar to

the World Trade Center Mount Sinai questionnaire and standardized statistical instruments, like the St. George’s translated in Chinese and ready to go on the Internet. But I am not currently funded to do so. My current NIH funding is to study the genetic causes

of asthma in mice. And, you know, we are developing a new drug

to treat asthma.

So I think if you study a controlled population, then you will be

able to compare other populations further out. An analogy is if

Osama Bin Laden decides to drop a nuclear weapon on a location

and you wanted to see the health efforts, you would start from that

location and move out.

Mr. MURPHY. I guess my question is more relevant to an individual case rather than as just a statistical analysis. When you are

dealing with an individual 8 year old who comes in with asthma

or an increased level of asthma they did not have before, what is

our ability to tell whether that increased level of asthma is due to

the contaminates?

Dr. SZEMA. Yes. One thing that we would like to do but we have

not done was to skin prick tests all over these kids for dust mite

antigen. There are at least two types. As well as to rat and mice.

Because after the World Trade Center collapse there were lots of

case reports of rodents running around the city. They came because

of the excavation, etc.

So I think your asthma can be worse as a result of irritation injury, as a result of inhalation lung injury, allergic sensitization to

antigens. Air pollution is known to increase asthma attacks and

there is something called endotoxin in the air which associated

with increased particulate matter in the air as well as air pollution.

So these are all things we can measure. You can skin test them

to these things. You can measure air quality. You can go into the

kid’s house and see if there’s any residual things left.

None of these kids got complete pulmonary function testing or

cardiopulmonary exercise testing. So the peak flow is just a little

tube you blow in in the office when you are stationary at rest. It

does not say whether you can rest around. So, you know, we did

not put any of these kids on a treadmill, etc.

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Mr. MURPHY. Let me ask the more general question to the panel,

which is that is there some fear that we are going to be set up for

a fall here? That individual citizens are going to be asked to

present far more information that is available here. If what we are

going to rely on in the end is maybe more aggregate data about

particular exposure by neighborhood or by geographical area, how

do you then go about treating those populations or dispersing

funds, treatment dollars, etc?

Mr. Newman.

Mr. NEWMAN. I think you are absolutely correct that it is difficult

to prove with confidence any individual—the association of health

symptoms or health condition, any particular individual with a presumed exposure, especially in the absence of data. However, in the

aggregate data as you mentioned, the scientific evidence is quite

clear that we have a number of clearly distinct geographic and

what I call exposure populations that have been adversely impacted by 9/11 related exposures. I think that there is virtually or

actually no scientific doubt about that.

So what is needed are programs in the aggregate and not programs aimed at the individual. We have the beginnings of those

programs with an excellent track record. Those are the Centers of

Excellence to which I referred in my comments. Those programs

need to be supported. They need to be funded. They need to be expanded and they need to continue over the long term so that they

can survive.

The eligibility criteria for people to get access to those programs

need to be expanded to include people who are effected or potentially effected by 9/11 so that they can be screened in or screened

out based on their symptoms and based on their exposure history

and the development or absence of symptoms.

Mr. MURPHY. Thank you.

Thank you, Mr. Chairman.

Mr. TOWNS. Thank you very much, Congressman Murphy.

Congressman Nadler from Manhattan and Brooklyn.

Mr. NADLER. Thank you.

Let me first compliment Mr. Chan for being one of the first EPA

or former EPA persons willing to speak out honestly on this subject.

Now, you say in your testimony—first of all, the Inspector General’s report, as I said, and it has been referred to before recommended that we do inspections of several hundred indoor spaces

going out in concentric circles from the World Trade Center to find

out where the contamination exists and where the cleanup is necessary. Do you concur that is still necessary to be done?

Mr. CHAN. I would say yes, if I answer 2 or 3 years ago. As time

moves on the more study I do not think is needed to determine

whether in fact the plume reach the citizens around here or

around——

Mr. NADLER. It’s becoming more clear that it did you mean?

Mr. CHAN. No. It is becoming more that, you know, the longer

you wait the less evidence you are going to find by definition. And

because what happened is that it is going to be in the body of individuals rather than—you know, it is all like getting the dirty. After

a while you can find it in the fish, as in mercury.

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Mr. NADLER. OK.

Mr. CHAN. So why not look in the fish rather than the water.

Mr. NADLER. Thank you. Second of all, you state in your testimony that EPA’s actions to evaluate, mitigate and control risk to

human health from exposure to indoor air pollutants in the WTC

area were consistent with applicable statutes and regulations

which do not obligate EPA to respond to a given emergency allowing for local agencies to lead a response. And New York City in fact

exercised the lead role.

Ms. Mattei says in her testimony when a significant release of

hazardous substance occurred, the EPA has authority to respond

under CERCLA and with regard to the September 11th attack,

EPA had a mandatory duty under Presidential Decision Directive

62 to conduct a cleanup. I believe that Marlanne Horinko, Deputy

Administrator of EPA, admitted under oath before the Senate in

2004, that under CERCLA and under Presidential Directive 62,

EPA had a mandatory duty to be the lead agency. Is that your understanding?

Mr. CHAN. Yes, but I don’t believe my comment is different from

what was just said. In fact, I think under CERCLA EPA does have

the responsibility to make sure that. But in this case here where

the New York City decided they wanted to make that it happens.

Mr. NADLER. But let me ask you the key question.

Mr. CHAN. OK.

Mr. NADLER. If EPA has the responsibility, it can delegate that

responsibility to some other responsible body to do it.

Mr. CHAN. Exactly.

Mr. NADLER, But if it clear that other body is not doing it, is

there EPA thereby OK to wash its hands of it?

Mr. CHAN. No. They should followup and take over, as they have

done. And there is a precedents for that. If you look at Libby, MT

where in fact the externals asbestos went into buildings and whereby EPA is responsible.

Mr. NADLER. In Libby, MT the Administrator said that it would

be immoral to ask homeowners to bear the expense of cleaning up

their homes. In New York that was what was done.

Mr. Newman, you state in your testimony that neither environmental or occupational health regulations were enforced at or

around ground zero. The failure to ensure that these protective and

legally required measures were utilized is likely to have contributed to the high incidence of 9/11 related illness that we are seeing

today and that we may see in the future.

Who had legal authority to decide not to enforce the environmental and occupational health regulations?

Mr. NEWMAN. To take your question literally, I do not think anybody had legal authority to decide to or not to enforce them.

Mr. NADLER. Nobody had legal authority? Who to your knowledge decided not to enforce the occupational health and safety

laws?

Mr. NEWMAN. Obviously the regulatory agency is—I mean the

enforcement agency is the Occupational Safety and Health Administration and New York State Department of Labor of Public Employee Safety and Health, and the applicable regulations?

Mr. NADLER. And the city? And the city, too?

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Mr. NEWMAN. The city does not enforce those regulations. The

city as an employer is legally required to comply with the requirements of those regulations. The enforcement body would be PESH

and OSHA.

Mr. NADLER. But the city didn’t comply with those regulations?

Mr. NEWMAN. In my opinion, absolutely not.

Mr. NADLER. So all three levels of government were at fault?

Mr. NEWMAN. Yes.

Mr. NADLER. And is it safe to say that probably thousands of people are sick today and will get sick because all three levels of government did not enforce or apply the law?

Mr. NEWMAN. I think that’s pretty clear.

Mr. NADLER. That is pretty clear?

Now, there was as you may recall, a New York City Department

of Environmental—what is it? New York City EDC—oh, DEP.

There was a New York City DEP memo that I recall quoted in the

Inspector General’s report saying we should enforce the OSHA

laws. And someone overruled that. Someone decided not to. And I

recall there is also a letter from Mayor Giuliani quoted as an appendix to the—either quoted as an appendix to the Inspector General’s report or listed in the EPA response to the Inspector General

report saying do not come in, we will handle it. Do you remember

that letter?

Mr. NEWMAN. I do.

Mr. NADLER. And that is what it said?

Mr. NEWMAN. Generally.

Mr. NADLER. OK. Let me ask you one other thing. If we do not—

and as I’ve said, I have always maintained that there are two

coverups. The first coverup was the fact that people who were exposed to an acute toxins that day and the days following because

they were caught in the plume or because they were first responders, they worked at ground zero and they didn’t wear respiratory

equipment, their health was compromised. That coverup is pretty

well unraveled and people are now admitting that happened. Some

people are saying we should deal with it, not everybody.

But the second coverup is the impact on residents in Manhattan

and Chinatown and Brooklyn, Queens, Jersey City, for all we

know, were indoor spaces were contaminated and never properly

inspected and cleaned up. And as you said before, the default was

the building owners. I remember there was a U.S. Senate hearing

in January 2002, it was the New York City department of something that while we sent notices to 1,800 building owners, owners

of 1,800 buildings telling them that they had to clean up the outdoor spaces and the common spaces of the buildings, not the individual spaces. It was asked well what was the agency of enforcement. Self certification, and how many certifications did you get

back? Three hundred, and what did you do about the other 1,500

buildings? Nothing. Not to mention that the individual spaces were

not dealt with.

If nothing is done, is it accurate to think that people who move

into an apartment or start working in an office next year or 5 years

from now are still going to be poisoned and come down with cancers eventually, or some proportion of them?

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Mr. NEWMAN. If you have indoor particulate manner, you know,

that have toxic properties, the likelihood is that some of these particulates can persist for extremely long periods of time unless

they’re subjected to a targeted and technical environmental remediation.

Mr. NADLER. So the answer is yes?

Mr. NEWMAN. Yes.

Mr. NADLER. Which means that one has to say that as far as we

know many buildings in the entire metropolitan area may be unsafe to live and work in in that sense?

Mr. NEWMAN. Well, the operative word is ‘‘may.’’ From my point

of view, you know, it is entirely appropriate and legitimate to have

a level of concern about that contamination that might remain indoors. In terms of our knowledge based on data we do not have any

knowledge, we do not have any data because the testing has never

been done. So it is entirely appropriate to do the testing now and

find out where we are at.

Mr. NADLER. And in fact essential to do the testing in order to

correct it?

Mr. NEWMAN. Correct.

Mr. NADLER. Thank you.

Mr. TOWNS. Thank you very much, Congressman Nadler.

Let me just before we close, you know I can’t close without asking this question, Mr. Gudaitis, you know the fact that we have all

these people that are ill, more people that might become ill that we

are cutting case managed services. I mean, that to me is the most

ridiculous thing I think I have heard. I mean, how could we explain

that if there is any kind of commitment or dedication on our part

that we would cut case services? I mean, there will be people that

is going to get sick in the future and all that, and the service will

not be there for them. How could that happen?

Mr. GUDAITIS. That’s a good question, sir.

You know, at the present time there is only one organization

funding case management in New York City, and that is the American Red Cross Liberty Fund, and we are administering that grant,

but it ends in 2007. And after that there will be no funding for

community-based case management.

And at the present time we know that we have about 60 percent

of the clients coming out of just one of the Centers of Excellence

needing case management services, and those numbers are only increasing. But the money, as far as any of us know, has run out.

So unless coordinated case management assistance and case management is added to one of the things that we are looking for the

Federal Government to fund along with the Centers for Excellence,

their needs will only be half met in the medical monitoring and

treatment programs.

Mr. TOWNS. Right. Let me, Mr. Chan, I am coming at this question another way. I went after it one way with you and I am going

to come another way.

Both you and your former supervisor, Nikki Tinsley, are no

longer working at the Office of the Inspector General for the EPA.

For years the Inspector General’s Office of the EPA produced quality and impartial reviews of EPA’s actions. Has there been a culVerDate 11-MAY-2000 14:33 Apr 29, 2008 Jkt 000000 PO 00000 Frm 00107 Fmt 6633 Sfmt 6633 C:\DOCS\40872.TXT HGOVREF1 PsN: HGOVREF1
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ture change in the IG’s Office in the EPA? In other words, you

know where I am trying to go.

Mr. CHAN. Let me say that I worked for EPA for 5 years and I

had great hope in terms of working and helping the citizens in

terms of the environment and helping out. So the fact that I left

the agency I think suggests how disappointed I am in terms of

what I have achieved. I am not very happy with what could be

done given the fact that the Inspector General’s Act gave us, you

know, independence as well as an ability to voice our views and so

on.

So I must admit to you, and I guess the first time in public, even

my wife does not know that, that I left with a heavy heart. I am

sorry that, you know, that there are a lot of other issues, environmental issues that I find very difficult to see how we are going with

this. So it is a difficult thing because I can talk to you about new

source review, I can talk to you about mercury and the effect on

children, I can talk to you about the coal fired stuff, and case after

case I find that, you know, somehow I am on the wrong side of the

issue.

But I am happy I was there because it gave me tremendous insight as to how Government works. Having worked for the General

Accounting Office from the congressional side or legislative side I

certainly learn a lot in terms of working for the executive side.

Mr. TOWNS. Thank you. Thank you very much.

I really appreciate your coming to testify. I think that Congressman Nadler indicated early on, you know, we really appreciate it

because there has been a silence, you know, and for you to come

and speak out, I think that to me is very, very important.

Any other comments that any other Members might have?

Mr. PLATTS. Mr. Chairman. One, I do want to thank all of the

witnesses again for their testimony, but especially for their reference on behalf of all the citizens of New York.

Also, I would like to ask unanimous consent that Mr. Shays be

allowed to submit a written statement for the record.

Mr. TOWNS. Without objection, so ordered.

Mr. PLATTS. Thank you.

Mr. TOWNS. Yes.

You have a comment that you wanted to make?

Dr. SZEMA. I just want to comment that our research is dead. We

published this paper in 2004.

Mr. PLATTS. Dead did you say?

Dr. SZEMA. Dead, D-E-A-D, dead. We did it with no money. I had

our fellows and students do it. We have no money now. The cost

of actually funding this type of research is actually less than that

of the long term health effects because if there are going to be kids

getting asbestosis or bronchial genetic carcinoma in the next 20

years, the health effects are going to be much more expensive, as

Mr. Roohan has even suggested.

So I think to fund a unique pediatric population, especially this

vulnerable population with preexisting disease is very important. I

cannot emphasize that enough. Because even other investigators

like Dr. David Purzone who has come before this committee before

from the Fire Department has shown that in the past 5 years previously healthy firefighters who do not have asthma, who are big

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strapping firefighters have lost lung function. They have measurable declines in lung function 5 years out from the World Trade

Center disaster based on the number of hours they put in ground

zero. And these are people who do not even live in the area. These

are workers, and to not study the residents is really a crime.

Mr. TOWNS. Ms. Mattei, yes.

Ms. MATTEI. Yes. I want to imagine yourself in a home in an effected area. A home in which the dust did infiltrate the dwelling.

There’s no World Trade Center dust left on the kitchen table. That

table has been washed plenty of times, thoroughly clean. You are

not going to find World Trade Center dust on the kitchen table.

But what about the carpet?

We know that asbestos fibers and lead can go right through an

ordinary vacuum cleaner’s bag. It goes right through and settles

right back down on that carpet. If it’s professionally cleaned the asbestos and the lead will still be there. And that is the concern that

I have.

I am more concerned for young children, toddlers who roll around

on carpets, bounce around on soft furniture and get dust on their

fingers and then put their fingers in their mouths. In my view

these are the people are most vulnerable to the indoor contamination.

I just want to point out, you know, I know a lot of time has

passed, but we supposedly did a great job scouring the area to recapture and try to identify the human remains. What are still finding now 5 years later? We are finding bone fragments, not only onsite but offsite. If the bones are still there, why would we assume

that the asbestos and lead are not.

Mr. NADLER. Thank you. Ms. Mattei, I am glad you brought that

up because you reminded me of something I wanted to ask earlier.

New York City Department of Health shortly after 9/11 put on

its website, and it remained there for years and may still be there

as far as I know, that if you returned to your apartment and you

find World Trade Center dust, you should clean it up with a wet

mop and a wet rag. What do you think of this advice as to its safety and its legality?

Ms. MATTEI. Completely irresponsible, and the Department of

Health knows better. They have very detailed regulations just for

lead dust. Their Part 171 regulations for cleaning up lead dust

which requires professional cleaning, HVAC vacuuming. None of

this nonsense of wet mop and wet rag. That was horrendous advice. What was even more horrendous is that EPA knew about this

advice and actually advocated and referred people to follow that advice.

Mr. NADLER. People who followed that advice, correct me if I am

wrong: No. 1, if they are not professionally trained and if they are

not wearing proper equipment, protective suits when they do it, are

likely to inhale some of those fibers when they correct it?

Ms. MATTEI. Definitely at risk for exposure, yes.

Mr. NADLER. And are likely to leave a lot of that in the carpets,

the porous wood surfaces and so forth?

Ms. MATTEI. It would not be a thorough cleaning. Yes, that is a

concern.

Mr. NADLER. Thank you.

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Mr. TOWNS. Thank you. Thank you very much.

Let me thank all the witnesses for your testimony. I really appreciate hearing from you, and to my colleagues also for their participation. And to say to you that based on the information that we

received from you that we will working together on a legislative fix.

This is a serious problem. This is the wealthiest country in the

world, and now if it is the wealthiest country in the world behaving

like this, I mean this just does not make a lot of sense. So I think

that the Federal Government has to step up to the plate and begin

to take some action.

So we will take the information that you have given us and we

will continue to work on it to see if we cannot bring about a solution to this problem.

Thank you so much for your testimony.

And this hearing is adjourned.

[Whereupon, at 12:41 p.m., the subcommittee was adjourned.)

[The prepared statements of Hon. Christopher Shays and Hon.

Vito Fossella and additional information submitted for the hearing

record follows:]

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