I 
110TH CONGRESS 
2D SESSION 
H. R. 6594 
To amend the Public Health Service Act to extend and improve protections 
and services to individuals directly impacted by the terrorist attack in 
New York City on September 11, 2001, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 24, 2008 
Mrs. MALONEY of New York (for herself, Mr. NADLER, Mr. FOSSELLA, Mr. 
KING of New York, Mr. RANGEL, Mr. ENGEL, Mr. TOWNS, and Mr. 
WEINER) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committees on 
the Judiciary and the Budget, for a period to be subsequently determined 
by the Speaker, in each case for consideration of such provisions as fall 
within the jurisdiction of the committee concerned 
A BILL 
To amend the Public Health Service Act to extend and 
improve protections and services to individuals directly 
impacted by the terrorist attack in New York City on 
September 11, 2001, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘James Zadroga 9/11 Health and Compensation Act of 
2008’’. 
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(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Findings. 
Sec. 3. Emergency funding. 
TITLE I—WORLD TRADE CENTER HEALTH PROGRAM 
Sec. 101. World Trade Center Health Program. 
‘‘TITLE XXX—WORLD TRADE CENTER HEALTH PROGRAM 
‘‘Subtitle A—Establishment of Program; Advisory and Steering Committees 
‘‘Sec. 3001. Establishment of World Trade Center Health Program within 
NIOSH. 
‘‘Sec. 3002. WTC Health Program Scientific/Technical Advisory Com-
mittee. 
‘‘Sec. 3003. WTC Health Program Steering Committees. 
‘‘Sec. 3004. Community education and outreach. 
‘‘Sec. 3005. Uniform data collection. 
‘‘Sec. 3006. Centers of excellence. 
‘‘Sec. 3007. Programs regarding attack at Pentagon. 
‘‘Sec. 3008. Entitlement authorities. 
‘‘Sec. 3009. Definitions. 
‘‘Subtitle B—Program of Monitoring and Treatment 
‘‘PART 1—FOR WTC RESPONDERS 
‘‘Sec. 3011. Identification of eligible WTC responders and provision of 
WTC-related monitoring services. 
‘‘Sec. 3012. Treatment of eligible WTC responders for WTC-related health 
conditions. 
‘‘PART 2—COMMUNITY PROGRAM 
‘‘Sec. 3021. Identification of eligible WTC residents and other non-re-
sponders and provision of WTC-related monitoring serv-
ices. 
‘‘Sec. 3022. Treatment of eligible WTC residents and other non-responders 
for WTC-related health conditions. 
‘‘Sec. 3023. Treatment of other individuals with WTC-related health con-
ditions. 
‘‘PART 3—NATIONAL ARRANGEMENT FOR BENEFITS FOR ELIGIBLE 
INDIVIDUALS OUTSIDE NEW YORK 
‘‘Sec. 3031. National arrangement for benefits for eligible individuals out-
side New York. 
‘‘Subtitle C—Research Into Conditions 
‘‘Sec. 3041. Research regarding certain health conditions related to Sep-
tember 11 terrorist attacks in New York City. 
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‘‘Subtitle D—Programs of the New York City Department of Health and 
Mental Hygiene 
‘‘Sec. 3051. World Trade Center Health Registry. 
‘‘Sec. 3052. Mental health services. 
TITLE II—SEPTEMBER 11 VICTIM COMPENSATION FUND OF 2001 
Sec. 201. Deadline extension for certain claims under September 11 Victim 
Compensation Fund of 2001. 
Sec. 202. Exception to single claim requirement in certain circumstances. 
Sec. 203. Immediate aftermath defined. 
Sec. 204. Eligible individuals to include eligible WTC responders and eligible 
WTC residents and other non-responders. 
Sec. 205. Limited coverage for additional individuals. 
Sec. 206. World Trade Center collapse and disaster rescue, recovery, debris re-
moval, cleanup, remediation, and response indemnification. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Thousands of rescue workers who responded 
to the areas devastated by the terrorist attacks of 
September 11, local residents, office and area work-
ers, and school children continue to suffer significant 
medical problems as a result of compromised air 
quality and the release of other toxins from the at-
tack sites. 
(2) In a September 2006 peer-reviewed study 
conducted by the World Trade Center Medical Moni-
toring Program, of 9,500 World Trade Center re-
sponders, almost 70 percent of World Trade Center 
responders had a new or worsened respiratory symp-
tom that developed during or after their time work-
ing at the World Trade Center; among the respond-
ers who were asymptomatic before 9/11, 61 percent 
developed respiratory symptoms while working at the 
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World Trade Center; close to 60 percent still had a 
new or worsened respiratory symptom at the time of 
their examination; one-third had abnormal pul-
monary function tests; and severe respiratory condi-
tions including pneumonia were significantly more 
common in the 6 months after 9/11 than in the 
prior 6 months. 
(3) An April 2006 study documented that, on 
average, a New York City firefighter who responded 
to the World Trade Center has experienced a loss of 
12 years of lung capacity. 
(4) A peer-reviewed study of residents who lived 
near the World Trade Center titled ‘‘The World 
Trade Center Residents’ Respiratory Health Study: 
New Onset Respiratory Symptoms and Pulmonary 
Function’’, found that data demonstrated a three 
fold increase in new-onset, persistent lower res-
piratory symptoms in residents near the former 
World Trade Center as compared to a control popu-
lation. 
(5) Previous research on the health impacts of 
the devastation caused by the September 11 terrorist 
attacks has shown relationships between the air 
quality from Ground Zero and a host of health im-
pacts, including lower pregnancy rates, higher rates 
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of respiratory and lung disorders, and a variety of 
post-disaster mental health conditions (including 
posttraumatic stress disorder) in workers and resi-
dents near Ground Zero. 
(6) A variety of tests conducted by independent 
scientists have concluded that significant WTC con-
tamination settled in indoor environments sur-
rounding the disaster site. The Environmental Pro-
tection Agency’s (EPA) cleanup programs for indoor 
residential spaces, in 2003 and 2005, though lim-
ited, are an acknowledgement that indoor contami-
nation continued after the WTC attacks. 
(7) The United States Geological Survey 
(USGS) reported on November 27, 2001 that cer-
tain outdoor dust samples collected by the agency in 
September 2001 at Varick and Houston Streets (ap-
proximately 1.2 miles north of Ground Zero) reg-
istered higher than 11 on the pH scale, a level the 
USGS characterized as being ‘‘as caustic as liquid 
drain cleaners’’. 
(8) According to both the EPA’s own Inspector 
General’s (EPA IG) report of August 21, 2003 and 
General Accountability Offices’s (GAO) report of 
September 2007, no comprehensive program has 
ever been conducted in order to characterize the full 
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extent of WTC contamination, and therefore the full 
impact of that contamination—geographic or other-
wise—remains unknown. 
(9) Such reports found that there has never 
been a comprehensive program to remediate WTC 
toxins from indoor spaces. Thus, area residents, 
workers and students may continued to be exposed 
to WTC contamination in their homes, workplaces 
and schools. 
(10) Because of the failure to release federally 
appropriated funds for community care, a lack of 
sufficient outreach, the fact that many community 
members are receiving care from physicians outside 
the current City-funded World Trade Center Envi-
ronmental Health Center program and thus fall out-
side data collection efforts, and other factors, the 
number of community members being treated at the 
World Trade Center Environmental Health Center 
underrepresents the total number in the community 
that have been affected by exposure to Ground Zero 
toxins. 
(11) Research by Columbia University’s Center 
for Children’s Environmental Health has shown neg-
ative health effects on babies born to women living 
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within 2 miles of the World Trade Center in the 
month following 9/11. 
(12) Federal funding allocated for the moni-
toring of rescue workers’ health is not sufficient to 
ensure the long-term study of health impacts of Sep-
tember 11. 
(13) A significant portion of those who have de-
veloped health problems as result of exposures to 
airborne toxins or other hazards resulting from the 
September 11, 2001, attacks on the World Trade 
Center have no health insurance, have lost their 
health insurance as a result of the attacks, or have 
inadequate health insurance. 
(14) The Federal program to provide medical 
treatments to those who responded to the September 
11 aftermath, and who continue to experience health 
problems as a result, was finally established more 
than five years after the attacks, but has no certain 
long-term funding. 
(15) Rescue workers and volunteers seeking 
workers compensation have reported that their appli-
cations have been denied, delayed for months, or re-
directed, instead of receiving assistance in a timely 
and supportive manner. 
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(16) A February 2007 report released by the 
City of New York estimated that approximately 
410,000 people were the most heavily exposed to the 
environmental hazards and trauma of the September 
11 terrorist attacks. More than 30 percent of the 
Fire Department of the City of New York first re-
sponders were still experiencing some respiratory 
symptoms more than five years after the attacks and 
according to the report, 59 percent of those seen by 
the WTC Environmental Health Center at Bellevue 
Hospital (which serves non-responders) are without 
insurance and 65 percent have incomes less than 
$15,000 per year. The report also found a need to 
continue and expand mental health services. 
(17) Since the 5th anniversary of the attack 
(September 11, 2006), hundreds of workers a month 
have been signing up with the monitoring and treat-
ment programs. 
(18) In April 2008, the Department of Health 
and Human Services reported to Congress that in 
fiscal year 2007 11,359 patients received medical 
treatment in the existing WTC Responder Medical 
and Treatment program for WTC-related health 
problems, and that number of responders who need 
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treatment and the severity of health problems is ex-
pected to increase. 
(19) The September 11 Victim Compensation 
Fund of 2001 was established to provide compensa-
tion to individuals who were physically injured or 
killed as a result of the terrorist-related aircraft 
crashes of September 11, 2001. 
(20) The deadline for filing claims for com-
pensation under the Victim Compensation Fund was 
December 22, 2003. 
(21) Some individuals did not know they were 
eligible to file claims for compensation for injuries or 
did not know they had suffered physical harm as a 
result of the terrorist-related aircraft crashes until 
after the December 22, 2003, deadline. 
(22) Further research is needed to evaluate 
more comprehensively the extent of the health im-
pacts of September 11, including research for 
emerging health problems such as cancer, which 
have been predicted. 
(23) Research is needed regarding possible 
treatment for the illnesses and injuries of September 
11. 
(24) The Federal response to medical and fi-
nancial issues arising from the September 11 re-
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