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NIOSH, 9/11, WTC and Cancer

NIOSH says, "No, for now."

First things first, NIOSH stands for National Institute for Occupational Safety and Health. They are part of the Centers for Disease Control (CDC) with whom they have often had a relationship that perhaps can best be described as strained. (Think of the CDC as a wealthy but stingy and slightly jealous mother-in-law.)

This rather modest "David" of a federal agency has become the "Goliath" in the post-9/11 responder health debate since they are effectively responsible for deciding which medical conditions will be covered under the $2.775 billion Victims Compensation Fund (VCF). Their entire annual budget is $300 million thus giving them out-sized influence in a highly controversial area, something they would probably prefer to do without.

NIOSH headquarters, Washington, D. C.

The Victims Compensation Fund operates through 2017. Importantly, during the first five years of the fund the maximum total payout is capped at $875 million with the "lion’s share", $1.9 billion, being paid out in the sixth year. Does this mean that congress expects the medical claims associated with 9/11 exposure to skyrocket in the out years?

The reaction to NIOSH’s decision, after a comprehensive literature review, to delay including cancer as a covered illness, has been predictable and unfortunate. NIOSH has come in for a shellacking from 9/11 responders and their families for failing to concede the obvious: they have been stricken with cancer and their work at Ground Zero is the reason.

But, not so fast. It is widely accepted that the resultant cancers from many occupational exposures take many years and sometimes decades to develop. NIOSH is simply doing their job by awaiting proof of 9/11 cancers to appear in medical journals and other treatment or research related documents. Criticizing them for adhering to professional standards is a little bit like the ignorant bystanders at a fire expecting firefighters to skip the supply line or SCBA so they can be quicker stretching a line: it may look good but the results could be disastrous.

All federal agencies are "political." NIOSH is part of the executive branch and they rely on Congress, part of the legislative branch, to provide them with funding. And, of course, depending on who is in the White House, the policy of these federal agencies can swing significantly, as it should. Having said (all of) that, NIOSH is consistently and appropriately dedicated to protecting the health of America’s workers regardless of who is in the WH or in the majority on the Hill. Their agenda is to make the workplace, wherever it may be, as safe as it can be made given constraints.

If cancer is a consequence of 9/11 duty, the studies will soon clearly show it and we can be sure that NIOSH will respond accordingly. Now is not the time to undermine the federal agency most dedicated to worker safety generally, and firefighter safety, specifically.

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