New York • Call it compassionate, even political. But … scientific? Several experts say there's no hard evidence to support the federal government's declaration this month that 50 kinds of cancer could be caused by exposure to World Trade Center dust.
The decision could help hundreds of people get payouts from a multibillion-dollar World Trade Center health fund to repay those ailing after they breathed in toxic dust created by the collapsing twin towers on Sept. 11, 2001.
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Scientific concerns:
Only a few of the 17 people on the advisory panel are experts at tracking cancer and weighing causal risks; they were outnumbered by occupational physicians and advocates for Sept. 11 rescue and cleanup workers.
Exposure to a cancer-causing agent doesn't necessarily mean someone will develop cancer. And if they do, conventional medical wisdom says it generally takes decades. But the panel agreed to cover those diagnosed with cancer within just a few years of the disaster.
The panel members favored adding cancers if there was any argument to include them. They added thyroid cancer because a study found a higher-than-expected number of cases in firefighters who responded to 9/11, even though thyroid cancer is generally linked to genetics or high doses of radiation. The same study found a lower-than-expected number of lung cancers, but it was added because it was considered a plausible consequence of inhaling toxins at the site.
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But scientists say there is little research to prove that exposure to the toxic dust plume caused even one kind of cancer. And many acknowledge the payouts to cancer patients could take money away from those suffering from illnesses more definitively linked to Sept. 11, like asthma and some types of lung disease.
“To imagine that there is strong evidence about any cancer resulting from 9/11 is naive in the extreme,” said Donald Berry, a biostatistics professor at the University of Texas MD Anderson Cancer Center in Houston.
Yet this month, John Howard, who heads the federal agency that researches workplace illnesses, added scores of common and rare cancers to a list that had previously included just 12 ailments caused by dust exposure.
Lung, skin, breast and thyroid cancer were among those added; of the most common types of cancer, only prostate cancer was excluded.
“We recognize how personal the issue of cancer and all of the health conditions related to the World Trade Center tragedy are to 9/11 responders, survivors and their loved ones,” Howard said in a June 8 statement.
He declined requests for an interview with The Associated Press. His decision, based on an advisory panel's recommendation, will go through a public comment period and additional review before it's final.
Even lawyers for the first responders were stunned: They had expected to see only certain blood and respiratory cancers put on the list.
“I understand the urge to want to compensate and reward the heroes and victims of that tragedy,” said Alfred Neugut, a Columbia University oncologist and epidemiologist. But “if we're using medical compensation as the means to that, then we should be scientifically rigorous about it.”
When the twin towers collapsed, much of lower Manhattan was enveloped in a dense cloud of pulverized glass and cement that left people in the area gasping for air. Fires smoldered in the rubble pile for weeks. Many workers labored in the ash wearing only flimsy paper masks, and went home coughing up black phlegm. Years later, some were still experiencing mild respiratory problems.
After Sept. 11, the government established the Victim Compensation Fund, which paid out about $7 billion for the nearly 3,000 deaths from the attacks and for injuries, including some rescuers with lung problems.
In late 2010, Congress set up two programs for anyone exposed to the rubble, smoke and dust at ground zero: rescue and cleanup workers and others who worked or lived in the area. Cancer was initially excluded, but Congress ordered periodic reviews based on the latest scientific evidence.
One $1.55 billion program is for treatment for any illness determined to be related to ground zero. The second $2.78 billion fund is to compensate people who suffered economic losses or a diminished quality of life because of their illness. Both programs expire in 2016, but could be extended.
How many people might apply isn't clear. In the decade since the attacks, about 60,000 people have enrolled in the two health programs for those who lived or worked within the disaster zone of lower Manhattan. Many have signed up for medical monitoring, but around 16,000 have been getting treatment annually.
Every new illness added to the list means less money for the group as a whole, especially when dealing with major diseases like cancer, acknowledged Sheila Birnbaum, the special master handling applications to the compensation fund.
Registration for the compensation program only began in October. How the money will be divvied up, or whether it will be enough, isn't clear, Birnbaum said. People with the gravest health problems would get the largest amounts, with cancer payments likely among the most sizable.
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