Will Zadroga Act Cover Cancer?

That's the multibillion dollar question being asked after a report released by Dr. John Howard, the director of the National Institute for Occupational Safety and Health, found no connection between exposures at Ground Zero and any multitude of cancers that Ground Zero responders believe to be caused by that exposure.

But the report, released by Dr. John Howard, the director of the National Institute for Occupational Safety and Health, said that there was very little evidence to go on, as there have only been 18 published research studies on the attack that even mentioned cancer, and only five of those were peer-reviewed. The results of the peer-reviewed studies were mixed.

Even if it appeared that the events of 9/11 caused cancer in certain people, it would be hard to prove because cancer is widespread in the general population. In the United States, the probability that a person will develop cancer over a lifetime is one in two for men and one in three for women, the report said.

“Drawing causal inferences about exposures resulting from the Sept. 11, 2001, terrorist attacks and the observation of cancer cases in responders and survivors is especially challenging since cancer is not a rare disease,” the report said.

The report was required by the James Zadroga 9/11 Health and Compensation Act, which took effect on Jan. 2; it provides $4.3 billion over the next five years to monitor, treat and compensate people who were exposed to the fumes and dust.

The act provides treatment and compensation for a specific list of illnesses, mainly asthma and other respiratory diseases. As part of a political compromise needed to pass the bill, cancer was not included. A provision of the law, however, specified that the administrator of the National Institute for Occupational Safety and Health would periodically review the evidence to determine whether cancer, which could be one of the most expensive illnesses to treat and compensate for, should be added to the list.

This goes to basic epidemiology. Scientists have to look at the specific incidence of a given disease and determine whether there is an increased rate. Then, they have to see whether there's more than a casual connection with exposure at Ground Zero.

The NIOSH will periodically review the findings, but it will take further studies to show that there's an actual cancer link between 9/11 and the responders' incidence of cancer. So, while a link hasn't been shown to date, this doesn't mean that within the next several years that the link wont be proven.

All this is cold comfort to those who are suffering from cancers they believe were the result of service at Ground Zero following the 9/11 attacks, and who believed that they would be covered by the Zadroga Act.

Dr. Howard may be the official responsible for not including cancers among the compensated illnesses, but that doesn't mean that other doctors treating Ground Zero responders aren't finding a connection.

Dr. Philip J. Landrigan, head of a 9/11 treatment, monitoring and research program at Mount Sinai Medical Center, said Tuesday that the possibility of cancer in the responders increases as time goes by. Mount Sinai, he said, is tracking the rates of 60 different cancers, and will be feeding that information to the federal government.

Dr. Landrigan said his researchers were looking especially hard at multiple myeloma, because they had already found eight cases — an unusually high number — in responders younger than 45. Usually, he said, myeloma is found in people who are older.

Landrigan and his fellow doctors have to publish their findings and get others to confirm those findings, before it can be added.