Testimony
	New York City Department of Health Office of Public Affairs

Good morning. I am Dr. Thomas Frieden, Commissioner of Health for New York City. With me is Commissioner Joel Miele of the New York City Department of Environmental Protection. We appreciate the opportunity to be here today.

As I have reviewed the record of activities of DOH and other agencies since the first day of the disaster, one of the most vivid pictures to emerge, and one that I find quite extraordinary, is the tremendous cooperation and coordination among federal, state and local environmental, occupational and health agencies. The teamwork among more than a dozen agencies is probably unprecedented. For the first several weeks after September 11th, health and environmental agencies met daily; close collaboration continues.

I. The Role of the NYC Health Department:

Following the attack, the New York City Health Department had a multifaceted role. The Health Department immediately established systems to monitor, first, emergency departments in the immediate area to assess acute injuries; second, hospital staffing and equipment needs citywide; third, illness and injuries among rescue workers; and fourth, unusual disease syndromes that might represent a bioterrorist event.

Other responsibilities included ensuring water and food safety in the immediate area, conducting rodent and vector control, initiating a worker safety program, and providing regular advisories to the public and the medical community. The Department also facilitated development and coordination of environmental sampling.

Many individuals were exposed to large amounts of smoke, dust, and airborne substances. The potential release of contaminants during and after the collapse was a primary public health concern from the beginning, and air monitoring was established immediately, and still continues. The Health Department reviews the numerous air quality, debris sample, and personal air monitoring tests being conducted by various agencies. The data from air quality tests thus far have been, in general, reassuring. None of the testing done to date has shown results that would indicate long-term health impacts.

The numerous substances of potential concern have led to some confusion about health effects over the short and long term. Some substances, such as the particulate matter from the dust or the smoke in the air, can be irritating but are not expected to have long-term effects. Other substances, such as asbestos, are not expected to have short-term effects, but if elevated over long periods of time can cause serious health problems. Asbestos was a known building component in the WTC. Fortunately, except for a few transient spikes found in outdoor air sampling, asbestos levels have been low and within standards.

The Department of Health and the federal Agency for Toxic Substances and Disease Registry (ATSDR) conducted a study of both air and dust samples taken in November and December of 2001 at thirty residential buildings in lower Manhattan. This study showed no elevated levels of asbestos in indoor air. Dust sample tests showed low levels of asbestos in some samples and fiberglass in some other dust samples. Asbestos and fiberglass can be a problem if they become airborne. Airborne fiberglass can cause cough and skin, throat and eye irritation. While these findings are not unexpected, they underscore the importance of proper cleaning to minimize exposure, as DOH has repeatedly emphasized.

The standards used are conservative. For example, for asbestos in outdoor air, we are using the indoor air quality standard for reentry into a school after asbestos removal. Stringent standards are also being used for other substances in outdoor air, such as dioxins, identified at the perimeter of the site. Both duration of exposure and concentration of the substance are important to determine health effects. Many standards were based on exposures for prolonged periods of time. The long-term health risks associated with short-term exposures are not well documented but are generally believed to be quite low.

As fires at the WTC site burned far longer than anticipated, many residents living and working in the community have reported short-term health effects, such as acute breathing problems; worsening of asthma; eye, nose, and throat irritation; nausea, and headaches. Many residents also continue to experience significant psychological and stress-related illness and anxiety.

Students of Stuyvesant High School, who returned to their school on October 9, 2001, reported similar complaints. A DOH analysis shows that the average daily rate of headaches, respiratory, skin, eye, throat, and injury complaints of Stuyvesant was higher than in the previous year, and higher than four other NYC public high schools. The data also show that complaints decreased from October to November, 2001. We will continue to monitor this situation.

DOH has also been working with the U.S. Centers for Disease Control and Prevention to develop a protocol for a WTC Registry. Since September 11, we have all had to live in a world of greater uncertainty. While we know the air meets safety standards today, we cannot state unequivocally that there will be no long-term physical health effects of exposures on or around 9/11. For that reason, rapid funding and implementation of the Registry is particularly important. The Registry would enable scientists to evaluate long-term health effects as objectively and comprehensively as possible. But with every day that passes, implementation of a Registry becomes more difficult. We therefore urge our colleagues in Washington to avoid any further delay in the support of this important project.

The City Health Department recognizes residents' concerns and will continue to work closely with local, state and federal agencies to monitor air quality and to inform the public of findings as soon as they are available. Together with the City Department of Mental Health, which is also under my jurisdiction, we are addressing residents' mental health concerns by promoting the ongoing Project Liberty program, a statewide disaster-recovery initiative that offers free crisis counseling, education and referral services. DOH will continue its community outreach and education efforts. Now I would like to turn to Commissioner Miele to discuss DEP's role in our joint efforts.

II. The role of the Department of Environmental Protection

In addition to DEP's operation of the City's sewer and water systems, our expertise in regulating asbestos in New York City was a significant portion of our responsibilities following September 11th. Since 1985, DEP has been the New York City agency with responsibility for regulating asbestos abatement. Starting September 12th,, DEP operated a network of outdoor air monitors that have been used for monitoring outdoor asbestos levels. Aside from repairing water and sewer infrastructure, assessing and mitigating risks caused by the presence of asbestos-containing material has dominated DEP's work in responding to the Trade Center attack.

Since September 11th, DEP or its contractors analyzed 3060 samples from 37 outdoor monitoring sites in lower Manhattan; 500 samples collected adjacent to the four schools in the vicinity of the Trade Center; and 328 samples taken in the four boroughs of the City outside of Manhattan. The map and all sampling results to date from the sites shown on this map are available to anyone on DEP's Web site: www.nyc.gov/dep. Of these samples, only 9 of the total of 3864, or 0.2%, exceeded the federal re-occupancy standard for indoor air. These 9 samples were all taken in the vicinity of the Trade Center site. There is no established standard for asbestos in outdoor air. Unlike carbon monoxide, nitrogen oxides and other gases whose presence in outside air is regulated under the Clean Air Act, asbestos is a once-prevalent building material, and previous work at standard-setting has focused on establishing safe levels for asbestos within buildings. On September 12th, when my colleagues and I were creating our monitoring networks, we knew that there were no reliable, scientifically-based, acceptable standards that would tell us what level of asbestos in outdoor air might be considered "safe" or "unsafe." Therefore, we opted to use EPA's indoor post abatement re-occupancy of schools standard as our threshold level of concern since we felt it was more protective.

Let me briefly explain our sampling methodology. The samples are collected on filters and examined under PCM (Phase Contrast Microscopy) utilizing a specific method developed by the National Institutes for Occupational Safety and Health. The PCM analysis counts all fibrous particles, including asbestos. PCM sample results are compared to the clearance/re-occupancy standard for indoor air following an asbestos abatement project. This standard is 0.01 fibers per cubic centimeter. Samples found to be above this standard are re-examined using TEM (Transmission Electron Microscopy). The TEM analysis identifies the type of particles collected. TEM results are compared to the clearance/re-occupancy standard for indoor air in schools after an asbestos abatement project. This standard is 70 structures of asbestos per square millimeter. The standard was established pursuant to the federal "Asbestos Hazard and Emergency Response Act", usually known as "AHERA".

Based on all federal, state and local test results, public health experts have consistently expressed confidence that, based on sampling, airborne asbestos levels do not pose a threat to human health. Health professionals have stated that short-term exposure to airborne asbestos, at levels equal to or lower than 0.01, carries an extremely low risk of causing asbestos-related illness.

Before allowing occupants in any residential or commercial building near the Trade Center site, the City's various agencies, acting through its Office of Emergency Management, required building owners to take these steps:

• assess the building's structural strength and stability using qualified professionals;
• restore gas and electrical service;
• restore building water service, including flushing, re-filling and cleaning roof tanks where necessary;
• assess the presence of hazardous materials such as asbestos, and remediate as required under applicable City regulations using qualified professionals; and
• inspect, clean and repair mechanical and HVAC systems.

While property owners were accomplishing these tasks, DEP and its sister agencies, again acting through the Office of Emergency Management, assumed responsibility for cleaning streets, sidewalks and common areas so that there was a safe outdoor environment to reach the buildings for contractors and workers who were retained by owners and managers to effect all necessary exterior and interior cleanup of private buildings . To assist property owners, DEP engaged in the following tasks, among others:

• developed and distributed advisories to building owners and occupants;
• established HELP lines for concerned owners or tenants to respond to complaints or concerns about proper abatement procedures for contractors;
• provided telephone consultation to building owners, contractors, consultants and tenants related to asbestos clean-up;
• performed site inspections and conducted building surveys
• reviewed sampling data submitted by building owners, their contractors and consultants;
• reviewed the scopes of work for clean-up of asbestos-containing material; and,
• developed emergency certification procedures and offered daily certification exams to ensure a properly trained and qualified work force was available.

Although city, state and federal agencies have provided oversight and guidance on interior clean-up, that task remains the responsibility of building owners and occupants. For example, some building owners identified the presence of asbestos-containing material (ACM) during their assessment for hazardous materials in areas of the buildings under their control. Once material is identified as ACM, New York City rules require that a licensed contractor with certified asbestos workers perform the clean-up activities. As noted above, DEP technical staff has been continuously available to assist in the development of plans for handling asbestos clean-up activities. At the completion of the clean up activities, the City's regulations require clearance air sampling by licensed professionals prior to allowing re-occupancy of areas where asbestos work had been performed.

As general guidance to lower Manhattan residents, the Department of Health developed a fact sheet "Recommendations for People Re-Occupying Commercial Buildings and Residents Re-Entering Their Homes." This fact sheet, along with others on related topics, was distributed very widely in lower Manhattan. These fact sheets offer general information on air quality issues as well as practical, "how-to" information on dealing with dust, debris and other potentially hazardous conditions that residents face as they return to their homes.

Finally, I have a few words concerning the potable water supply and the marine waters that surround the City. Although I believe the Subcommittee's major objective is to review issues associated with air quality, I would like to take a few minutes to assure the Subcommittee that neither New York Harbor, nor the City's potable water supply were degraded by the Trade Center attack.

As a result of the attack, DEP and EPA were concerned that rainwater washing off the Trade Center site and into the sewers and the harbor could be polluted. Manhattan's sewers -- as well as most City sewers --- are combined sewers, meaning rainwater flooding into the sewers from the streets ends up in the same pipe as the sanitary flow. During a rainstorm, a percentage of this combined flow ends up at our treatment plants, and the remainder of the combined flow is discharged untreated into surrounding waters through outfalls located at the bulkheads. In the case of lower Manhattan, the combined sewers serving that area lead to a very large pumping station at East 13th St in Manhattan. From there, the sewage is pumped to Greenpoint, Brooklyn where it is treated at the Newtown Creek wastewater treatment plant.

DEP routinely samples raw sewage going into the Newtown Creek plant, as well as treated effluent coming out of Newtown Creek, several times each day. We also regularly take samples from open waters at various locations in New York Harbor, including near the Battery. DEP tests these samples for "conventional parameters," such as temperature, pH, dissolved oxygen, suspended solids and coliform. These conventional parameters have consistently remained within their normal ranges since September 11th.

Using the more sophisticated testing capabilities that EPA has at its disposal, beginning September 11th, their staff immediately began supplying us with results from tests for "unconventional parameters" on samples of run-off from the Trade Center site, harbor waters, and sewage. These unconventional parameters include PCB's, dioxin, asbestos and other organic chemicals and contaminants for which the City's harbor water quality laboratories do not routinely test. Initial runoff samples taken near Rector Street showed elevated levels of PCB's, dioxin, asbestos and metals. Follow-up samples showed concentrations of these substances below levels of concern. Samples of harbor water and samples of effluent from the Newtown Creek plant also show the presence of "unconventional parameters" at levels too low to be of concern.

Finally, let me reassure all New Yorkers that continuous sampling of the drinking water supply at the reservoirs, in the aqueducts, and within the City's distribution system have shown all parameters to be within the normal range and below any levels of concern.

Thank you Mr. Chairman and Senators for this opportunity to present testimony. We look forward to answering your questions.