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What's
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WTC Medical Monitoring: Cancer Update
| Health concerns
after the exposures at Ground Zero were raised soon after
September 11, 2001. In the immediate aftermath, full attention
was focused on caring for those hospitalized with injuries
and finding the perished. Our entire workforce worked at the
site in the days, weeks and months after this tragic day.
Initial eye irritation and pulmonary complaints began within
the first few days. Cough and respiratory complaints have
continued in many of our members since then.
Medical monitoring began in October 2001 and continued through
February 2002 with 10,166 WTC medicals done at BHS. Additional
WTC medicals were performed since for a total of 12,000. FDNY-BHS
with cooperation from FDNY, the UFA, UFOA and our EMS unions
has received federal funding to continue WTC Medical Monitoring
evaluations for both incumbents as well as retirees. These
medical evaluations will continue to track patterns of illness
and evaluate emerging medical problems. This tracking is critical
to follow both our active members and our retirees who worked
at the site for so many months.
BHS has been tracking cancer cases for several years. The
computerized medical record captures the primary diagnosis
of members. The Cancer Bill is a presumptive bill that was
passed with the efforts of the UFA and UFOA in recognition
of the exposures of FDNY UNIFORMED members in the daily activities
of firefighting. The cancer bill provides for an accidental
¾ disability pension for members retiring with a disability
caused by cancer. The bill was expanded in the last year and
now covers most kinds of cancer. Some members with the diagnosis
of cancer have also returned to full duty.
The numbers of active members with cancers are tracked by
type. This tracking will continue as active members come forward
with medical problems. Here is the latest update for our active
members (for both EMS AND FIRE), looking at patterns from
9/1999 through 9/2003.
Continued gathering of information will help determine patterns
of illness. The WTC Medical Monitoring will help us track
both active and retired members. At this point, the overall
numbers for cancer have not increased. The numbers for specific
types of cancer have varied and for nearly all types have
also not increased. However, lessons learned from prior environmental
and occupational exposures (both in the fire service and throughout
the world) have clearly shown us that the time lag between
exposure (acute or chronic) and the diagnosis of cancer is
typically 15 to 30 years. This is why continued medical monitoring
is critical if we are to provide effective early warning signs
and treatment. |
Our joint labor
management WTC Medical Monitoring program undergoes frequent
revisions to reflect the needs of our members. Whole body
scans are not effective in early cancer screening but scans
focused on specific symptoms or diseases of interest are effective.
Chest X-ray imaging was offered to every member appearing
for a WTC medical. Chest CT imaging cannot be offered to every
member due to the risk of radiation exposure but was done
for over 600 members with increased risk for disease. The
results of these tests are included in the above table. Your
participation in the WTC medical monitoring program is our
best chance to provide early detection and warning for each
individual and for FDNY (Fire and EMS).
| NUMBERS OF CANCERS DIAGNOSED:
|
| TWO YEARS PRE- & POST-WTC |
| Time Frame |
9/11/99
to
9/10/01 |
9/11/01
to
9/10/03 |
| |
Two year period |
Two year period |
| Cancer Type |
|
|
Kidney |
1 |
1 |
| Colon |
4 |
8 |
Esophagus |
1 |
0 |
| Leukemia |
3 |
2 |
Lung |
4 |
3 |
| Lymphoma |
|
|
| (Non Hodgkins) |
4 |
0 |
Lymphoma |
|
|
(Hodgkins) |
6 |
5 |
| Breast Cancer |
4 |
2 |
Prostate |
17 |
6 |
| Skin |
35 |
28 |
Testicular |
6 |
4 |
| Pancreatic |
2 |
1 |
Cervical |
1 |
1 |
| Thyroid |
1 |
3 |
Throat |
2 |
2 |
| Multiple |
|
|
| Myeloma |
0 |
0 |
Brain |
1 |
0 |
| Stomach |
1 |
0 |
Mouth |
1 |
0 |
| Parotid |
2 |
0 |
Bladder |
3 |
0 |
| Totals |
99 |
66 |
|
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Authorizations
We, at the Bureau of Health Services, remain steadfastly committed
to the health and safety of our members. Part of that commitment
toward wellness includes the authorization for treatment to qualified
professional outside medical providers. Providers who not only give
our members the utmost professional care but also understand the
rigors of firefighting and emergency medicine. We expect nothing
less of the care given to our members, care that will facilitate
healing and return them to the profession they hold so dear.
Our current policy of authorization for treatment is antiquated
at best; we understand how labor intensive the current process is
and the challenges it presents. That is why we have entered a contract
with "Imagework", a business processing company, who has worked
with us to develop a state of the art Workers Compensation application.
A brief description of how this works:
Upon interaction with the Medical Officer in either Clinic or the
Annual Medical Area, a member (patient) will be authorized for treatment.
The Medical Officer then chooses the treatment required via the
computer which will be electronically sent to the Nursing Station.
As the member reports to the Nursing Station, all demographics on
the member will be automatically completed on the electronic authorization.
The Nurse will assist the member on what provider he/she would prefer.
The medical provider and all related demographics (address, telephone
#) will also be electronically loaded. The Nurse shall then print
out a copy and give to the member to present to the provider at
their appearance. Authorizations to members of the EMS Command will
be held in abeyance and reviewed for eligibility by Captain Jay
Swithers. His office will notify the member by mail with either
an endorsement to appear for treatment (authorization will be enclosed)
or denial of treatment based on their workers compensation claim
eligibility.
This automated authorization now has an electronic 'barcode' which
assists the Workers' Compensation Unit in matching the authorization
to the bill thereby expediting claims processing.
Members will have the opportunity to voice their feedback to the
Nursing staff on the treatment they receive (positive or negative)
and it shall be duly noted; in the event our members have a less
than favorable interaction with a provider, we will have a system
in place to address the issue with the provider and work toward
a viable and accepted resolution. Providers will be reviewed periodically
for quality assurance and participation in our medical provider
network.
This automation will assist the Workers' Compensation Unit to process
claims more efficiently and expeditiously. As most of our members
already know, providers have been calling and billing them for outstanding
claims. On the fire side, Workers Compensation are self-insured,
for EMS, they are processed through the NYC Law Department. The
benefits of an automated system will satisfy all the needs and requirements
of all involved.
We ask, however, your patience as we work on the transition from
our existing procedure to our new one. We anticipate some 'bumps'
in the road until all parties at BHS become familiar with the new
process. We thank you for your continued support as we move ahead
with this initiative.
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Kids Connections Program
In September 2003, the Kids Connections program of the Counseling
Service Unit of the FDNY launched a partnership with Big Brothers
Big Sisters of NYC to serve children who lost their FDNY fathers
in the line of duty. The majority of children who are participating
in the program lost their fathers on September 11th, but any child,
age 6-17, who experienced the line-of-duty death of a parent is
eligible to participate. Through this partnership the CSU and BB
BS are recruiting current and retired FDNY members to be Big Brothers
to boys, and women affiliated with the fire department (firefighters,
EMS workers, civilian employees, wives or sisters of FDNY members)
to be Big Sisters. There are currently 29 Big/Little matches in
the program. Mentors are required to spend 8 hours per month with
the child that they are matched with, doing one-on-one activities,
for a minimum of one year. The 8 hours can be spent in whatever
way works with the schedule of the mentor and the schedule of the
family. This commitment is crucial due to the loss these children
have sustained. It is important to provide them with a stable experience
with a mentor. The emphasis is placed on building a relationship
over time, doing simple things like playing ball, going to the movies,
and whatever else the child enjoys. Mentors are discouraged from
going on extravagant outings and spending a lot of money early in
the relationship. Many mothers have said that they are just looking
for someone to throw a ball around in the backyard with their son,
something many boys have not done since the deaths of their fathers.
Kids Connections provides outings in the communities where FDNY
families reside to allow these children who lost their fathers to
meet other children and have some fun, and "Bigs" and "Littles"
are encouraged to come to these events as well.
Matches are based primarily on personality and geography. FDNY members
who are interested in volunteering fill out an application over
the phone with the CSU. They then meet with Big Brothers Big Sisters
for an interview. The interview process allows BB BS to get to know
the perspective mentor in some detail and to guide them in making
the best match. The same staff members who interview the volunteers
also interview the children who are applying for the program, so
they thoroughly get to know the people enrolling, which in turn
help them make the most appropriate matches. Once a volunteer is
accepted into the program, he or she attends a one-day training
with other FDNY volunteers at Big Brothers Big Sisters' office in
Manhattan. The training covers topics such as defining what a mentor
relationship is in comparison to other relationships, dos and don'ts,
roll plays that are specific to FDNY, childhood development, and
issues around grief and bereavement.
Once training is completed a "match meeting" is set up. This is
the meeting where the Big Brother or Sister is introduced to the
Little Brother or Sister and his or her mom. Time is spent with
the mom, and then Big and Little are encouraged to take a walk together
to start the process of getting to know each other. From that point
on, it is the Big's responsibility to call the Little and his or
her mom and set dates for outings. Bigs are required to check in
with a caseworker at BB BS once a month, either by phone or email,
to let them know how things are going with the match and to alert
them if any problems surface. Bigs are also encouraged to stay in
touch with the caseworker or CSU staff if any questions or issues
arise at any time.
Anyone who is interested in volunteering for the FDNY Big Brothers
Big Sisters program should call Kim Ahearn in the CSU at (212) 570-1693
x 323.
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| Dr. Kerry Kelly
Chief Medical Officer |
Dr. David Prezant
Deputy Chief Medical Officer |
Malachy Corrigan
Director, FDNY CSU |
Mary T. McLaughlin
Director, FDNY BHS |
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