Statement of Mr. Frieden, Feb. 11, 2002

TESTIMONY

Thomas R. Frieden, M.D., M.P.H.

Commissioner

New York City Department of Health

and

Joel A. Miele Sr., P.E.

Commissioner

New York City Department of Environmental Protection

before the

U. S. Senate Committee on Environment and Public Works

Subcommittee on Clean Air, Wetlands, and Climate Change

9:30 a.m., Monday, February 11, 2002

Alexander Hamilton U. S. Customs House

New York City

Good morning. I am Dr. Thomas Frieden, Commissioner of Health for New York City. With me today is Commissioner Joel Miele of the New York City Department of Environmental Protection. We appreciate having the opportunity to be here today. I am very pleased that the Committee is holding these hearings. This is a complex and highly technical subject, and we would like to take this opportunity to explain how the situation is being monitored and let you know our views on the implications of these findings.

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 degree of teamwork among more than a dozen agencies is probably unprecedented. For the first several weeks after September 11^th,health and environmental agencies met daily to discuss environmental health issues. These meetings and conference calls continued three times a week through the end of 2001. Weekly conference calls continue.

I. Department of Health Role:

Following the attack on the World Trade Center, the New York City Health Department had a multifaceted role in overseeing and coordinating many health-related issues. Immediately after the attacks, the Health Department established surveillance systems to (1) monitor emergency departments in the immediate area to assess acute injuries among victims, (2) assess hospital staffing and equipment needs citywide, (3) monitor illness and injuries among rescue workers at the World Trade Center site, and (4) detect unusual disease syndromes that might represent a bioterrorist event at emergency rooms throughout the city.

Other responsibilities included monitoring 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 regarding issues of public health concern related to the attack. The Department also facilitated development and coordination of environmental sampling plans and results.

Many individuals were exposed to large amounts of smoke, dust, and airborne substances during and after the initial collapse of the World Trade Center buildings. The potential release of contaminants, including asbestos, particulate matter, volatile organic compounds, dioxins, PCBs, metals and other substances during and after the explosion was a primary public health concern from the very beginning, and air monitoring was established immediately, and continued over time. The Health Department closely reviewed, and continues to review, the numerous air quality, debris sample results 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 have serious health effects. Asbestos was one of the substances of greatest concern since it was a known building component in the World Trade Center. However, except for a few transient spikes found in air sampling during the initial weeks, the asbestos levels have been within standards.

An indoor study conducted by Department of Health and the federal Agency for Toxic Substances and Disease Registry (ATSDR) of both air and dust samples taken in November and December of 2001 at thirty residential buildings in lower Manhattan showed no elevated levels of asbestos in the air. Dust sample tests showed low levels of asbestos in some samples and the presence of 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 there are no known long-term effects of fiberglass, it is classified as a possible carcinogen. While these findings are not unexpected, they underscore the importance of properly cleaning surfaces to minimize exposure. DOH has issued advisories to building owners and residents about appropriate cleaning methods. DOH has issued advisories for residents about appropriate cleaning methods.

The standards used are very conservative. For example, for asbestos, we are using the indoor air quality standard for reentry into a school after asbestos removal. This stringent standard is being applied to outdoor air quality in the residential areas. Stringent standards are also being used for other substances, such as dioxins, identified at the perimeter of the site. It is both duration of exposure and concentration of the substance that are important to determine health effects. Many of the standards were based on exposures for prolonged periods of time. This is a key point. Some substances may cause short-term effects; others have the potential to cause long-term impact. In some instances, the health effects of exposures are not known. Standards for other substances have been designed to include many safety factors so that acceptable levels of exposure are far below the levels at which health effects are expected to occur.

Many residents living and working in the community have reported short-term health effects, such as acute breathing problems; worsening of existing respiratory disease such as asthma; eye, nose, and throat irritation; nausea, and headaches. Many residents also continue to experience emotional and stress-related illness and anxiety.

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

DOH has also been working with the U.S. Centers for Disease Control and Prevention to develop a protocol for a World Trade Center Registry, which, if funded, would generate and maintain a database that can be used as a basis for conducting studies that can provide a more complete picture of short- and long-term health and mental health impacts among affected populations.

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 results are available. Together with the City Department of Mental Health, which is also under my jurisdiction, we are addressing resident’s 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 11^th. Since 1985, DEP has been the New York City agency with responsibility for regulating asbestos abatement. Starting September 12^th,, 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 11^th, 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 website: 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 Ground Zero. As Commissioner Frieden noted, 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 12^th, 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:

ü assess the building’s structural strength and stability using qualified professionals;

ü restore gas and electrical service;

ü restore building water service, including flushing, re-filling and cleaning roof tanks where necessary;

ü assess the presence of hazardous materials such as asbestos, and remediate as required under applicable City regulations using qualified professionals; and

ü 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:

ü developed and distributed advisories to building owners and occupants;

ü established HELP lines for concerned owners or tenants to respond to complaints or concerns about proper abatement procedures for contractors;

ü provided telephone consultation to building owners, contractors, consultants and tenants related to asbestos clean-up;

ü performed site inspections and conducted building surveys;

ü reviewed sampling data submitted by building owners, their contractors and consultants;

ü reviewed the scopes of work for clean-up of asbestos-containing material; and,

ü 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.