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Tuesday 25th October 2016

Dust victims left off 9/11 list

24th October 2006

23052006_americanflag1.jpgThe New York City medical examiner’s office has refused to put on its official list of 9/11 victims a lawyer who died of a rare lung disease five months after fleeing from the dust cloud generated by the collapse of the twin towers.

Officials say that by their standards there was insufficient medical evidence to link her death to the dust.

In 2004, Kenneth Feinberg, special master of the federal September 11 Victim Compensation Fund, awarded $2.6 million to the family of a downtown office worker who died from a rare lung disease five months after fleeing from the dust cloud released when the twin towers fell.

That decision made the worker, Felicia Dunn-Jones, a 42-year-old lawyer, the first official fatality of the dust, and one of only two deaths to be formally linked to the toxic air at ground zero.

Mrs Dunn-Jones’s case shows how difficult it can be to prove a causal connection with any scientific certainty - and how even government agencies can disagree. With thousands of people now seeking compensation and treatment for dust exposure, the debate about the relationship between the toxic particles and disease will be a central issue in the flood of September 11-related lawsuits. Health experts are starting to document the connections, but any firm conclusion is still years away.

In legal cases, "a reasonable degree of medical certainty" is considered the gold standard in making a causal connection. 

A federal judge cleared the way for thousands of workers’ lawsuits to go to trial. When the cases are heard, any proof that does not meet that legal standard is likely to be challenged.

It can take decades to approach any degree of certainty. For instance, only after years of observation did doctors agree that there was a strong link between asbestos and diseases like asbestosis and mesothelioma.

Nearly every ground zero study shows that workers and residents exposed to the dust in the hours after the collapse have suffered the worst health problems. The consistency in that data has helped doctors monitor and treat people since September 11.

Mrs Dunn-Jones, a dynamic civil rights lawyer with the United States Department of Education, was swallowed by a whirling dust plume filled with asbestos, benzene, dioxin and other hazards when the first tower fell. All she could do was cover her nose and mouth as she fled from her office one block north of the World Trade Center. Her official death certificate said she died of sarcoidosis.

Dr David Prezant, deputy chief medical officer of the New York Fire Department was one of two experts who testified at a hearing conducted by Mr. Feinberg. In the first four years after 9/11, he found 20 cases of sarcoidosis in the Fire Department, a rate of 80 per 100,000 in the first year (with treatment, all are now stable), compared with a national rate of fewer than 6 per 100,000, according to the American Thoracic Society.

The other expert was Dr Alan Fein, a clinical professor of medicine at the New York University School of Medicine. He, too, was skeptical at first, but he said he changed his mind after reviewing Mrs. Dunn-Jones’s medical record, including the autopsy report.

In the effort to collect definitive data, Dr John Howard, the federal government’s 9/11 health coordinator, circulated a draft set of autopsy protocols that directs pathologists to use a standard of proof that establishes both biological plausibility and unequivocal evidence of a causal connection to the dust. But doctors and elected officials have said those standards are so restrictive that almost no death could be linked to the dust for years to come.

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