| Title Page Previous Contents | Part 4. Lessons Learned |
Part 4.
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sk environmental health experts and local health
officials about how they performed on September 11, and you’re likely to get
the same response: People responded admirably, especially given the unexpected
and unprecedented nature of the attack.
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Sept 15, 2001 - The sun streams through the dust over the WTC wreckage. |
Former EPA administrator Christie Whitman testified
proudly in Senate hearings that “EPA accomplished a remarkable achievement to
three national [terrorist] incidents during the same time period,” referring to
the response at the World Trade Center, the Pentagon and the
anthrax-contaminated buildings at various locations.
“It’s so
easy to be critical in hindsight when everybody was out there and their brother
and they were really working hard,” says Jessica Leighton, assistant commissioner
for environmental disease prevention at the New York City Department of Health.
“At Ground Zero, heroism was in ample supply” among the safety experts who traveled down to rescue the “brave band of rescuers.”
“What we did at the Pentagon was
the way it should be; there was a real success here at the Pentagon and we want
everyone to know,” says Mark Penn, head of OEM for Arlington County, VA.
The highest praise goes to those
who supplemented the government’s efforts.
“At Ground Zero, heroism was in ample supply” among
those like Bruce Lippy and Don Carson for the International Union of Operating
Engineers, wrote Rep. Nick Rahall (D-W.Va.) of the safety experts who traveled
down to rescue the “brave band of rescuers in New York City are endangered by
asbestos, dust, and noxious vapors.” According to Rahall, “They are American
patriots.”
When asked what, in hindsight, they might have done
differently, however, many officials and experts have a long list of
suggestions.
It’s clear that there have been many more
ramifications in New York than in Washington, so in many ways, one can’t
compare the situation in New York and Washington, D.C. because the nature and
scale of their crises were so different. Nevertheless there are some points on
which they may be compared. In both cases, there were a lot number of surviving
victims needing medical care, but in both cases, there were plenty of physical
damage, infrastructure disruptions and environmental hazards needing attention,
from hazardous materials monitoring to decontamination.
But critics of those charged with enforcing
occupational safety and health standards in New York don’t mince their words:
“First responders, and many unequipped workers like those in construction went
in to do heroes’ work and became martyrs instead,” says Joel Shufro, executive director of The
New York Committee for Occupational Safety and Health (NYCOSH), a coalition of
unions and health professionals.
“Where we see a real need is to understand incident
command, chain of command, so that all the things like protecting disaster
responders, can get done,” says Joseph (Chip) Hughes of NIEHS’ Worker Education
and Training Program (WETP).
Almost all those polled agree one of the biggest
areas to improve is risk communication, how public officials communicate
hazards to the public. New York City Health Department’s Kelly McKinney admits
that the real lesson for his department was for officials to communicate what
they know “every day and all day long.” He adds, “If it is a hazard, be clear
about what you know and don’t know – and where the uncertainty lies.”
“The public is a little bit smarter and could have
understood more complexity.”
“EPA
came out way too early about the safety of the site,” says Alison Geyh of Johns
Hopkins. “The public is a little bit smarter and could have understood more
complexity.”
Paul
Lioy criticizes the agencies for letting people come back to Lower Manhattan
prematurely. “People came back but they never should not have been allowed to
be back,” says Lioy, “No one should have been back at work. Children should
definitely have not been back in school.” This was a chaotic time, but there
was no basis, he says, for the city and federal government to state that the
environment was safe to reinhabit.
Environmental health professionals feel they made a positive difference
in many areas. “We were very lucky to have be prepared with incident command,
urban search and rescue, medical and occupational response, and quick federal
response in ruling out a bio-terrorist attack,” says Arlington County’s Mark
Penn.
Despite the problems in pinpointing air pollutants at Ground Zero,
there were many words of praise for those who worked hard to get data under
pressure and to be responsive to the needs of agencies. Bruce Lippy praises
Leighton of DOH because “She did a really nice job of getting hundreds of air
samples and reviewing them.
“Agencies without having a plan did a terrific job,” says Alison Geyh.
“Three times a week people on the AQ issue spent an hour on the phone making
sure everyone was aware of what they were doing; “It was a huge time commitment
on the part of Region II EPA, NY State Department of Environmental
Conservation, NYC DOH and others. Kelly McKinney did a fantastic job, running
on overdrive and fumes. He was good at keeping things on track.”
Public health officials say that public health system worked well under
such high pressure.” The bottom lines was that 100,000 medical charts were
surveilled and that went on through November,” Ron Burger of CDC. And scholars
agree.
Amazingly, New York City was able to “weather this episode” despite the
fact the state’s disaster plan had not been updated since the early 1990s, and,
according to New York State Assemblymember from Manhattan Richard Gottfried,
the plan “did not function” during the crisis, David Rosner and Gerald Markowitz point out,
in their report on September 11th.
“The
episode reveals the enormous resources available in New York, and that the
institutions themselves were able to implement emergency protocols quickly and
efficiently, despite the chaos of the moment and the lack of clarity as to the
true extent or nature of the disaster,” they wrote. (1)
Where did safety succeed best?
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EPA
and city sanitation got much of the dust off the streets in the first days of
the crisis, says Captain Terrance Revella of the New York State Department of
Environmental Conservation. That greatly reduced the city populations’
exposures to the dust.
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Although
the city, specifically those designated agencies such as the Department of
Design and Construction, can be faulted for failing to enforce worker
protections, there were no fatalities at the site.
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The
Coast Guard’s able evacuation of people from Lower Manhattan spared people’s
health as well as their lives.
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EPA monitored the air for pollutants. |
Despite the many successes, however, by the agencies’ own estimations,
they were stressed beyond their limits.
EPA feels its responders were able to carry out their mission to
protect human health and the environment. “Their response, though successful,
was hampered by the unprecedented demand on Agency’s emergency response
resources and by limitations posed by EPA’s still developing capacity to
respond to terrorist events.”
Having so many air samples to run from so many agencies at one time
stressed EPA to its limit. According to EPA, it was seriously tested by having
to coordinate air samples being run by 13 different agencies, had to reconcile
numerous different sampling protocols. It didn’t have enough facilities and
equipment to quickly analyze samples given the volume of data; “The volume of
samples requiring quick laboratory analysis greatly exceeded the Regions’
capabilities” and they couldn’t get access to other national labs. (2)
Others would be far less charitable in their assessments. “The heroes were the police and firefighters
who got people out of the buildings,” says Mt. Sinai’s Philip Landrigan.
If a terrorist incident without chemical, nuclear or bioterrorism could
so strain the system, what would happen in the event of a highly
environmentally hazardous event? EPA says: in its leaked report, “EPA’s mission
was to protect front-line responders from dust and contaminants released when
commercial aircraft were deliberately crashed. Although the Attacks did not
contain weapons of mass destruction (WMD), the results were a series of
disasters on a scale greater than EPA had ever encountered during emergency
response.” (2)
Since there’s like to be some sort of environmental contamination in
future attacks, local agencies need to be prepared to deal with the kinds of
issues to surfaced in New York – indoor contamination and removal, assessment
of risks to vulnerable populations.
And, experts point out, all sorts of future environmental disasters,
from earthquakes in urban areas, to tornadoes, fires and hurricanes, could
involve a complex building collapse.
Critics also some major policy failures: No agency enforced proper
respiratory protection for workers; no agency took charge of the environmental
health piece of the 9/11; and no agency focused on indoor cleanup, and, in
fact, according to critics like Congressman Jerrold Nadler, tried to evade it.
If EPA has authority under
the National Contingency Plan to control the release of hazardous substances it
should be ready to address complex building fires in the future.
Some blame the insufficient awareness of the risks and hazards on
political factors like the rush for normalcy and to get financial district back
running; lack of good sampling in the first days due to factors beyond their
control, like no electricity and not being prepared, and the anthrax crisis
coming on its heels; too much focus on asbestos to the exclusion of other
toxicants; and too much focus on physical hazards of cleanup and not enough on
environmental health.
September 11th, of course, has made the idea of unthinkable
environmental disasters involving hazardous chemicals or nuclear byproducts far
more imaginable but that has done little to slow their commercial production or
encourage their being more strictly regulated. Certainly, the focus on
terrorism has permanently changed the terms of the environmental debate in some
respects: After 9/11 politicians began to view environmental hazards as
security threats too.
At first, the political winds favored regulating toxic chemicals at
chemical plants more strongly. Environmentalists in the past used to play down
the terror threats of chemicals because industry would complain “Greenpeace was
courting attacks by spotlighting potential hazards,” wrote Wall Street
Journal reporters Jacob. M. Schlesinger and Thaddeus Herrick. “But soon
after the Sept. 11 attacks, the activists made terrorism the new centerpiece of
their old crusade. That fall, Rena Steinzor of the Natural Resources Defense
Council told Congress: "Human error ... killed several thousand people in
Bhopal. What price will we pay for deliberate sabotage at such a
facility?" (3)
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New York, NY—March 15, 2002 Photo: Larry Lerner/FEMA News
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Have we learned anything in the two years’ worth of lessons?
Environmental professionals cite a litany of lessons, as well as their
recommendations for the future:
(1)
Call a hazard a hazard.
Be ready to protect the public
against all environmental risks by giving them ample warning. “It’s very clear that the government may
have gone too far in reassuring people,” says Kenneth Olden of the NIEHS.
“People are still suffering. And there well be long-term consequences to the
public [from the hazards at the disaster site of the former World Trade
Center.]”
Recommendation: Public officials need to be open
about risks and hazards to the public, and agencies should not try to downplay
those hazards.
(2)
If it is a health emergency—as well as a disaster--treat it that way.
Be clear about what kind of event it is.
Critics say EPA could have done
more to protect residents from the pollutants coming off the Ground Zero site,
by warning them, or making efforts to restrict them from hazards.
Air pollution expert Thomas Cahill
of the University of California at Davis, and Marjorie Clarke, hazardous waste
expert at Lehman College fault the agencies for not coming up with a way to
keep unprotected populations away while the “pile” was burning like an
uncontrolled incinerator.
If EPA has authority under the
National Contingency Plan to control the release of hazardous substances it
should be ready to address complex building fires in the future.
Define the perimeters of
environmental contamination. There should have been systematic testing of dust
and debris in different gradients from the epicenter of Ground Zero, to know
the level of hazard to the public, suggests Dr. Stephen Levin of Mt. Sinai
Hospital. “Instead, the city set an arbitrary line at Canal Street,” says
Levin. “But that is a political, not a medical or scientific boundary.”
Recommendations: Data is critical in managing
emergencies. Investments should be made in making sure that adequate
environmental data is available.
(3) Clear Chain of command to protect health and
safety.
The authority for the Ground Zero
site changed many times, and it was unclear which agency was in charge of which
functions. Occupational health protections suffered, and some environmental
health questions fell through the cracks – such as protecting residents from
hazardous indoor dust.
Critics suggested that there ought
to have been a lead agency for environmental health, to coordinate among the
various other agencies. (Lioy; NRDC; Jerrold Nadler’s Ground Zero Task Force)
Had there been such an agency at
Ground Zero, this would have made sure respiratory protection was emphasized
from day one. “The way it was at Ground Zero, we couldn’t throw workers off the
site if they didn’t comply,” says EPA’s Steve Touw.
“There ought to be solid interagency
agreements worked out beforehand to insure good coordination,” says Paul Lioy,
“and perhaps under the Department of Homeland Security there can be much better
pre-planning and coordination.
Recommendations: Need for effective pre-planning,
coordination, and (most important) enforcement mechanisms to insure standards
are enforced.
(4) Open communication with the public.
“I don't think we understood at
the time the magnitude of the risk communication challenges we faced,” says New
York City DOH’s Kelly McKinney.
However critics say that the
public shouldn’t be kept in the dark about real or potential environmental
hazards. Public officials should not make reassuring statements before they
have the information. “EPA came out way
too early about the safety of the World Trade Center site,” say critics like
scientist Alison Geyh.
At the same time, federal agencies
shouldn’t withhold data, as some charge the EPA did under the guise of
“national security” in fighting terrorism. The EPA’s OIG report states that the
agency never suppressed any data it could have made available to the public.
However it is clear that many scientists and nonprofit groups had to file
Freedom of Information Act requests to get information because the agency
wasn’t forthcoming with its data. “We had trouble getting clearance to put data
up on the web and had to clear it through the White House counsel for national
security reasons,” says EPA’s Steve Touw. “Yet we had nothing to hide; it was
just one or two people in the White House trying to keep it close to the vest.”
Nor should
‘terrorism’ be used as an excuse to hold back information, as it has been in
some instances—an issue raised by journalists. For
example, the Society of Environmental Journalists, on behalf of its 1200
members, signed a letter to Secretary Tom Ridge at the Department of Homeland
Security, along with other organizations also representing scientists,
librarians, privacy advocates and others, calling on it to allow public input
on procedures for "safeguarding" and sharing a vaguely defined set of
information between firefighters, police officers, public health researchers,
and federal, state and local governments. In a news release, they wrote,
"Under the auspices of fighting terrorism, the Department is poised to
write — without guarantees for public input — procedures that could sweep up
otherwise publicly available information that has nothing to do with terrorism
into a zone of secrecy while subjecting millions of Americans to
confidentiality agreements."
Disaster experts, instead,
emphasize that officials should enlist the public’s help. They stress that it
is important to have the public trust so that it can be depended upon to help
in a crisis, by, for example, stopping cell phone use so as not to deter the
transmission of emergency information.
Recommendation: “Make data available as soon as
possible, with a registry of samples.”
(5) Better training and preparedness
Fire departments are not used to
respirators needed for hazardous events unless they’ve been trained. Some first
responders don’t fall into current “environmental health” training and went
into the WTC disaster without any sense of the consequences of being exposed,
such as tow truck operators, electricians, telephone repair people and others
need to be considered. (4)
In responding to the World Trade
Center disaster, local hospitals were ready for any casualties and injured
victims because they were prepared from the last terrorist attacks. In
Arlington County, local emergency responders had experience from an earlier
airport disaster. In New York City, by contract, local, state and federal
agencies were not prepared to coordinate their efforts because those disaster
plans had never been tested before. And, strikingly, the Rand Corporation has
found that few localities are prepared for chemical or biological terrorism (5)
Recommendation: Have a broader definition of first
responder, says Mark Penn of the Arlington County Office of Emergency
Management.
(6) Better health registries and
health tracking. Localities should start developing health data right away,
instead of simply relying on samples and monitors.
New York’s 9/11 Environmental
Action group complained that the city waited too long—two years—to start its
promised Health Registry in New York, months after physicians, researchers and
residents clamored for it.
A similar charge is leveled at the
national level. “The September 11 attacks have made the gap in our public
health knowledge more dangerous than ever,” according to advocates for better
disease monitoring. “While Congress is considering how to help the public
health system be better prepared in the face of unprecedented health
risks—whether from the increasing concerns of disease clusters or the
unforeseen threats from chemical and biological terrorism—we must make sure
investments are made in the right way and that they part of a long-term
commitment.”
While we track more than 50
infectious diseases in this country, the Pew Environmental Health Commission
found almost no national monitoring of chronic diseases. (“For instance, more
than half of the states have no ongoing tracking and monitoring of asthma, and
less than half of the nation's population is covered by birth defects
registries. Only nine states report tracking developmental disabilities such as
mental retardation and cerebral palsy.”)
Supporters of a Nationwide Health
Tracking Network, advocate involving a network of local, state, and federal
public health agencies in tracking the trends of priority chronic diseases and
relevant environmental factors in all 50 states and Washington, D.C., Puerto
Rico, and U.S. territories. This, they say, will help create an
early warning system to monitor immediate health crises, such as heavy metal
and pesticide poisonings, that can trigger action against hazards. It would
also be vital as baseline data in any future terrorist incident.
Recommendation: Start a tracking system as soon as
possible after a terrorist attack. (6)
(7) Better preparedness on
evacuation plans.
Even though cities have evacuation plans, they’re not enforced
adequately.
New York City, for example, didn’t even contemplate any kind
of evacuation plan, not having updated its disaster plan in more than 10 years.
Recommendation: Cities should update evacuation plans and make
them enforceable; train fire marshals.
(8) Improve the way buildings
are designed and constructed.
Fire fighters and their advocates
have long been concerned about building materials because of their tendency to
make for unusually toxic fires.
But is the construction industry
revising how it builds—and how high it builds—especially in likely targets? To
make for a safer post 9/11 built environment, construction planners need to
investigate safer materials, and designs that facilitate easier evacuation in
emergencies.
Recommendation: From an environmental health
perspective, designers ought to also look at construction materials for their
durability and well as elimination of toxic products and processes.
(9)
Manage an abundance of volunteers—and donations.
Localities need to learn to manage
volunteers as they converge upon the scene. Dodie Gill of Arlington County, Va.
suggests finding constructive ways to accept people’s donations of time and
resources. When it comes to food, “Thank them, and once they’ve left, dispose
of it quickly.”
“As in other disasters, New York
saw a tremendous influx of resources after the disaster. Some of these
resources were needed, while others were a burden on the system.” Notes Tricia
Wachtendorf in her presentation, “A changing risk environment: Lessons Learned
from the 9/11 World Trade Center Disaster.” (7)
(10) Make way for better
partnerships
Robert Martin, former EPA
ombudsman faults the EPA for failing to consult with the New York community on
places hardest hit from a public health standpoint.
When it comes to research, the
public and research community could benefit in the future if a more formal
process were developed to guide the reactive and proactive steps that researchers
should take in disaster situations. A national body such as the NIEHS or
National Academy of Sciences could play a role in developing an action plan
Recommendation: Consult with the community and
empower them to be involved. Set up a process to have a liaison research
committee to the community.
(11) New on-scene emergency protocol for
measuring potential pollutants.
Sen. Hillary Clinton has suggested
that setting health-based air quality standards should be part of the Homeland
Security Act. She has called for the passage of the Disaster Area Health and
Environmental Monitoring Act of 2003, legislation she cosponsored with Senator
George V. Voinovich (R-OH) and which was approved by the Senate Environment and
Public Works Committee.
“This legislation would ensure
that the health of first responders, workers, residents, school children, and
other community members is adequately protected and monitored when exposed to
harmful substances and other health risks in a declared disaster area,"
according to Clinton. (8)
Recommendation: Create a new emergency protocol for
environmental health identifying the pollutants to be measured in the aftermath
of a disaster and standards for controlling them.
(12) Give environmental health higher priority.
“At 9/11 safety professionals were
rotated in and out but we didn’t have the manpower,” says Bruce Lippy of the
National Union of Operating Engineers.
Professionals needed more staff
and funding, argues CDC’s environmental health expert Ron Burger. “There should
be more than 2 or 3 environmental health professionals in a local health
department of 20 or 30,” says Burger.
Patrick Meehan at the CDC agrees.
“New York City, as well funded as it was, didn’t have enough capability. That
speaks to what we can expect from other, much smaller, cities and towns.”
One way to give environmental
health greater priority would be to issue advisories to physicians so that they
can be aware of illnesses that may arise out of environmental health
consequences, suggests Stephen Levin of Mt. Sinai Hospital.
Recommendation: Beef up environmental health
funding, staffing, and other public and professional resources.
(13) Be ready to improvise.
“You can’t
plan for every single thing; but when something happens, it’s not time to take
a plan out,” says CDC’s Ron Burger. At both Ground Zero and the Pentagon, says
disaster scholar Kathleen Tierney, improvisation was as critical as
pre-planning in helping handle everything from unsolicited food donations to
creating credentialing procedures that balanced effective access to the site
against security.
Recommendation: “Plan
effectively beforehand,” urges Tierney, but also create an environment where
you can “improvise solutions to unforeseen problems that will inevitably
develop.”
Footnotes:
(1)
Rosner
and Markowitz, et al.http://www.milbank.org/reports/911/foreword
(2) EPA,
“Lessons Learned”
(3)
“Chemical Manufacturers Elude Crackdown on Toxic Materials: Sen. Corzine
Pushed for Rules to Reduce Terror Threats, but Political Wind Shifted,” By
Jacob M. Schlesinger and Thaddeus Herrick, Wall Street Journal, 5/21/03
(4) http://wetp.org/oldchfiles/awardee_mtgs/spring02/WMDreport.pdf
(5) http://www.rand.org/publications/IP/IP217/IP217/index.html
(6) http://healthyamericans.org/resources/testimony/hearne030602-oral.php3
(7) Wachtendorf, Disaster Research
Center, University of Delaware,
http://www.udel.edu/DRC/tricia/AEM%20Presentation%20July%202002%20DRC.pdf
(8)
Proposal for Disaster Area Health and Environmental Monitoring Act of 2003
http://www.cbo.gov/showdoc.cfm?index=4503&from=2&sequence=0
(9)
Kathleen Tierney, National Academies Press, http://www7.nationalacademies.org/ndr/1Tierney_Presentation.pdf