NYU/Bellevue WTC Health Impacts Research Registry

The destruction of the World Trade Center (WTC) resulted in long-term adverse health effects
for workers and volunteers involved in rescue and recovery (2002; 2004a; 2004b; Skloot et
al. 2004). In addition, increasing data demonstrate persistent adverse health effects for
local residents as well as for the responders (Lin in press; Reibman 2004).

Screening programs for responders, funded by the CDC-NIOSH have included extensive medical,
mental and exposure histories, combined with physical examinations, chest x-rays, and
spirometry Screening programs for health effects in residents have been much more limited
and have only studied selective populations; to date, our studies are the most comprehensive
- and consisted of simple questionnaires with limited spirometry. The results of these
studies, have now led to the recognition of extensive adverse health outcomes in the
residential, as well as the worker and volunteer populations.

Despite this information, many individuals, workers as well as residents, may not recognize
that their ailments may be related to WTC exposures. Few programs exist that educate these
populations as well as provide supportive services for medical treatment. Individuals with
medical insurance may have sought care among health care providers but many individual
practitioners have varying expertise in the predominantly pulmonary and mental health
disorders experienced by these populations. Those lacking insurance may have gone untreated.
The goal of this application will therefore be to address this unmet need by providing a
multi-disciplined, comprehensive evaluation and treatment program for individuals with
suspected World Trade Center-related health issues.

Target populations who will participate in the Bellevue Hospital Red Cross WTC Health
Impacts Program will include:

- residents (children and adults) of Lower Manhattan communities at the time of the
attacks, who remained or returned to their homes soon after the attacks

- individuals involved in debris removal in surrounding commercial and residential
buildings,

- individuals involved in rescue, recovery and debris removal who have been previously
screened through the World Trade Center Worker and Volunteer Medical Screening Program
and are in need of continued treatment.

Goals of the Bellevue Red Cross WTC Health Impacts program will be to provide:

- Medical evaluation and treatment for suspected WTC-associated illness Initial medical
evaluation or medical consultation with an integrated mental health and social service
needs assessment Subspecialty testing or consultation for diagnosis and further
evaluation of suspected WTC-associated illness

- Treatment for WTC-associated limited or prolonged illness

- Development of a multi-discipline referral program with preferred practitioners
for:

1. Specialty care health needs

2. Primary care health needs

3. Mental health care needs

- Collaboration with WTC Worker and Volunteer Medical Screening and Monitoring Program to
develop practice suggestions for further evaluation and diagnostic testing,
interpretation of testing, and treatment of individuals with suspected WTC-associated
health problems