A federal health official has proposed expanding the list of illnesses associated with 9/11-related exposure to include about 50 cancers -- a major step toward granting first responders and others treatment and compensation for the disease.
The decision by Dr. John Howard, director of the National Institute for Occupational Safety and Health, followed a scientific advisory panel's recommendation to add 14 broad classes of cancers to the list.
The proposed rule, released Friday, could become final following a 30-day public comment period starting Monday.
Advocates, politicians, doctors and cancer sufferers viewed the decision as vindication for the tens of thousands exposed to the toxic soup at Ground Zero and other sites.
Others, however, worried that including cancer could bankrupt the $4.3 billion pool set aside under the James Zadroga 9/11 Health and Compensation Act.
Initially, the Environmental Protection Agency declared the World Trade Center area safe, but since then studies have linked exposure to the toxins to a number of illnesses, ranging from respiratory to chronic digestive disorders. Cancer, which often takes years to develop, had been a question mark.
"This is a monumental decision," said Dr. Benjamin Luft, director of Long Island's World Trade Center Health Center Program, which monitors and treats about 5,000 first responders from Long Island. "The responders have been living in a twilight zone for over a decade."
"I'm more relieved today than when we got the bill passed," said John Feal, founder of the FealGood Foundation, a 9/11 first responders advocacy group.
But Manhattan attorney Michael Barasch, who represents about 5,000 sickened emergency responders, said he's concerned including cancers will bankrupt the system.
"While it is absolutely the right decision today, Congress had better pay attention and do the right thing," he said. "There's no way there's [currently] enough money to pay for very expensive cancer treatments."
Sen. Charles Schumer (D-N.Y.) said the issue of money should not affect a decision based on scientific evidence. "If the funds end up being insufficient, we will push Congress to provide more funds for all who deserve them," he said.
Feal agreed: "We walked the halls of Congress for eight years to get the bill passed, and we're prepared to do it again."
The Zadroga Act, signed by President Barack Obama in January 2011, allocated $1.5 billion over five years to fund the World Trade Center Health Program, which treats and monitors about 40,000 first responders and others. It also set aside $2.8 billion to compensate first responders and others made ill by exposure to World Trade Center sites.
Sheila Birnbaum, special master of the victims' compensation fund, said the fund will start procedures to add the cancers if the proposed rule is formally adopted.
So far, more than 5,000 people have registered for the fund, but fewer than 400 have submitted claims and no disbursements have been made, according to the U.S. Justice Department.
The advisory panel based its March recommendations on scientific evidence linking cancers to toxins. Last September, the first major cancer study of city firefighters who worked at Ground Zero found they were 19 percent more likely to have cancer than those who didn't.
FDNY firefighter Ray Pfeifer learned Thursday he must undergo a fourth surgery to remove a tumor as a result of kidney cancer he was diagnosed with two years ago. He called the news a "massive relief."
"It gives me peace to know my family will be taken care of, if and when this cancer goes bad," said Pfeifer, 54, a father of two from Hicksville.
The firefighter, who spent more than 1,000 hours at Ground Zero, said his cancer has spread to his bones. "I'm very grateful; I just wish this had been solved earlier before guys died, that's all."
Dr. Jim Melius, chairman of the World Trade Center health program's steering committee, said omitting cancers "would have been blatantly unfair."
Reps. Carolyn Maloney (D-Manhattan), Jerrold Nadler (D-Manhattan) and Peter King (R-Seaford), House sponsors of the bill, said they were "thrilled. . . . It helps pave the way for expanding the scope of available medical care and compensation," they said in a joint statement.
The federal government proposes adding about 50 cancers to the list of 9/11-related illnesses, in these categories:
Cancers of the respiratory system
Cancers of the digestive system
Cancers of the oral cavity and pharynx
Soft tissue sarcomas
Cancers of the urinary tract
Cancers of the eye and orbit
Lymphoma, leukemia and myeloma
Rare cancers, not specified
Source: National Institute for Occupational Safety and Health