Cancer will be added to the list of diseases covered under a federal law that provides financial aid and health monitoring to ill 9/11 first responders and others exposed to toxins at Ground Zero, a federal official ruled on the eve of the 11th anniversary of the terror attacks.
Dr. John Howard, director of the National Institute for Occupational Safety and Health, issued a proposed rule in June expanding the list of illnesses covered under the James Zadroga 9/11 Health and Compensation Act to include about 50 types of cancer. Monday, he made his ruling official.
"The publication of this final rule marks an important step in the effort to provide needed treatment and care to 9/11 responders and survivors through the WTC Health Program," he said in a statement.
While elated by the decision, advocates worried there wouldn't be enough money to cover treatment and compensation over the long term.
Under the Zadroga law, enacted in January 2011, $2.8 billion was set aside to compensate people made ill by exposure to toxins at Ground Zero. Another $1.5 billion has been allocated over five years to fund the World Trade Center Health Program, which treats and monitors about 40,000 first responders.
For Joseph Vuoso, 68, of Mount Sinai, the ruling means he will be able to worry less about money and more about keeping himself alive. A court security officer at the Foley Square courthouse in 2011, Vuoso watched the towers fall and stayed at his post the rest of that week. The next year he was diagnosed with leukemia that has since become an aggressive lymphoma.
"We have heavy medical bills," he said. "I'm on seven different drugs and the co-pays are astronomical . . . I'm fighting to keep me here right now."
His attorney, Troy Rosasco of Ronkonkoma, who represents about 500 first responders, called having cancer covered "a godsend." But he, like others, said he is worried there won't be enough money.
"It sounds like a lot, but when you start calculating people with cancer who are now out of their careers, their lost wage claims can add up to millions," he said.
Manhattan attorney Noah Kushlefsky, who with fellow Manhattan attorney Michael Barasch represents about 6,000 first responders or others working or living near Ground Zero, agreed.
"I think the program was underfunded without cancer and this kind of magnifies the problem," he said.
Those suffering from a 9/11-linked cancer, like those suffering other 9/11-recognized ailments, have until October 2013 to apply to the fund. But Kushlefsky and Barasch said that, under the present law, federal coverage for health care costs, including cancer treatments, ends in 2016.
In a statement, New York's Democratic Sens. Charles Schumer and Kirsten Gillibrand called the decision "a huge step forward," adding that "if the funds end up being insufficient, we will push Congress to provide more funds for all who deserve them."
John Feal, founder of the FealGood Foundation, a first-responders' advocacy group, said proponents of more congressional funding know "we're only at the 50-yard line."
"Five years is not going to cut it, he said."
How many first responders suffer from cancer is unclear. Last September, the first major cancer study of city firefighters who worked at Ground Zero after the Sept. 11, 2001, attacks found they were 19 percent more likely to have cancer than those who weren't there. Feal said his group has compiled an unofficial list of close to 400 responders with the disease. Dr. Benjamin Luft, director of the World Trade Center Health Program in Suffolk, Nassau and Brooklyn, which monitors or treats about 7,000 first responders, called Howard's announcement "an important milestone" that acknowledges "that the toxic environment that responders were exposed to was not safe."
Luft said he plans to begin offering cancer screening and treatment within months. Howard said the addition of cancer becomes effective 30 days from Monday. "At that time, WTC Health Program members may begin the process of certifying their cancers as WTC-related health conditions," he said.
But for the moment, some responders were feeling a little less anxious.
In 2008, Patrick Triola, 49, of Wantagh, a former New York City police officer who worked 104 days at Ground Zero, lost a kidney after he was diagnosed with kidney cancer.
"It's some security for my wife and kids," he said. "I want to make sure they are taken care of." With Sarah Crichton