Coroners to Get Sept. 11 Autopsy Guides

Federal health officials have drawn up a plan for autopsies of Sept. 11 workers when they die, to determine whether they were slowly killed by their exposure to World Trade Center dust.

New York lawmakers said Wednesday they fear rising numbers of early deaths among ground zero workers. They called for hearings and a new, nearly $2 billion treatment program for sick workers and lower Manhattan residents.

The federal coordinator of Sept. 11 health issues, John Howard, found coroners around the country need specific instructions for conducting autopsies on those exposed to World Trade Center dust and debris.

The towers' collapse in 2001 produced thick plumes of concrete dust, fiberglass, asbestos, and lead.

The autopsy guidelines, which were submitted for review by outside experts on Sept. 15, follow the release last month of treatment guidelines for sick workers, issued by New York City health officials.

The draft autopsy guidelines from the federal government describe which parts of the lungs should be examined, and urge the creation of a "tissue bank" so that certain organs and body fluids are preserved for later testing.

Tissue and fluids should be collected not just from the dead, but from the living, the draft said.

"Ideally, this 'tissue banking' system would also be able to accommodate biopsy specimens taken as part of diagnostic workups on patients, since such specimens could be as, or even more, informative than autopsy specimens," the draft says.

Dr. Robin Herbert, co-director of the Mount Sinai Medical Center program that found thousands of ground zero workers were still sick 2 1/2 years after the attacks, said the release of the guidelines is an important step as the government decides what to do about the ongoing illnesses among firefighters, police officers, and construction workers.

"We need to think about how the guidelines are used," said Herbert. "There's a social question of what to do in a disaster situation such as this."

The guidelines may become a sticking point in the debate over whether specific deaths were conclusively caused by ground zero exposure.

Rep. Carolyn Maloney, D-N.Y., insisted Wednesday that at least seven people had died from the toxic exposure. The federal guidelines maintain that a direct link has yet to be proven, but say that autopsies and tissue collection could help make the case.

Before the Sept. 11 terrorist attacks, the New York City fire department usually saw about 30 retirements per year from lung problems. Starting in 2002, that number jumped to 120 to 160 per year.

Sen. Hillary Rodham Clinton, D-N.Y., offered an ominous warning of future casualties _ noting studies have found "high percentages of firefighters who cannot breathe, who cannot continue working, who are sick, and I would add, are even dying."