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New York Times

No to Planned Guidelines on 9/11-Related Autopsies

By ANTHONY DePALMA

November 18, 2006—The federal government has abandoned efforts to create standardized autopsy guidelines to help determine whether deaths of people who worked at ground zero during recovery operations in 2001 and 2002 can be conclusively connected to the hazardous smoke and dust they breathed there.

The guidelines were supposed to be sent to doctors nationwide to avoid the kind of confusion that resulted earlier this year after a New Jersey coroner concluded that the death of James Zadroga, a New York City police detective, had been caused by exposure to the hazardous air at ground zero, the first such official finding for anyone who worked at the site.

While Mr. Zadroga’s family and colleagues saw the autopsy report as clear proof connecting his death to the dust at the World Trade Center site, experts were troubled because certain specialized tests that might have identified material found in the detective’s lungs had not been performed.

The proposed federal guidelines would have laid out methods for taking and analyzing tissue samples from workers in the New York area and across the country. The draft document also established a process for reaching a conclusion about the cause of death.

Autopsy reports often are presented as evidence in civil suits seeking to establish liability. But medical experts outside the federal government asked to review the proposal expressed concern that guidelines could be seen as an attempt to assess liability for diseases linked to the dust rather than an effort to find answers that could lead to improved diagnosis and treatment.

They said the proposed autopsy procedures would not provide conclusive results and could be subject to inappropriate use in the thousands of lawsuits filed against the city and its contractors by injured workers.

“The draft document could be misinterpreted or misapplied, hindering rather than furthering progress in addressing W.T.C. health concerns,” the National Institute for Occupational Safety and Health said in a note on its Web site yesterday.

In place of the proposed autopsy protocols, the federal government intends to have the New York State Departmentcupational Safety and Healthf the long-term health effects of exposure to the contaminants in the air at ground zero.

“From our evaluation of the independent reviews, it appears that other avenues are more likely to achieve our goal, and that of our partners, of reducing uncertainties in assessing W.T.C. health effects,” the note on the Web site explained.

Medical studies have shown that many of the 40,000 people who worked at ground zero are now suffering from respiratory ailments and some doctors fear they could develop more serious diseases in the future.

The institute’s director, Dr. John Howard, who is the official in charge of coordinating the federal response to ground zero-related health issues, had made the development of standard autopsy procedures a priority as he tried to establish the extent of the health risks facing those who worked on the trade center cleanup.

Dr. Howard could not be reached for comment. But his spokesman, Fred Blosser, said that although Dr. Howard had considered the guidelines a promising concept, he changed his mind after the external reviewers reported that “they didn’t believe scientifically that this would give us meaningful information to accomplish what we want to accomplish, which is to shed light on the long-term health effects of working at ground zero.”

One of those reviewers was Dr. David J. Prezant, chief medical officer of the New York City Fire Department. In a copy of his written comments to the draft guidelines, Dr. Prezant said that only a large-scale epidemiological study that analyzes the medical history of many workers would yield the kind of information Dr. Howard was seeking.

He also noted that the collection and detailed microscopic analysis of tissue samples recommended in the guidelines could only be done in specialized laboratories and pathology centers, which were not named in the draft.