November 17, 2006

The link provided below leads to an inactive draft document and external scientific reviews of the draft document. Based on the independent scientific reviews, there will be no further development of this archived draft document, "Standardized Postmortem Examination Guidelines for Individuals Dying After Environmental Exposures Related to the Collapse of the World Trade Center on September 11, 2001." NIOSH instead will pursue other avenues for documenting long-term health effects from exposure to air contaminants from the World Trade Center disaster. 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 WTC health effects.

Background: On September 15, 2006, NIOSH submitted the draft document to external scientific reviewers, and simultaneously posted it on the Web, anticipating public interest in the draft during the scientific review. That independent review was completed on October 31, 2006.

Reviewers suggested that NIOSH focus its efforts on putting in place systems that can be used to monitor epidemiologic patterns of disease in exposed cohorts over time. That approach is more likely to achieve the goals of NIOSH and its partners than the development of standardized postmortem examination guidelines, the reviewers found. For example, one review noted that, “…only epidemiologic studies can assess causality…Long-term studies will be required for identification of late emerging diseases such as cancers, autoimmune diseases and others.” Similarly, another review recommended “an appropriately designed mortality study or longitudinal morbidity study…”

Reviewers also expressed concern that the draft document could be misinterpreted or misapplied, hindering rather than furthering progress in addressing WTC health concerns. One comment suggested that other steps in the scientific process needed to be taken first: "...the idea of this document is reasonable but it is perhaps a bit ahead of the process."

NIOSH thanks its reviewers and will respond as suggested. Our shared goal may be more effectively met by developing systems to collect and analyze epidemiological information that will document the long-term health effects of the World Trade Center disaster. NIOSH is focusing on that approach. NIOSH will also continue its support of medical monitoring and treatment programs and research needed to help those with World Trade Center-related illnesses. NIOSH is deeply committed to serving the ongoing needs of those who responded to the World Trade Center disaster.

Entire Document	WTC_examguidel.pdf (98 KB; 23 pgs)
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