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WTC Health Program History

Hundreds of thousands of people in the New York City (NYC) Disaster Area, at the Pentagon, and at the crash site in Shanksville, PA were exposed to dust, debris, and traumatic events, and physically and emotionally stressful conditions on and after September 11, 2001. Workers and volunteers performed rescue, recovery, clean-up, and other related support services in the disaster areas.

Examination of the dust and other hazards or stressors revealed numerous toxic substances at all 3 disaster areas that could cause short and long-term health conditions to those exposed. These contaminants remained in Lower Manhattan and parts of Brooklyn months after 9/11. Now many who were exposed to those toxins are sick.

Congress created the WTC Health Program to provide medical monitoring and treatment for certified WTC-related health conditions with no out-of-pocket costs to those directly affected by the 9/11 attacks in New York, the Pentagon, and in Shanksville, Pennsylvania.

Below is a timeline of the advocacy efforts and events that led to the creation of the WTC Health Program.

To view a more detailed description of the events below, visit the WTC Health Program’s Online Exhibition: 9/11 Health Effects.

Timeline of Events leading to the creation of the WTC Health Program

  • A Town Hall was held at Pace University in Lower Manhattan. It was the first public forum where responders, residents, and others publicly aired their health concerns about 9/11 exposures.
  • New York City (NYC) began providing limited funds to cover treatment for city employees who responded. Philanthropic funds later helped expand treatment for other responders.
  • The Fire Department of the City of New York (FDNY) and the Mount Sinai School of Medicine—now Icahn School of Medicine at Mount Sinai (MSSM)–received initial federal funds for one-time health screenings of responders through the Response to Terrorist Attacks on The United States Act of 2002.
  • Bellevue Hospital partnered with the Beyond Ground Zero Network to set up an unfunded pilot clinic to treat affected community members.
  • The WTC Health Registry was established in NYC’s Department of Health and Mental Hygiene to monitor the health of people directly exposed to the 9/11 attacks in NYC and administered by the Agency for Toxic Substances and Disease Registry (ATSDR). The funding was originally appropriated by Congress through the 2001 Emergency Supplemental Appropriations Act for Recovery from and Response to Terrorist Attacks on the United States.
  • After much stakeholder lobbying, Congress provided funds through the National Institute for Occupational Safety and Health (NIOSH) to deliver periodic medical monitoring to responders, called the Medical Monitoring Program (MMP) through the Consolidated Appropriations Act of 2004.
  • The pilot clinic at Bellevue Hospital gained support from the American Red Cross.
  • Congress provided NIOSH with additional federal funds through the Emergency Supplemental Appropriations to Address Hurricanes in the Gulf of Mexico, and Pandemic Influenza Act of 2006, to cover treatment and the MMP, which was renamed the WTC Medical Monitoring and Treatment Program.
  • NYC announced local funding for the WTC Environmental Health Center (WTC EHC) at Bellevue Hospital (now part of NYC Health + Hospitals) for community members (known as “survivors”).
    Dr. John Howard, Director of NIOSH, addressed survivors at a Town Hall organized by 9/11 Environmental Action.
  • NIOSH created a National Responder Program to administer treatment to responders living outside of the NY metropolitan area.
  • The Consolidated Appropriations Act of 2008 was signed into law by President Bush, which provided $109 million for the WTC Monitoring and Treatment Program for responders and survivors.
  • The NYC Health + Hospitals WTC EHC began receiving federal funding from the Consolidated Appropriations Act of 2008 for medical monitoring and treatment for survivors.
  • The administration of the WTC Health Registry was moved from ATSDR to NIOSH.
  • After the nearly decade-long effort of 9/11 health advocates, President Obama signed the James Zadroga 9/11 Health and Compensation Act of 2010 (Zadroga Act) into law establishing the federal World Trade Center (WTC) Health Program and reopening the September 11th Victim Compensation Fund (VCF).

    James Zadroga 9/11 Health and Compensation Act of 2010

  • The WTC Health Program officially launched replacing the MMP and the WTC EHC. Individuals who were part of the previous Programs were automatically enrolled into the WTC Health Program. December 18, 2015: President Obama signed into law a bill reauthorizing the WTC Health Program for 75 years, ending in 2090.

    CDC’s World Trade Center Health Program

  • President Obama signed into law a bill reauthorizing the WTC Health Program for 75 years, ending in 2090.

    Consolidated Appropriations Act

  • President Trump signed the Continuing Appropriations Act, 2020, and Health Extenders Act of 2019 which raised the limits on enrollment of 9/11 responders and survivors in the WTC Health Program from 25,000 to 75,000 for each.

    Program Laws 2019

Learn more about the WTC Health Program on the About the Program and Program Newsroom pages.