NIOSH Director Denies Sixth Petition to Add Autoimmune Diseases to WTC List

Five previous petitions requested the addition of autoimmune diseases. Dr. John Howard, administrator of the WTC Health Program and NIOSH director, determined that the new petition did not provide additional evidence of a causal relationship between 9/11 exposures and autoimmune diseases.

Dr. John Howard, administrator of the World Trade Center Health Program and director of NIOSH, has denied a petition seeking to have autoimmune diseases, including rheumatoid arthritis, added to the List of WTC-Related Health Conditions. The decision, made Feb. 21 according to the NIOSH notice in the Federal Register, was made after a review of information provided with the petition received on Sept. 29, 2016, and a determination that this petition "is not substantially different from Petitions 007, 008, 009, 011, and 013, which also requested the addition of autoimmune diseases, including various subtypes," the notice states.

"The Administrator has published responses to the five previous petitions in the Federal Register and has determined that Petition 014 does not provide additional evidence of a causal relationship between 9/11 exposures and autoimmune diseases, including rheumatoid arthritis. Accordingly, the Administrator finds that insufficient evidence exists to request a recommendation of the WTC Health Program Scientific/Technical Advisory Committee (STAC), to publish a proposed rule, or to publish a determination not to publish a proposed rule," the notice says.

The program was created by the James Zadroga 9/11 Health and Compensation Act of 2010; it provides medical monitoring and treatment benefits to eligible firefighters and related personnel, law enforcement officers, and rescue, recovery, and cleanup workers who responded to the Sept. 11, 2001, terrorist attacks in New York City, at the Pentagon, and in Shanksville, Pa., and to eligible people who were present in the dust or dust cloud on 9/11 or who worked, resided, or attended school, child care, or adult day care in the New York City disaster area.

A section of the law allows interested parties to petition the administrator to add a health condition to the List. Within 90 days after receiving a petition, the administrator must take one of four actions: 1) Request a recommendation of the STAC; 2) publish a proposed rule to add the health condition; 3) publish the administrator's determination not to publish such a proposed rule and the basis for that determination; or 4) publish a determination that insufficient evidence exists to take action under the first three of these. The administrator is required to consider a new submission for a previously evaluated health condition determined not to qualify for addition to the List as a valid new petition only if the submission presents a new medical basis—evidence not previously reviewed by the administrator—for the association between 9/11 exposures and the condition to be added.

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