Kristen Lombardi in the Village Voice Sept. 6 remembers 9-11's forgtten victims—who continue to suffer in silence:

Alex Sanchez likes to say he's "living proof" the U.S. Environmental Protection Agency's response to the September 11 terrorist attacks bordered on the criminal. Sanchez was exposed to dust from the World Trade Center disaster as a cleanup worker in skyscrapers around ground zero. He spent seven months enveloped in the lethal material, wiping it from cubicles, blowing it out of vents. It stung his throat, burned his eyes, and choked his lungs.

"The EPA said the air was safe," he remembers, as the fourth anniversary of 9-11 nears, "and when you read that coming from a government official, you don't second-guess it."

Now he does. Sanchez, 38, of Washington Heights, walks with a cane, hunched in pain, hampered by escalating respiratory problems. Doctors have diagnosed him with musculo-skeletal syndrome and asthma, attributed to exposure to the WTC dust. He takes as many as 23 medications.

Yet what bothers Sanchez isn't so much his own health—"I'm already damaged goods," he says—but the bigger picture. He thinks about people who live and work in the buildings surrounding ground zero, like the ones he used to clean, the ones he worries weren't properly tested for contamination. Residents, office workers, schoolchildren: These are the people who may still be breathing in toxic dust, yet not know it. "I'm afraid there are people who will end up just like me walking around these buildings today," he says.

Sanchez isn't alone. For more than a year, dozens of people who live and work in and around Lower Manhattan have been locked in a debate with the EPA over its latest proposal to test for lingering Trade Center dust. A coalition of activists—from labor, tenant, small business, and environmental groups—have pushed agency officials to do the right thing—that is, determine the 9-11-related contamination remaining in downtown and clean it up.

The coalition is helped by a few local lawmakers, among them Representative Jerrold Nadler and Senator Hillary Clinton, and fueled by distrust born of the EPA's initial response after 9-11. New Yorkers were told back then that conditions were safe when in fact they were not. None of these activists finds it easy to believe the agency's latest promises.

In July, activists pressed their case before an EPA advisory panel, made up of 18 technical experts and government officials, who are charged with helping the agency establish a sampling plan and identify unmet public-health needs. Attendees describe the scene as a "showdown," with residents and office workers offering emotional testimony. One resident even collected dust from the blackened filter of her air purifier and presented it to the panelists. "I said, 'This is the dust from my apartment. Why don't you take it home and eat with it and sleep with it every day?' " relays Esther Regelson, who lives two blocks south of ground zero, and who has noticed her pre-existing asthma condition worsening.

The EPA has defended its strategy, which is to analyze only limited samples from Lower Manhattan and Brooklyn. "I believe the plan is scientifically sound," says Michael Brown, of the EPA Office of Research and Development, which convened the panel after Senator Clinton put the screws to the agency. Though, he adds, "we still have what I'll call a short distance to go to get the plan to a place where the community will support it." He says the agency is committed to doing what's right. "We will spend whatever is necessary to assure the health and well-being of those living and working in Lower Manhattan."

But activists say the EPA has produced a plan so seriously flawed that it appears designed to find as little remaining pollution as possible. And the less the EPA finds, the less it has to clean up.

No one knows for a fact whether Trade Center dust lingers downtown. But as Catherine McVay Hughes, a Lower Manhattan resident who sits on the EPA board, points out, what people do know doesn't allay their concerns. To date, a handful of tall buildings have been deemed so heavily contaminated that they've been slated for demolition. Some neighboring buildings have been deemed in need of years-long cleanup. Others have seen no cleanup at all.

At the very least, McVay Hughes says, the community wants a sampling plan that answers the questions, once and for all. "We expect the EPA to design a plan that will look for the dust, find it, and clean it up."

The community has every reason to worry about remaining contamination. The collapse of the 110-story twin towers released a lethal cloud of debris. Concrete, steel, glass, asbestos, plastics, mercury, lead: It all came crashing down, pulverized into dust. Add to this brew the fires that burned for three months, giving off a putrid plume.

"It was a toxic soup," says Suzanne Mattei, of the New York City Sierra Club, who wrote a 265-page report on the 9-11 fallout. "People were exposed to not one chemical but multiple chemicals"— in short, to dangerous stuff.

It didn't take long for those most heavily exposed—the workers who sifted through the rubble and shipped it away—to experience health problems. Almost instantly, the coughing emerged, as did wheezing, throat irritation, and chest pain. Last September, the Mount Sinai Medical Center released data from its 9-11 medical-screening program, which has tested over 14,000 first responders and volunteers. The center reported that 88 percent suffered from at least one WTC-related ear, nose, or throat symptom. Over half endured respiratory ailments for months.

But you didn't have to work on the pile to get sick. Many, like Sanchez, who cleaned the Trade Center dust in downtown skyscrapers have suffered similar illnesses. In 2001, Queens College professor Steven Markowitz, an occupational-health physician, set up a medical van two blocks from the WTC site and screened 415 cleanup laborers. He recorded the coughs, the wheezing, the sore throats. A year later, he found most workers' symptoms were persisting.

Meanwhile, the few studies on residents uncover a wave of damage. In 2003, researchers examining 205 asthmatic children found that those who live within five miles of the WTC site endured more bouts, requiring more doctor visits and medicines. That year, researchers surveyed 2,812 residents and determined that half of them living within a mile of ground zero had developed respiratory troubles.

Count Kelly Colangelo among this group. The Lower Manhattan resident has lived in three apartments since the terrorist attacks, moving repeatedly in an attempt to escape adverse health effects. Her first apartment, on John Street, a block from the WTC site, was saturated in dust. "It covered everything," she says, from the sofa to carpet to drapes. She even discovered it inside her cabinets.

She hired cleaners, who wiped away the dust in what she calls "a once-over." Yet soon after she returned, she noticed symptoms. She couldn't breathe. She broke out in a rash. She felt dizzy. Worse, she endured searing abdominal pain. Seeking answers, Colangelo says she sent dust samples of her freshly cleaned abode to a lab, only to find asbestos at double the threshold for safety.

Things didn't get better at apartment two, along the Hudson River, overlooking the pier where debris was loaded on barges bound for Staten Island. So when another unit in her building went vacant last fall, she relocated again. This time, she has tossed the carpet, drapes, and upholstered furniture. And this time, finally, she hasn't experienced a single symptom.

"Personally," she says, "I feel my health problems have to be related to residual dust. What other explanation could there be?"

Gail Benzman, a city employee at the Housing Authority, wonders the same thing. She works at a municipal building on Center Street, seven blocks from ground zero. From the moment she returned to her office, two weeks after the attacks, she began experiencing ailments she never had before.

"Some days are better than others," she says, between strained-sounding coughs. Doctors diagnosed her with sinusitis and asthma, attributed to WTC-related pollution. She now uses an inhaler regularly; about four times a year, she takes antibiotics to relieve the infections.

Benzman knows the Trade Center dust blew into her building. And she knows it pervaded the place until November 2001, when a cleaning crew had at it. Still, she suspects traces linger to this day. Why else would colleagues who started on the job a year after the cleanup develop the same respiratory troubles she has?

"This isn't the only building where people keep getting sick," Benzman says, struggling to control her cough. She cannot believe that she and thousands more don't know the extent of WTC-related pollution downtown, even now, four years later. She tends to push the thought out of her mind. But whenever her asthma acts up, she says, "it brings back the anger that something is not being done."

That anger, in many ways, stems more from the EPA's overall response to 9-11 fallout than from its current plan. Invariably, critics bring up the agency's actions—or lack thereof—within days of the attacks. How administrators proclaimed the air "safe" to breathe. How their assurances provoked employees to return to work and residents to return home. How the agency shirked its mission to protect people from what amounted to a massive chemical spill.

[...]

That outrage has only been reinforced over the years. In August 2003, the EPA inspector general issued a scathing 165-page report on the agency's 9-11 response. It disclosed some disconcerting facts—that the White House had pressured the EPA to sanitize its warnings about ground zero, for instance. In effect, the report revealed a whitewash the agency has yet to live down.

Even advisory panel members recognize the past has made the current debate over a sampling plan more difficult. Says David Prezant, deputy chief medical officer for the New York fire department, who serves on the board, "There's a lot of resentment about the way this issue was originally handled."

Brown, of the EPA, speaks of the distrust this way: "I believe that by judging EPA's actions—not just our promise to do what's right, but our work in sampling and cleaning up whatever should be cleaned up—the community will recognize that we are worthy of their trust."

To hear critics, though, the EPA has never acted without outside pressure. Congressman Nadler, a Manhattan Democrat, has drawn attention to the issue from the start, hosting press conferences, testifying at hearings. In April 2002, his office put out a critical "white paper" documenting how the EPA had violated its own rules by failing to test and clean up downtown.

"We've pushed and pushed and gotten nowhere," Nadler says. "The only time we've gotten anywhere is because Hillary pushed for it."

Indeed, as advocates like to point out, it was Senator Clinton's willingness to fight the good fight that spawned the EPA panel. Back in 2003, in response to the inspector general's report, she wrote a letter to the White House, calling for immediate testing. She could make that kind of demand, since she sits on a Senate committee that oversees the EPA. Clinton blocked President Bush's nominee to head the agency for 45 days, agreeing to lift her "hold" only after the White House agreed to have the EPA set up the advisory panel.

"New Yorkers deserve a firmer assurance that they are safer in their homes," the senator said when the EPA finally formed the body, in March 2004, "and I am hopeful that this panel will lead to that point."

So were advocates. As they see it, the panel has given them a chance not just to voice concerns about residual toxins, but to keep the EPA in check. Without it, there'd be no talk of testing, let alone cleanup. Still, the process has turned into a protracted fight, with advocates poring over proposals, criticizing the same main issues. Since January, the sampling plan has undergone three revisions. Panel members expect a fourth soon.

"We have gone back and forth," says Micki Siegel de Hernandez, a union representative who sits on the panel and considers the plan "quite inadequate." The struggle, she says, has left residents and workers "feeling as if [EPA officials] haven't been listening."

The EPA's Brown insists the agency has made a good-faith effort. "We're doing everything we can to make sure it's safe to live and work in Lower Manhattan." And some panel members agree, saying it'd be unfair to paint the EPA as hostile. The panel, they contend, has made the plan more responsive to the community.

When panelists first convened, the EPA had proposed testing for re-contamination, not for residual toxic dust. That meant excluding every place that hadn't been cleaned up before—arguably, the places most in need of testing. Panelists shot that idea down, they say, after resounding community complaints.

What's more, the original plan ignored workplaces. Now, it won't. Originally, it tested only for asbestos. Now, it includes such toxins as lead and fiberglass. Originally, it focused only on the blocks south of 14th Street, then Canal Street. Now, it extends up to Houston Street, and over to parts of Brooklyn. Brown suggests the boundaries could expand further. "If the data suggests we need to go further, we will," he says.

Even Clinton's aides say the panel has resulted in a better plan. Philippe Reines, the senator's spokesperson, explains that if the panel had stuck with the initial proposal—which reflected the agreement between Clinton and the White House—testing would have been limited. "It was the senator's hope all along that once the panel got started the EPA would look more broadly at World Trade Center air quality issues," he adds, "and that has happened."

Still, the plan has shortcomings. As it stands, critics tick off a litany of technical problems. Like how the plan would test oft used areas, such as countertops, rather than hidden ones, such as ceiling beams. Or how it would rely on what they see as improper methods to collect dust on soft surfaces and in ventilation systems.

By far, the biggest complaint has to do with the so-called "signature"—or as Mattei says, "some magic substance that's a marker of WTC dust." The signature consists of slag wool, mostly, an insulation used in the towers. Under the plan, if the EPA detects slag wool, it'll clean up. If not, it won't. Critics contend it's foolish to reconstruct a signature years after the Trade Center collapse; it's more foolish to require one to clean up.

Another thorny issue deals with access. Currently, the plan would select 150 buildings to test if owners agree to participate. That leads to dilemmas: Employees can't volunteer their offices; tenants can't volunteer their lobbies.

Even panel members find the complaints reasonable. The problem, says Markowitz of Queens College, who sits on the board, is that many issues come down to policy, not science. To wit: the debate over the plan's voluntary nature. "We've tossed it around for months," he explains, yet it has nothing to do with dust particles. So panelists have little influence in the outcome.

"Ultimately," Markowitz says, explaining his frustration over the fight, "if we don't get to some action on the ground, then I don't think we've served any useful purpose."

Evidently, Senator Clinton would agree. Over the past 17 months, she has remained a force behind the panel, working quietly to move deliberations forward. When advocates have bumped up against the EPA, they've turned to her for help. Explains Siegel de Hernandez, "It's easy for the EPA to discount us; it's not as easy to discount Senator Clinton."

Last June, the senator met with critics to discuss the plan. They asked her to intervene. And so, on June 29, she wrote a letter to EPA administrator Stephen Johnson, highlighting ways the plan "does not go far enough." In July, her office stepped in again, arranging a negotiation session between the EPA, panelists, and critics. That meeting is expected to happen later this month. Her staff says they're hoping a deal can be hashed out.

So is the EPA. "I'm very hopeful this work-group meeting will get us into the homestretch so we can resolve outstanding issues," Brown says.

Who knows what will come of the effort? The agency could revise its plan, or not. Things could unravel, or not. Many people expect the EPA to undertake some type of testing, if only to show that it has acted. But whether the sampling plan will provide answers about the full extent of WTC-related pollution is anyone's guess.

Advocates don't sound optimistic. After all, they note, the decision rests with the EPA—and the White House. And toxic Trade Center dust seems like one of many environmental causes the Bush administration has ignored, despite evidence. "It's a hard fight," Mattei says, "when you have a government that doesn't listen to science and doesn't want to admit it did anything wrong."

No one understands the consequences of this more than Sanchez. Every day, as he struggles with his health, he says he's reminded of how the administration first failed New Yorkers. And as he's become more active in the EPA fight, he's reminded of how the agency continues to fail the city. If it had come through for people, he asks, wouldn't the testing and cleanup have been finished long ago?

"I'm really disgusted by it," he says. "It's shameful."

See our last post on the battle for Ground Zero, and our special report, "9-11's Lingering Toxic Menace."