00030

World Trade Center Disaster Response

New York City Department of Health
Day 10: 9/20/01 (Thursday)
8am-8pm Summary
COMMAND CENTER AND OEM OPERATIONS
Disaster area has been divided into different zones, no map available yet

I. Environmental Workgroup
Air quality
EPA-DEC has a group to receive data, conf call at 2
Plan to get data to community
Sampling plan - comments sent last night
Monitors going on

Continuous ambient air monitoring

Self-monitors is not systematic, some on NYPD, some ConEd
Bulk monitoring at site
Scientific panel to review and evaluate data
Q and A for call center about air quality

Water
All bac-T samples are negative
4 water tank samples run for PCBs, all negative
2/4 are negative for asbestos
No plan to do more routine water tank sampling

Radiation
Flyover occurred yesterday, results were negative
Another flyover scheduled for 9/24

Food and Restaurant Inspection

Working with NY Restaurant Assoc
Closing of rogue food establishments
Informal food distribution feeding sites at perimeter
None of them have been registered, approved
Food and respite being set up in central locations, with handwashing
State and Nassau Co sanitarians, still available
Working out details of continued involvement

Pest control
Rodent baiting happening
Traps only in a few places
Use National Guard to help? Possible
 Sanitation
Mosquito pools for larviciding near area will happen tomorrow
Mosquito traps in Battery Park City, not accessible for collection
Will set up additional traps in area
Fit testing for sanitation workers, supply of masks
Have Tyvek suits
Survey where all the porto-johns are, so hand washing can happen

II. Med/Clinical Workgroup

Occupational Health and Safety Plan for worker safety at site
Supply problems of respirators
Shipment last night of 4000 PI00 OV masks
Trying to coord with OSHA about personnel, supervision, OSHA to take over
OSHA fit testing at PS89, not sure if our site at AMEX will be closed
OEM/DC AS to be put in touch with OSHA, DOH is not best middle person
Today it was decided to place fit testing in 2 sites, on PS 89 and Albany/West
National Guard will erect 2 tents, and we well do the fit testing, they will do
inventory, DCAS to make orders.
No more distribution at the site near the disaster, so our site will be inside the buffer
Replacement cartridges will be kept at the 4 zones cache sites
Staten Island will be doing fit testing
OSHA site in Queens, World's Fair, instead of being fitted on site
Today, because of rain, workers not wearing them much
4 companies there, they should get respirators themselves

Hep B and Td vaccine - should it be available?

Hep B not an urgent priority, will do case by case
No problem with Td being given
Jane is going to coord with NYPD and FDNY
Incident specific Hep B vaccine, as needed

Fact sheets for community moving into apartments

Being distributed?

PulmoCort being donated, given to workers with cough

Anyone with wheezing and SOB will be referred
Consensus not agreed upon

Worker fact sheets

Given to central sites, like EMS headquarters
Public information sheets being given S of Canal by canvassing

1 MI and 2 CVAs reported, and one severe fall?

Will check system regarding the fall to get more clinical details

Fact sheet for workers not taking their regular medications - will be prepared
More signs needed at site

Short list to be prepared about what PPE are needed, need daily
Long sleeve overalls or work shirt, hard hat, steel tip boots, goggles, PI00 respirator,
leather gloves
Standard advisory as to air quality results for public - need fact sheet

III. Epi/Surveillance Workgroup

Daily report from 9/19 handed out at 12 pm meeting

A. Hospital needs assessment

GNYHA sent report
B. ER Acute injury/trauma surveillance
Prelim final report by tomorrow
Should they do 1st 3 days vs 1st 2 days
Data from 9/14 missing
C. Syndromic Surveillance
Most visits not one of our syndromes of interest
2 ways - geo temp cluster (had 15 small clusters, most 1 or 2 cases)
CDC analyzes it another way, Qsum moving averages, mostly found
anxiety
Plan to end on 27th evening
D. Disaster site worker surveillance for injuries and illness
Work there may go on for months, at 4 hospitals and DMAT
Need denominators
FBI has clinic as well, not sure where
Will be in contact with DMAT folks about doing finger sticks
E. Mental health surveillance
Columbia involved with setting up epi study
Lots of people involved NY Acad Medicine, DOH, DMH
Descriptive study being discussed
F. CDC wants to collect samples from all workers, urine and blood?
CDC developing protocol for our review, ? IRB issues
Question of finding a cohort to follow, state health dept is interested
G. Evacuation plan study of all the companies in the buildings
H. BT issue
Calls from hospitals about stockpiling

Can we give name data from the injury surveillance and rescue worker studies?
Will check with legal dept

Regular, ongoing surveillance activities

2 new West Nile cases, update to go out
 IV. Sheltering Workgroup
7 total shelters open, shift by shift basis
3 closed yesterday, more may be closed today
Homeless still using services
Some medical problems seen, referred
Move to contract nurses

VI. Laboratory Workgroup

No new issues

VII. Operations/Facilities
No summary today
OEM wants phone contact for every building that is open

vm. MIS.
Phone lines being put in at 125 Worth
Internet access will be a problem, will take up phone lines

OTHER ISSUES
MTU. Public Relations
Canvassing going on in south Manhattan to distribute DOH fact sheets
Another fact sheet for building owners
Mayor's request for information

IX. Personnel/Staffing
DC AS meeting for charging time for week of 9/9
Transition plan to 125 Worth
Need to discuss about on call staff, meeting once vs twice/day

Are we issuing permits for new restaurants?

Work sheets for Mayor's office of operation distributed

Prepared by THH
 Department of Health
World Trade Center Disaster
Emergency Operations Center
Current Issues/Agenda
9/20/01 - 12 pm Meeting

TOPIC OUTSTANDING CONCERNS RESPONSIBLE

PARTY
Shelters Status on continuation Carmen Ramos
Security problems (taken care of) Linda Moskin
Staffing (continue to arrange as needed)
Radiation and Update Allan Goldberg
Monitoring Gene Mishkin
Pest Control Larvaciding in "red zone" James Gibson
Update on mosquitoes at site
Anti-odor masks for clean-up crew -
On-site clean-up update
Pest control assessment below Canal St t
Garbage pickup below Canal St.
Food Access to restaurants in lower Manhattan; print out of restaurants Elliott Marcus
Two distribution sites establishment - update Bob Edmon
Closing of rogue food establishments
Fulton St. Market, Hunts Point Market update on problems
SDOH/Nassau Co sanitarians: will a constant group be available?
Update on handwashing facilities
Water Bacteriological water test results (no new results) Jim Luke
Sampling of water tanks for PCBs and asbestos (no new results)
Air Update on coordination of DOH/EPA/DEP to get updated data to Jessica Leighton
the community Kelly McKinney
Update on EPA sampling plan
Update on scientific panel to review and eval data
Update on Q/A for Call Center
Medical and Advisories Sue Blank
Clinical Katherine Kaye
Worker Safety Update on coordinate effort to provide respirators and other Jessica Leighton
safety equipment: Kelly McKinney
o Transition of fit testing to OSHA (incl. schedule and
location);
o Update on National Guard conducting inventory and
distribution of respirators (and other safety equipment?)
o Update on DCAS ordering equipment
o DOH plan for monitoring OSHA, including staffing
DOH recommendations for H&S workers: status of sign off and
distribution plan development
What is evidence of use of PPE on site?
Update on fire & police departments use of inhaled steroids for
acute reactive airway disease
Shelters Status on continuation Carmen Ramos
Security problems (taken care of) Linda Moskin
Staffing (continue to arrange as needed)
Surveillance Retrospective ER injury Marci Layton
Hospital needs assessment/casualties, by GNYHA Polly Thomas
Syndromic surveillance, transportation issue
Site/worker safety surveillance
Update on Mental health surveillance
WTC Disaster Plan study
Medical community concerns about bioterrorism
CDC Medical Screen Project (CDC Contact: Pat Mehan): lead
DOH program/bureau?
MIS Update on restoration of data service at 125 Worth Ed Carubis
Update on survey of database development
Staff and Facility update - phones at 125 Worth? Stu Mirsky
Operations Rich Naeder
DOH 1) Need update as hotlines reopen (esp. vital records) Pam Harmon
Complaints 2) Questions about getting restaurant permits coming in
Line 3) Do we have a Board of Ed hotline number for them?

Press Situation 1) Was water tank protocol incorporated in press release, fact Sandra Mullin
sheets, and/or website? Andrew Tucker
Greg Butler
 Department of Health
World Trade Center Disaster
Emergency Operations Center
Current Issues/Agenda
9/20/01-5pm Meeting

TOPIC OUTSTANDING CONCERNS RESPONSIBLE

PARTY
Shelters Status on continuation, staffing Carmen Ramos
Linda Moskin
Radiation and Update Allan Goldberg
Monitoring Gene Mishkin
Pest Control Update on anti-odor masks for clean-up crew James Gibson
Update on mosquitoes/larvaciding in "red zone'Vis there a need to
recommend repellent and/or long sleeves to night shift?
Update on receipt of map of OEM zones
On-site clean-up update
Pest control assessment below Canal St t
Garbage pickup below Canal St.
Food Lower Manhattan restaurants - access & cleanup: Elliott Marcus
update on use of National Guard Bob Edmon
update on NYS Restaurant Association
- is a plan being developed to get records from 42 Worth?
Two distribution sites establishment - update
Closing of rogue food establishments (Resolving with NYPD?)
Fulton St. Market, Hunts Point Market update on problems
SDOH/Nassau Co sanitarians: will a constant group be available?
Update on handwashing facilities - if porto-potties are moving
with reduction of "hot zone," do we have up-to-date locations?
Water Bacteriological water test results Jim Luke
Sampling of water tanks for asbestos (2 remaining samples)
Air Update on coordination of DOH/EPA/DEC to get updated data to Jessica Leighton
the community Kelly McKinney
Update on EPA sampling plan
Update on scientific panel to review and eval data
Update on Q/A for Call Center
Medical and Advisories Sue Blank
Clinical Katherine Kaye
Worker Safety Update on effort to coordinate provision of respirators and other Jessica Leighton
safety equipment: Kelly McKinney
- Transition of fit testing to OSHA (including possibility of
fit testing at FDNY location);
- Update on National Guard conducting inventory and
distribution of respirators (and other safety equipment?)
Update on DCAS ordering equipment
DOH plan for monitoring OSHA/Quality Assurance plan,
including staffing
DOH recommendations for H&S workers: was sign off received?
What are components of plan to distribute the recommendations?
Update on plan to notify workers to continue taking their meds
for chronic diseases
What is evidence of use of PPE on site?
Update on fire & police departments use of inhaled steroids for
acute reactive airway disease
Update on tetanus vaccine recommendations (FDNY, NYPD, 4
construction companies)
Surveillance Retrospective ER injury Marci Layton
Hospital needs assessment/casualties, by GNYHA Polly Thomas
Syndromic surveillance (to stop next Thursday at midnight)
Site/worker safety surveillance:
how long will this continue?
- plan to get denominator numbers
plan to get surveillance reports from FBI clinic
Update on Mental health surveillance
WTC Disaster Plan study
Medical community concerns about bioterrorism
CDC Medical Screen Project (CDC Contact: Pat Mehan): lead
DOH program/bureau?
MIS Update on restoration of data service at 125 Worth Ed Carubis
Update on receiving surveys of database development
Update on access to internet for Commissioner's office
Staff and Responses to mayor's request for information Stu Mirsky
Operations Facility update: Plan to transition to 125 Worth (incl. phones) Rich Naeder
2 Lafayette access update
Status on providing OEM a contact for open and closed buildings
Result of DCAS meeting on charging time for week of 9/9 - 9/15
DOH Need to receive update as hotlines reopen (Public Affairs also Pam Harmon
Complaints needs this information)
Line Receiving questions about getting restaurant permits: are new
permits being issued?
Press Situation Update on possible development of fact sheet for building Sandra Mullin
owners, and other plans to disseminate water tank protocol Andrew Tucker
Greg Butler
 ' 0/2001

Shelter Client Usage

Shelter 9/17 9/17 9/17 9/17 9/18 9/18 9/18 9/19 9/19 9/19 9/20 9/20 9/20 9/21
~1A 8A 3P IIP 8A 3P IIP 8A 3P IIP 8A 3P IIP 8A
# # # # # # # # # # # clients # clients # # clients
clients clients clients clients clients clients clients clients
clients clients clients
Seward Park 5 2 0 4 0 1 4 6 Closed Closed Closed Closed Closed Closed
HS
Washington 28 30 40 20 26 25 17 13 20 35 45
Irving HS
Fashion 44 39 55 52 45 8 52 33 Closed Closed Closed Closed Closed Closed
Industry HS
Chelsea HS 6 14 3 8 8 13 11 15 23 24 22

Norma Thomas 19 22 22 21 24 14 14 14 Closed Closed Closed Closed Closed Closed

HS
City School HS 4 6 2 2 7 3 4 6 2 8 1

JHS22 2 3 0 4 4 4 5 5 3 4 1

IS 131 12 14 17 11 7 13 7 8

Comprehensive 7 6 5 8 8 9 9 9 8 10 4
Day&Night HS
Bayard Rustin Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed
HS

Curtis HS, SI Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed

Westinghouse 49 8 0 1 0 0 0 0 0 0
HS,BK worker workers 30 100 30 work
work work
 Prepared on September 20, 2001

WTC Surveillance Systems Summary

Report for 9/19/01

Overview of Surveillance Programs:

1. Retrospective Emergency Room- Review of medical records from four hospitals in close
proximity to ground zero for frequency and types of injuries seen during the interval
9/11-9/13.
Team Leaders: Susan Wilt (NYCDOH) & Mike Bell (CDC)

2." Rescue Team- Involves the four lower Manhattan hospitals and the DMAT site treating
rescue workers. Focuses on injury and illness occurring in any individual working at
ground zero (includes EMS, Fire, Police, construction, etc.)
Team Leaders: Mike Phillips (NYCDOH) & Sandra Berrios (CDC)

3. Syndromic- A monitoring system of eleven syndromes at 15 sentinel hospitals for

detection of a biologic agent release.
Team Leaders: Sharon Baiter (NYCDOH)& Brad Winterton (CDC)

4. Hospital Assessment- Daily reports on ED visits and admissions stratified by those

related to the WTC incident. Surveillance is conducted by the Greater New York Hospital
Association in coordination with NYSDOH & NYCDOH

File name is "Combined report for 9-19-01"

W:Apps/Pdox40/worldtrade/reports/Intemal
 Prepared on September 20, 2001

Table lA-Emergency Department, Initial Diagnoses

Diagnostic categories below include individuals with more than one diagnosis. Categories therefore overlap.
Total Saint Bellevue Beth Israel NYU- New York
Vincent's N (%) N (%) Downtown Hospital -
N (%) N (%) Cornell
N (%)
Respiratory (all) 482 119 80 89 141 53
(25) (16) (18) (29) (ID
Respiratory (smoke 389 78 54 91 137 27
inhalation) (20) (14) (23) (35) (7)
Trauma 435 109 90 90 80 66
(25) (21) (21) (18) (15)
Ophthalmologic 213 74 51 32 23 33
(37) (25) (16) (11) (10)
Cardiac 92 38 10 23 14 7
(41) (11) (25) (15) (8)
Gastrointestinal 74 24 11 19 9 11
(32) (15) (26) (12) (15)
Burn 44 9 5 3 2 25
(20) (11) (7) (5) (57)
Obstetric/Gynecologic 19 0 1 11 4 3
(0) (5) (58) (21) (16)
Infection 44 10 7 8 1 18
(23) (16) (18) (2) (41)
Psychiatric 116 38 16 37 11 14
(33) (14) (32) (9) (12)

Table IB-Trauma Sub-types

Sub-type N
Laceration 157
Sprain/Strain 140
Contusion 123
Fracture 53
Crush 10

Table IC-Outcomes of ED visits

Total Saint Vincent's Bellevue Beth Israel NYU-Downtown New York
N (%) N (%) N(%) N (%) Hospital -
Cornell
N (%)
Admitted to 66 51 57 45 42
261
Hospital (25) (20) (22) (17) (16)
Discharged 295 196 253 276 179
1199
Home (25) (16) (21) (23) (15)
Died in
6 2 1 0 1 2
ED
Unknown 4 4 12 73 3
96
(4) (4) (13) (76) (3)

File name is "Combined report for 9-19-01"

W:Apps/Pdox40/worldtrade/reports/Intemal
 Prepared on September 20, 2001

Table IF-Initial Diagnoses, Selected Responder-types v. Civilian

Diagnostic categories below include individuals with more than one diagnosis. Categories therefore overlap.
NYPD FDNY Civilian
N(%) N (%) N (%)
Respiratory
51(10) 60(12) 375(77)
(all)
Respiratory (smoke
inhalation) 47 (12) 58(15) 285 (73)
Trauma
44 (10) 41(9) 356 (81)
Ophthalmologic
51(24) 48 (22) 115(54)
Cardiac
6(6) 12(13) 76(81)
Gastrointestinal
3(4) 4(5) 67 (91)
Burn
2(5) 2(5) 40 (90)
Infection
1(2) 1(2) 43 (96)
Psychiatric
2(2) 9(8) 106 (90)
Neurologic
7(8) 16 (18) 65 (74)

File name is "Combined report for 9-19-01"

W:Apps/Pdox40/worldtrade/reports/Internal
 Prepared on September 20, 2001

Injury Type (Table-IB cent.) 9/14/01 9/15/01 9/16/01 9/17/01 9/18/01 Total 3

Laceration 6 10 5 10 4 35
Contusion 2 6 1 4 1 14
Crush 0 1 0 1 0 2
Fracture 1 1 2 1 2 7
Burn 0 0 2 1 3 6
Concussion 0 1 1 0 0 2
Headache2 1 4 4 3 12 24
Eye Injury1 15 12 21 30 21 99
Eye Irritation2 0 0 1 0 1 2
Corneal Abration2 0 0 0 0 1 1
Psychological Stress 1 2 1 3 2 9
Other (See Table 4) 9 20 20 15 21 85
Unknown 0 1 1 7 9 18
Total 88 106 89 116 116 515
Option deleted from surveillance form distributed after 9/18/01.
2 Option added to surveillance form distributed after 9/18/01.
3 One record was reported without a date and is currently being rectified.

Table 2C: Injury Type by Facility Type

Injury Type DMAT Emergency Total
Departments
Smoke/Dust Inhalation1 29 25 54
Cough2 0 0 0
SOB/Wheezing2 4 10 14
Chest Pain2 3 6 9
Skin Irritation/Rash 17 2 19
Blisters2 24 0 24
Dehydration2 1 5 6
Heat Exhaustion2 0 0 0
Nausea/Vomiting/Diarrhea2 7 1 8
Sprain/Strain 25 43 68
Abrasion 6 3 9
Laceration 19 16 35
Contusion 5 9 14

File name is "Combined report for 9-19-01"

W:Apps/Pdox40/worldtrade/reports/Intemal
 Prepared on September 20, 2001

Table 2E-Types of Rescue Worker Evaluated at All Facilities, by Day

Type of Rescue Worker 9/14/01 9/15/01 9/16/01 9/17/01 09/18/01 Total '
Fire 14 13 11 32 22 92
Police 24 33 30 42 36 165
Medical 8 7 8 1 6 30
Construction 10 10 16 12 27 75
Military 2 13 4 1 3 23
Red Cross 2 2 1 0 3 8
Other (See Table 7) 27 26 15 20 15 103
Unknown 1 2 4 8 4 19
Total 88 106 89 116 116 515
One record was reported without a date and is currently being rectified.

Table 2F- Rescue Worker Type by Facility Type

Type of Rescue Worker DMAT Emergency Total
Departments
Fire 64 28 92

Police 91 75 166

Medical 23 7 30.

Construction 58 17 75

Military 15 8 23

Red Cross 6 2 8

Other 49 54 103

Unknown 15 4 19

Total 321 195 516

Table 2G-Other Rescue Worker Most Frequently Reported

Other Rescue Worker Number
Volunteer (not specified) 45
Transportation 5
Animal Search & Rescue 4
FEMA 4
Civilian 3
City University of NY 3
OEM 2
Rescuer (not specified) 2

File name is "Combinedreport for9-19-01"

W:Apps/Pdox40/worldtrade/reports/Internal
 Prepared on September 20, 2001

3. Syndromic
After seven days of surveillance, there were 11,897 emergency department (ED) visits reviewed. Completeness of
ED record capture increased dramatically since EIS officers were placed in the hospitals on 9/15/01 (see Table 3A).
The majority of ED visits are not for those selected syndromes under surveillance (category = " none of the
following", see Table 3B). The combined frequency of syndromes under surveillance specifically for biologic agent
release continues to be low at 6.5% (includes respiratory illness with fever, diarrhea/gastroenteritis, sepsis,
meningitis/encephalitis, botulism-like syndrome and unexplained death with fever).

Table 3A-Data/Census=CompIeteness, by hospital by ER visit date

Date Bellevue Lutheran Staten Island u. St. Vincent's Beth Israel

12SEP01 9/ . = . 1/150=0.00 2/172=0.01 22/149=0.14
13SEP01 S4/ .=. 52/137=0.37 79/154=0.51 71/156=0.45 121/123=0.98
14SEP01 33/119=0.27 106/126=0.84 100/141=0.70 57/125=0.45 126/145=0.86
15SEP01 126/128=0.98 117/131=0.89 127/133=0.95 125/126=0.99 140/147=0.95
16SEP01 128/118=1.08 122/128=0.95 126/133=0.94 113/128=0.88 141/146=0.96
17SEP01 175/181=0.96 174/197=0.88 117/147=0.79 145/167=0.86 169/172=0.98
18SEP01 232/225=1.03 194/180=1.07 151/138=1.09 148/162=0.91 147/159=0.92
Date Coney Island Elmhurst King's County Lincoln Long Island Jewish
12SEP01
13SEP01 59/164=0.35 107/270=0.39 1/234=0.00 72/350=0.20 90/182=0.49
14SEP01 119/157=0.75 218/248=0.87 85/222=0.38 153/346=0.44 124/147=0.84
15SEP01 113/165=0.68 212/308=0.68 164/235=0.69 258/348=0.74 165/184=0.89
16SEP01 98/171=0.57 192/257=0.74 159/224=0.70 269/314=0.85 175/177=0.98
17SEP01 129/197=0.65 272/282=0.96 177/291=0.60 356/414=0.85 160/169=0.94
18SEP01 183/209=0.87 257/337=0.76 144/244=0.59 363/419=0.86 141/156=0.90
Date Mt sinai Queens Hospital Brooklyn Hospital NYH-Columbia Montefiore
12SEP01
13SEP01 66/109=0.60 30/119=0.25
14SEP01 92/108=0.85 10/ 83=0.12 97/141=0.68 32/114=0.28 5/229=0.02
15SEP01 99/106=0.93 72/ 94=0.76 130/149=0.87 74/125=0.59 197/303=0.65
16SEP01 111/122=0.90 51/ 85=0.6 140/147=0.95 93/121=0.76 257/285=0.90
17SEP01 143/145=0.98 69/122=0.56 140/157=0.89 104/156=0.66 267/329=0.81
18SEP01 126/134=0.94 87/125=0.69 148/172=0.86 85/144=0.59 227/310=0.73

Table 3B- Cumulative frequency of reported syndromes

Frequency Percent
None listed 8243 69.3
Trauma 1472 12.4
Smoke/dust inhalation 178 1.5
Exacerbation of resp illness 601 5.1
Resp illness with fever 251 2.1
Diarrhea/gastroenteritis 420 3.5
Sepsis 33 .3
Rash & fever 23 .2
Mening/enceph 9 .1
Botulism-like 2 .0
Anxiety 193 1.6
Left blank 465 3.9
Total 11890 99.9
Missing 7 .1
Total 11897 100.0
'Syndromes with no reports: Unexplained death with fever

File name is "Combined report for 9-19-01"

11
W:Apps/Pdox40/worldtrade/reports/Intemal
 Prepared on September 20, 2001

Table 3F-AH syndromes frequency by hospital

Frequency Percent
Bellevue 758 6.4
Brooklyn Hospital-Downtown 670 5.6
Beth Israel-Petrie 868 7.3
Coney Island Hospital 710 6.0
Columbia-New York Presbyterian 405 3.4
Elmhurst 1274 10.7
Kings County Hospital 737 6.2
Lincoln Hospital 1481 12.4
Long Island Jewish 878 7.4
Lutheran Hospital 111 6.5
Montefiore Medical Center 971 8.2
Mt. Sinai 643 5.4
Queens Hospital Center 325 2.7
Statet Island University-North 709 6.0
St. Vincent's 691 5.8
Total 11897 100.0

Table 3G-Syndrome frequency by date (for all hospitals)

Count
DATE

9/12 9/13 9/14 9/15 9/16 9/17 9/18 9/19 Total

None listed 13 445 914 1500 1504 1833 1903 131 8243
Trauma 11 82 133 297 279 310 346 14 1472
Smoke/dust inhalation 4 45 31 26 18 32 18 4 178
Exacerbation of resp
3 20 59 98 129 140 140 12 601
illness
Resp illness with fever 18 22 39 54 59 56 3 251
Diarrhea/gastroenteritis 1 17 41 78 92 111 75 5 420
Sepsis 1 12 5 7 7 1 33
Rash & fever 3 1 3 8 4 3 1 23
Mening/enceph 1 6 2 9
Botulism-like 1 1 2
Anxiety 3 4 28 42 63 48 5 193
Left blank 2 168 151 38 38 37 27 4 465
Total 34 802 1357 2119 2175 2597 2626 180 11890
NOTE: Full implementation of surveillance system began on the evening of 9/14/01

File name is "Combined report for 9-19-01"

W:Apps/Pdox40/worldtrade/reports/Intemal
13
 Prepared on Septer 20, 2001
4. Hospital Needs Assessment Survey for September 19, 2001 (GNYHA, NYCDOH, NYSDOH)
#of #ofER #of
Admissions . Visits Mortalities #of #of
Date Related to Related to Related to the Admissions # of ER Visits WTC Share Unidentified
Hospital Prepared WTC WTC WTC (Any Total) (Any Total) of ER Visits Patients
Beth Israel Medical Center- Kings Highway 9/19/01 2 69 - 221 801 9% .
Beth Israel Medical Center- Petrie Division 9/19/01 27 276 - 647 1,231 22% .
Beth Israel Medical Center- Singer Division 9/19/01 - 21 - 57 251 8% -
Cabrini Medical Center 9/19/01 9 192 - 217 518 37% .
Calvary Hospital 9/19/01 - - - - - 0% -
Jacobi Medical Center 9/19/01 1 159 - 458 1,697 9% -
Lawrence Hospital 9/19/01 - 27 - 182 527 5% -
Lenox Hill Hospital 9/19/01 3 63 - 94 108 58% .
Long Island Jewish Medical Center 9/19/01 1 50 - 527 991 5% .
Memorial Sloan Kettering Cancer Center 9/19/01 - - - 382 - 0% -
Mount Sinai Medical Center 9/19/01 - 43 - 1,115 1,208 4% .
New York Community Hospital 9/19/01 1 36 - 120 395 9% .
New York Methodist Hospital 9/19/01 2 119 - 677 1,420 8% -
New York Presbyterian Hospital- Westchester 9/19/01 - - - 55 - 0% -
North Central Bronx 9/19/01 1 12 - 129 977 1% -
North Shore University Hospital at Plainview 9/18/01 - 21 - 164 647 3% -
North Shore University Hospital at Syosset 9/19/01 - 13 - - - 0% -
Northern Dutchess Hospital 9/19/01 - 2 - 35 216 1% -
NYU Downtown Hospital 9/19/01 24 497 3 65 731 68% .
Parkway Hospital 9/19/01 - 33 - 148 347 10% -
Roosevelt Hospital 9/19/01 4 131 - 351 910 14% .
St. Clare's Hosptital 9/19/01 3 42 - - - 0% .
St. John's Episcopal Hospital, South Shore 9/19/01 1 17 - 266 714 2% .
St. John's Riverside Hospital 9/19/01 1 10 - 288 627 2% .
St. Joseph's Medical Center-Yonkers 9/19/01 - 1 - 138 645 0% .
St. Luke's Hospital 9/19/01 - 54 - 416 1,292 4% -
St. Vincents Hospital Manhattan 9/19/01 106 590 4 452 1,388 43% -
SUNY Stonybrook Hospital 9/19/01 - 32 - 580 1,509 2% -
SVCMC - Mary Immaculate 9/19/01 2 44 - 211 1,042 4% -
Yasser Brothers Hospital 9/19/01 - 15 - 349 788 2% -
_
Wycoff Heights Medical Center 9/19/01 2 72 - 386 1,601 4%
Total 31 190 2,641 7 .. 8,730 22,581 12% -
File name is "Combined report for 9-19-01"
W:Apps/Pdox40/worldtrade/reports/Intemal
15
To: Sandra Mullin, Associate Commissioner
Public Affairs

Fr: Jessica Morris, Direct

Community Relations

Re: WTC Outreach

cc: Neal Cohen, MD, Commissioner

Laura Mascuch, Chief of Staff
Ben Mojica, MD, Deputy Commissioner
Issac Weisfuse, MD, Associate Commissioner
Kelly McKinney, Associate Commissioner

Date: September 20, 2001

On Wednesday, September 19, 2001 three fact sheets were printed for
distribution to the community around ground zero.

Yellow - RECOMMENDATIONS FOR RESIDENTS & COMMERCIAL TENANTS

A stack of this fact sheet was given to every building superintendent to
distribute to tenants. A large quantity was also distributed to the NYC
Department of Buildings at 60 Hudson Street, the EDC outreach site at
1 10 Maiden Lane and Yaffa Cafe (local tenants choose it as a site where
neighborhood volunteers could pick up fact sheets for distribution to
their neighbors).

Battery Park City 10,000

Yaffa Cafe 10,000
DOB 20,000
Delis, Restaurants, Businesses, etc. 10,000

Outreach was done by a small group from Community Relations on

Wednesday. On Thursday, a team of 30 people (from Economic
Development Corporation, Asthma, Lead Poisoning) helped to canvas the
entire area south of Canal Street by foot. Fact Sheets were taped on
buildings, stacks of information was given to school principals, supers """
and storeowners to distribute.

Green - AIR QUALITY

This fact sheet was distributed in a similar way as the latter.
Battery Park City 5,000
NYPD/FD 5,000
Other 5,000

Pink - HEALTH OF RESCUE PERSONNEL

On Wednesday, these were driven in bulk to ground zero and given to

appropriate personnel at NYPD and NYFP for widespread distribution at
briefings.

NYPD COMMAND CENTER 5,000

NYFD COMMAND CENTER 5,000
OEM 500
 NYC
Health
THE NEW YORK CITY
DEPARTMENT of HEALTH

RECOMMENDATIONS FOR PEOPLE RE-OCCUPYING COMMERCIAL BUILDINGS

AND RESIDENTS RE-ENTERING THEIR HOMES

What steps have building owners and managers taken to ensure building safety?

Before building owners and managers allow residents and occupants to return, they have been required by New
York City to assess and certify the stability and safety of their buildings. Specifically, no building may be re-
occupied unless each of the following steps has been taken:

1) the structure has been thoroughly assessed for strength and stability;
2) gas service has been checked and restored, with the help of Con Edison;
3) electrical service is operating, and any exposed wires or damaged fixtures have been repaired or
removed;
4) building water service is operating, roof water tanks have been flushed and re-filled and, if necessary,
cleaned;
5) steam service has been checked and restored, where appropriate;
6) the building has been assessed for hazardous materials and if any have been found, they have been
removed according to applicable regulations;
7) building mechanical systems have been inspected and cleaned and repaired, as necessary, including
heating, ventilation and air conditioning systems;
8) the interior has been cleared of dust and debris.

In addition, New York City is requiring building owners and managers to communicate with building occupants and
be available to answer questions regarding building conditions. If you have questions about any of the above issues,
you should contact your building owner, manager or superintendent.

What steps should I take upon returning to my workplace or home?

In a workplace, speak to your supervisor to see if there special startup and cleaning procedures. In very dusty
places, clean-up may be necessary before equipment can be restarted. Follow the cleaning procedures discussed
below.

In your home, you should first make sure that conditions are safe. You should enter your home dressed in a long
sleeve shirt and pants, and with closed shoes. Upon entry:

• Check for the smell of gas. If the apartment smells of gas, leave immediately and report it to your building
manager and to Con Edison.
• Check for broken glass and fixtures. Wrap any broken glass in paper and mark it "broken glass." If large pieces
of glass are broken, ask your building superintendent for help.
• Run hot and cold water from each of the taps for at least two minutes, or until water runs completely clean,
whichever is longer.
• Flush toilets until bowls are refilled. For air pressure systems, you may need to flush several times. If there are
any problems with the toilet or plumbing system, call a plumber — do not try to fix the problem yourself.
• Follow the cleaning procedures discussed below.

I have heard that asbestos was released from the collapse of the World Trade Center. What are the health effects
of asbestos?

City, State, and Federal agencies have collected dust, debris, and air samples since the World Trade Center collapse.
Though most of the samples have no asbestos, some have found very small amounts of asbestos.
 NYC
Health
THE NEW YORK CITY
DEPARTMENT of HEALTH

PUBLIC HEALTH ADVISORY CONCERNING AIR QUALITY IN THE AFFECTED

AREA OF THE WORLD TRADE CENTER DISASTER

The NYC Department of Health (DOH), in collaboration with the City, State, and Federal
agencies, is closely monitoring and analyzing air quality data in the wake of the World Trade
Center disaster. Following the collapse of the Twin Towers, significant quantities of smoke and
dust have been released into the air. The plume of smoke contained dust, ash, soot, and other
burning materials present at the site.

In general, dusts can cause respiratory symptoms and eye and throat irritation. Because dust will
continue to remain in the air during the ensuing clean-up efforts following the World Trade
Center disaster, residents in the vicinity of the World Trade Center are encouraged to take
precautions when they return to their homes.

What are the Recommendations for Residents Living in Lower Manhattan ?

All residents in the immediate vicinity of the World Trade Center - particularly those who live
the area bounded by Warren Street to the North, Broadway to the East, the Hudson River to the
West, and Exchange and Thames Streets to the South - should take the following precautions
when they return to their homes:

! Avoid unnecessary outdoor strenuous activity;

! Avoid sweeping or other outdoor maintenance;
! Keep dust from entering the home (e.g., remove shoes before entering the home);
! Keep windows closed;
! Set the air conditioner to recirculate air (closed vents), and clean or change the filter
frequently;

What should I do if I experience respiratory symptoms?

Dust and other paniculate matter have the greatest impact on persons with underlying respiratory
conditions. Such individuals may experience chest tightness, wheezing, and shortness of breath.
Anyone who has difficulty breathing should consult their physicians, especially those with
underlying respiratory conditions. People with asthma may need to increase their usual medical
treatment with more frequent use of bronchodilators, and should consult their physicians if
necessary.

If I experience any eye irritation what should I do?

Ocular saline solutions or tap water may be used to rinse eyes irritated by dust. All persons
should avoid wearing contact lenses while in the affected area.
 NYC
Health
T»€}»EW YORK CITY
DEPARTMENT at HEALTH

HEALTH OF RESCUE PERSONNEL

What risks do human body parts found inside of exploded and collapsed buildings pose
to rescue workers?

There is no threat of a general outbreak of infectious disease among workers at the site.
You may be at risk for infection if you cut yourself with an object contaminated with
blood, body fluids or tissue, or if these materials touch your eyes, nose or mouth or areas
of broken skin. Bad odors that come from decomposing bodies, although unpleasant, are
not harmful.

What should I do if I'm injured or splashed?

Immediately report to your supervisor any injuries or splashes to eyes, nose, mouth or
broken skin by blood or body fluids so that appropriate medical evaluation and care can be
provided. Infections can be prevented if you follow appropriate precautions.

What precautions should rescue workers take?

Do not touch bodies or body parts directly. Rescue workers who expect they might have
direct contact with human remains should do the following:

• Wear heavy-duty waterproof gloves to protect against injury from sharp objects.
• Use eye protection and respirators equipped with O VAG cartridges to protect
eyes, nose, and mouth from splash exposures and noxious odors.
• Wear protective garments to protect skin and clothes.
• Immediately wash hands with soap and water after removing gloves.
- Alcohol-based hygiene products are a useful substitute only when hands are
not visibly soiled.

How can my overall health be affected from exposure to decomposing remains?

Seeing decomposing remains can cause emotional trauma, grief, anger and sadness.
Immediately after the disaster, it will be normal for you to feel:

• Numbness • Denial or shock

• Flashbacks and nightmares • Grief reactions to loss
• Anger • Despair
• Sadness • Hopelessness

What should a rescue worker do if he or she experiences emotional distress?

 Shelter Client Usage

Shelter 9/17 9/17 9/17 9/17 9/18 9/18 9/18 9/19 9/19 9/19 9/20 9/20 9/20 9/21
8A 3P IIP 8A 3P IIP 8A 3P IIP 8A 3P IIP 8A
# # # # # # # # # # # clients # clients
# clients #
clients clients clients clients clients clients clients clients
clients clients clients
Seward Park 5 2 0 4 0 1 4 6 Closed Closed Closed Closed Closed Closed
HS
Washington 28 30 40 20 26 25 17 13 20 35 45 So
Irving HS
Fashion 44 39 55 52 45 8 52 33 Closed Closed Closed Closed Closed Closed
Industry HS
Chelsea HS 6 14 3 8 8 13 11 15 23 24 22 \o
Norma Thomas 19 22 22 21 24 14 .14 14 Closed Closed Closed Closed Closed Closed
HS
City School HS 4 6 2 2 7 3 4 6 2 8 1
*
JHS22 2 3 0 4 4 4 5 5 3 4 1

IS 131 12 14 17 • 11 7 13 7 8 0
$ ^ *
Comprehensive 7 6 5 8 8 9 9 9 8 10 4 •T
Day&Night HS
Bayard Rustin Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed
HS

Curtis HS, SI Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed

Westinghouse 49 8 0 1 0 0 0 0 0 0
HS,BK worker workers 30 100 30 work (C«J<?--too
work work
 Shelter Client Usage

Shelter 9/17 9/17 9/17 9/17 9/18 9/18 9/18 9/19 9/19 9/19 9/20 9/20 9/20 9/21
~1A 8A 3P IIP 8A 3P IIP 8A 3P IIP 8A 3P IIP 8A
# # # # # # # # # # # clients # clients # # clients
clients clients clients clients clients clients clients clients clients clients clients
Seward Park 5 2 0 4 0 1 4 6 Closed Closed Closed Closed Closed Closed
HS
Washington 28 30 40 20 26 25 17 13 20 35 45 50 32 37
Irving HS
Fashion 44 39 55 52 45 8 52 33 Closed Closed Closed Closed Closed Closl7ed
Industry HS
Chelsea HS 6 14 3 8 8 13 11 15 23 24 22 10 24

Norma Thomas 19 22 22 21 24 14 14 14 Closed Closed Closed Closed Closed CloseOd

HS
City School HS 4 6 2 2 7 3 4 6 2 8 1 3 12 0

JHS22 2 3 0 4 4 4 5 5 3 4 1 2 1
2 work
IS 131 12 14 17 11 7 13 7 8 0 11 5

Comprehensive 7 6 5 8 8 9 9 9 8 10 4 7 15 5
Day&Night HS
Bayard Rustin Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed
HS

Curtis HS, SI Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed Closed

Westinghouse 49 8 0 1 0 0 0 0 0 0 0 2
HS,BK worker workers 30 100 30 work 10 work 50 work
work work
 Environmental Monitoring Update
Data reported to NYC DOH 9/20/01 as of 4 pm

Asbestos

Ambient air monitoring

Agency Date Location N N above 0.01 N above OSHA Maximum Comment

samples fibers/cc* PEL@ (fibers/cc)
USEPA (rounds 9/18/01 Hot zone, close in 11 2 0 0.047 Highest levels at Albany ai
8 and 9) Greenwich and Liberty and
v f South End, TEM was <0.0(
9/18/01 Hot zone, perimeter 7 0 0 0.042 Max was at Wall and Broac
TEM was O.008
9/18/01 Nearby neighborhood to 4 0 0 0.018
Hot zone
9/19/01 Fresh kills 18 2 0 0.029 Both samples above 0.01 at
screening OPS (site)
* 0.01 fibers per cc by TEM method. Approximately equivalent to
@ US-OSHA permissible exposure limit for 8 hour time weighted average. Results are by PCM method.

Personal air monitoring

Agency Location Activity N N above Maximum Comment

samples OSHA (fibers per
PEL* cc) #
Con Ed Hot Zone Cable splicing 2 0 O.007
in manhole
 Hot Zone Walking - 4 0 0.012
various
locations
OSHA Data not received at DOH as of 4 pm
Federal Data not received at DOH as of 4 pm
Occupational
Health
* 0.1 fibers per cc. US-OSHA permissible exposure limit for 8 hour time weighted average. Results are by PCM method.
(i>

Bulk (settled) dust

Agency Date Location N N asbestos N>1% Maximum Comment

y samples detected (%)
USEPA 9/18/01 Hot zone, close in 11 10 6 1.9%

Interpretation: The most recent ambient air samples in and around WTC and Fresh Kills, generally well below permissible exposure
limits for occupational exposure and, in most cases, for community exposure. However, potential for higher exposures exist based on
past personal air samples and presence of asbestos in dust and debris. Continued use of appropriate respiratory protection for workers
in or near potentially dusty locations or tasks is indicated. Dust suppression measures should be expanded. Additional personal
monitoring underway.
 Other Compounds

All test results below provided by US EPA

Lead in ambient air: Four samples in hot zone were collected. Highest was 1.9 micrograms per cubic meter. Other samples < 1.5
micrograms per cubic meter (National Air Quality Standard), OSHA PEL is 50 micrograms per cubic meter.

Interpretation: Lead levels in ambient air well below levels for worker concern. Personal monitoring pending.

Volatile organic compounds in ambient air: 3 samples were collected around the debris pile. Low levels of VOCs, no immediate
health concerns. 2 samples were collected in the plume - Benzene detected at 100 parts per billion, just at OHSA PEL.

Interpretation: VOtTexposures for most workers should be low, but potential exposures exist. Appropriate respiratory protection
should continue to be worn.

Miscellaneous toxic and acid gasses (by direct reading instruments): low levels of phosgene and hydrogen cyanide present.

Interpretation: No immediate public or occupational health threat. Personal air sampling pending. Appropriate respiratory protection
should continue to be worn.
 The City of New York
DEPARTMENT OF HEALTH
Rudolph W. Giuliani Neal L. Cohen, MD
Mayor Commissioner

Minimum Safety Gear That Should Be Worn

Prior to Entry
Within the Police Line of WTC Work Area
(issued 9/20/01)

Personal Protective Equipment:

Hardhat
Safety glasses (Z.87) with side shields
OR Face Shields
OR Goggles
Half-face re-useable respirator with
PI00, organic vapor/acid gas (OVAG) cartridge
Change cartridge after every shift
Leather gloves with latex (or nitrile) glove liner (or equivalent)
when handling human remains or rubble
Coveralls or long-sleeved work shirt
Steel-toed boots (or equivalent)

Eye and respiratory protection is strongly advised whenever smoke or

odors from the rubble occur outside the Police line.

Fit-checking is needed to assure proper seal.

Facial hair that interrupts the seal is not permitted.
Entry into confined spaces with unknown or untested atmospheres
requires air-supplied respirators.
Welders need appropriate eye protection and leathers.
 r/^ i 'fa i
Lead Agency/
Issue Support Agency Deadline | Status
Cifo OtHtty
ijjltj <5<ifi»fv -' , - ' . ;; - - -- , , ' - ' • :-',-'„"
^,- -•'•<• > N-
, , . »•';* ":.'*-, A- , '-- >v^--v'c
* / *'-';" x^"^-"" «. ?,•', •' ',;
v*" *•'•; ,-"*„ <•; "s- - V~,/'
- "X/
--' ,-„*; >V.'/
" .'"»< ••• -! ,-- , - , •, „' ,• - • :, -
4' .. .. \... r1 , .'. "•.'. f . •: > v .. «

Implement Health & Safety Plan, establish safety NYC DDC / OSHA, NYS 09/25/01; 08:00 -. • - Bechtel sending 30 CSP
parameters, conduct tool box meetings, conduct ongoing DOL, NYS, Bechtel, FDNY personnel.
site surveillance, provide field guidance)
0 Establish respirator fit-testing locations NYC DOH / OSHA 09/21/01; 08:00 ' Interim location @, PS 89
0 Provide respirator fit-testing, maintenance and use NYC DOH / OSHA Ongoing Completed 9/19
information, comprehensive technical support
0 Designate site safety officer and support staff NYC DDC 09/20/01; 18:00 Completed; Bob Adams
assigned as site safety officer

Q- Provide respirator wash stations NYC DOH /EPA 9/22/01; 08:00 Being implemented
D NYC DDC /NYC DOH, 9/21/01 .. Deing developed
Develop the job and site specific PPE requirements OSHA, NIOSH
D ' Develop and distribute a list of required PPE to all site NYC DDC /NYC DOH, 9/21/01; 24:00 Being developed
emergency response and workers. Including posters for OSHA, NIOSH
staging areas.
D Install eyewash stations at each of four Sector Command NYCDOH/EPA, DCAS 9/20/01; 8:00 am Should be on-site 9/21
Posts
0 Quartermaster to determine resource needs and NYC DOH /NYS National 9/17/01 Ongoing
coordinate supply, delivery and distribution. Guard
Co-located at feeding stations/ access point
HazCat
0 Implement. Coordinate with Lt Tim Duffy DEC, Asst NYC DEP /NYS DEC, EPA 9/19/01 OSC Hazard Characteristic
Chief Cruthers FDNY and Enzo Catanzaro DEP personnel on the ground
HazMat 9/19/01
D Conduct HazCat Assessment. Coordinate analysis. NYC DEP / NYS DEC, EPA, 9/21/01
Distribute results and provide information to 1C, OEM, NIOSH
and all support agencies.
D Put in wind socks at various locations throughout DDC /DOH 9/21/01
disaster site.
Worker Exposure
0 NYC DOH /NIOSH DOH on-site 9/13/01 NIOSH Ongoing - Daily
Conduct worker hazard assessment on-site 9/17/01
9/21/01 9/21/01 11:40 AM page O f4
 Lead Agency/
Issue Support Agency Deadline Status
0 NYC DOH7NIOSH) Implemented by NIOSH/ SCA Ongoing - Daily
Implement initial worker exposure monitoring program 9/18/01
D Issue daily work site air quality update (distribute via NYC DOH / NIOSH, EPA, Daily Daily
hard copy and Internet) NYSDEC
Occupational Medicine
0 Develop protocols for on-site exposure related Tetanus NYCDOH/DMAT Completed 09/20/01 Ongoing - Daily
and HepB vaccinations
B" Provide inhaled steroid for relief of cough FDNY / CDC,NYCDOH 9/21/01 Procedures being developed
D Conduct ott-site_pjppjalactie-i-etanarand HepB ^~" NYC DOH 9/21/01 Procedures being developed
yaeeinsfions
0 Provide tetanus ^n^jiejmtitis^-vaccme^on-siie when NYCDOH/ DMAT Implemented 09/20/01 Ongoing - Daily
puncture^wSunds or blood exposure occurs
- , , - . ^- - • • - , , . ~ , - - - } , , :
litetifttt • ' * \ ' '- <
Water
0 Implement water monitoring program NYC DOH /NYC DEP Implemented 09/1 9/01 Report daily
D Establish procedure for communicating results and NYC DOH 9/21/01 Ongoing - Daily
decision making
Ambient Air
0 NYCPOH / NYC DEP, DEC, Completed 9/1 4/01 Ongoing - Daily
Develop community air monitoring protocol to determin^ ^EPA^DEP, Port Authority,
air quality impacts of disaster NIOSH^pSHA
0 Implement ongoing community air monitoring program NYC DOH<ragJl^^EP, Commenced 9/15/01 Ongoing - Daily
for contaminants of concern Port AuthorityTNTOSHTOSHA

Food ^
& Establish full-service feeding stations at locations at OEM7)FDNY, NYC DOH, 9/21/01 Finalizing locations
ground zero perimeter ^ NYC DOS
B- Control food sources to the site NYC DOH Completed 9/14/01 Ongoing - Daily
D- Remove food vendor carts NYC DOS 9/22/01 Order being placed
Install hand washing facilities at all feeding stations N'vr" 1 now"7'PPA TiPAQ
I T A V*- \J\J\QL. 1 Cf r ft. Kjf \_ff\ij 9/20/01 60 ordered o/s 9/20; 60
additional ordered for delivery
w • on 9/23

9/21/01 9/21/0111:40 AM page 2 of4

 Lead Agency/
Issue Support Agency Deadline Status
0 Implement ongoing FSE inspection program NYC DOH / PHS Permanent PHS crew on site Ongoing - Daily
9/19.
0 Establish daily waste collection from feeding stations NYC DOS Completed 9/15/01 Ongoing - Daily

Pest
0 Establish vigorous waste collection within and around NYC DOS 9/15/01 Ongoing - Daily
work site
0 NYC DOH Implemented 9/18/01 Ongoing - Daily
into work site
0 Establish surveillance within work site and exterminate NYC DOH Implemented 9/1 8/01 Ongoing - Daily
as needed
0 NYC DOH 9/19/01 Ongoing - Daily
Implement Mosquito Control Plan within secure area
0 Establish surveillance within work site and larvicide as NYC DOH Implemented 09/20/01 Ongoing - Daily
needed
W^W^frTWw^hswsyw. / A «. ##&, f?y*^f*^^*>b*W$p<4firX(p*frS «

Public Information ^ ', ' - , ' '•'"'*, :%,^'^^>f^;-^'^J5^4>

Public Health Advisories
B" Centralize issuance of public health advisories at DOH NYC DOH / NYS DOH, CDC As needed Process and coordination in
and coordinate releases as needed place
Surveillance
0 Daily Injury/ Illness Surveillance NYC DOH Commenced 9/14 Ongoing - Daily
D Determine number of workers on-site (to plan service NYC DOH Commenced 9/15 Numbers received from FDNY,
volumes) 7t construction companies

U NYC DDC / FDNY, OEM, 09/21/01; 18:0.0

Site map showing sectors; actual & planned access sites, EPA, NYSDEQNIQSH,
fit-testing locations, feeding stations & zones of concern. NYCDOHCg^SP
D NYCDOH/FDNY.DDC, 09/21/01; 18:00 Being developed by Bechtel
Draft Emergency Plan (including evacuation procedures) (^J3o±te3
Wash down Stations

9/21/01 9/21/0111:40 AM page 3 of4

 Lead Agency/
Issue Support Agency Deadline Status
0 Determine capacity requirements, washdown station size, NYC^DOH^NYFD, NYC 9/15/01 Capacity issue is critical.
configuration and location (coordinate with stakeholders) MOEM . Facilities cannot constrain
operation.
0 Submit Request for Assistance NYCJDOH 9/16/01 Completed
0 Assess site configuration, access points, and personnel NY^JOH / EPA,OSHA, 09/19/01;18:00 Flexible to meet changing
and equipment flow rates NYSDEC resource needs
D EPA Region II 9/21/01 Contractors hired. Must be at
Implement 100% by 1800 on 9/21

Washdovm locations: Rector & West St, Southend & Liberty (Gateway Plaza), Barclay & Church, WFC Marina, Albany & Southend (Checkpoint Alpha), Albany (South of I Financial
Plaza)
24/7 operation, DataRams, meteorological and portable eyewash stations.

9/21/01 9/21/0111:40 AM page 4 of4

 THE CITY OF NEW YORK GARY p- SHAFFER
phone: 212-676-2740
MICHAEL A. CARDOZO LAW DEPARTMENT fax:212-788-0367
Corporation Counsel 100 CHURCH gshaffer@law.nyc.gov
NEW YORK, NY 10007

April 1,2004

BY HAND

Sam Caspersen, Esq.

The National Commission on Terrorist Attacks Upon the United States
26 Federal Plaza
Suite 13-100
New York, NY 10007

Re: Document Production - City of New York

Dear Mr. Caspersen,

Enclosed is a CD that contains the grid locations where remains of Fire Department
personnel were located at the World Trade Center site. Also enclosed are is a victim tracking
map that may be helpful. We understand that because of the sensitivity of the information, you
have agreed that this information will not be released to the public.

Very truly yours,

Assistant Corporation Counsel