shirlaw et al

MADDENING BARRIERS PERSIST: Court Lieut. Angela Shirlaw (left) faced stubborn resistance from the Office of Court Administration that her breast cancer was a result of the time she spent at the World Trade Center site despite ‘pretty much indisputable evidence’ of a connection until she testified at a state hearing last year. Attorney Jeffrey Goldberg (center) and World Trade Center Health Program Director Jacqueline Moline said such problems have been common among female 9/11 responders because of old prejudices and the lack of large numbers of case studies that exist for their male counterparts.

In the 18 years since the World Trade Center attacks, the health status of the first-responder population that logged time there has been closely screened and monitored.

Yet according to several 9/11 female first-responders interviewed, there’s not enough attention being paid to the health impact on women of the contamination from prolonged exposure to toxic substances at the site.

And as a consequence, they argue, the bar can be higher for them when it comes to proving a connection to their aliments and that exposure, and as well as in getting the benefits their similarly situated male colleagues get.

They contend part of the problem is derived from the disparity in numbers that was created by being trailblazers in jobs long dominated by men.  

Outnumbered 7-to-1

The World Trade Center Health Program for responders has 64,408 men and just 9,036 women. The women interviewed for this article contend that gap stems from prejudices that historically made it difficult for women to break into the city’s emergency services  

“This is a problem in general, with the emergency services particularly with women firefighters because of the very small numbers nationwide and especially in New York,” said retired FDNY Capt. Brenda Berkman, who served at the WTC site from 9/11 until the clean-up was completed in May 2002. “At the time of 9/11, there were about 25 women in the firehouse out of 11,000 firefighters."

Over the years, women’s-health advocates around the world have documented a pronounced disparity between the sexes in terms of their participation in clinical trials and medical research.

"If I am doing this [medical] investigation and we are using men as our research  subjects and then think we will apply that [research] to women, that's a medical problem, that's a scientific problem that has affected women’s medical treatment across the general population that is particularly acute in the emergency services," Ms. Berkman said. "When you think about it,  if the scientists are missing the general population of women, who are more than 50 percent of people on the earth, what makes you think they will focus on a subset who in the case of the Fire Department are less than 1 percent."

When Proof Isn't Enough

On 9/11 Court Lieut. Angela Shirlaw was in the locker room at 100 Centre St. getting ready for work when the first plane hit. After she and her colleagues evacuated the courts, they were detailed to the World Trade Center site.  

In August 2017, she was diagnosed with an aggressive form of breast cancer that the World Trade Center Health Program certified as 9/11-related. Last year, she had a bilateral mastectomy and was diagnosed with polyneuropathy, a side effect of her treatment that was also certified as a WTC condition.

In an interview, Ms. Shirlaw recounted the resistance she encountered from her agency, the Office of Court Administration, which initially refused to honor a state law that required it to restore the 855 hours of sick time she had accumulated over her 20-year career and used to get the treatment she needed.

“I turned over pretty much indisputable evidence to my employer [OCA],” Ms. Shirlaw said. “I turned over World Trade Center Health Program [documentation], letters from my oncologist, from Sloan Kettering, the New York Workers Compensation Board, who sent me to an independent medical examiner, but my job didn’t accept any of it and then they turned around and said I volunteered.”

Testimony Got Action

After she publicly testified last year before the State Senate Civil Service and Pensions Committee recounting her experience with OCA, her banked time was restored.

“I can’t help but wonder if I was a male if it would have been as difficult as it was for me,” Ms. Shirlaw said. “When we talk about the women of 9/11, often times we think just of the moms and wives of the first-responders who died. We are never thinking about the women first-responders, and that’s because we are the minority.”

She continued, “What flows from that is women’s health conditions are less understood and less acknowledged…When men present something as common as prostate cancer, it is accepted and they are going to get benefits and services right away, but with women I feel that we are subject to a little bit more scrutiny….I know men that have been compensated for two [WTC-related] ailments, while I know one particular woman who is still trying to prove the connection for the cancer she sustained.”

“My cancer was one of the most-aggressive breast cancers and least-common,” Ms. Shirlaw said. “I would love to see more research done on what happened and why did I get this cancer. Now we are seeing more men being diagnosed with [WTC linked] breast cancer.”

Jeffrey Goldberg is an attorney who specializes in WTC employment and compensation claims and has handled several female first-responder cases.

Unequal Treatment

“It is still a chauvinistic world,” he said in a phone interview. “Most of the medical boards are male and you don’t just get this from the doctors but from males in general: some of whom don’t believe women belong in these jobs. It does have an impact. Females get approved, but not at the same rate.”

Mr. Goldberg said he’s representing a female NYPD Officer who had come down with WTC-linked fibromyalgia first diagnosed in 2004 “and the medical board pooh-poohed her and treated her like she was a girl who just didn’t want to work anymore.”

He said he was pressing that officer’s case in the courts. “I had to go to the Appellate Division—we had a great decision and the Court of Appeals affirmed it,” he said.  “She is going back to the medical board Sept. 18.”

Doctor: Concerns Valid

Dr. Jacqueline Moline, one of the nation’s leading occupational medicine specialists, is director of the Northwell Health Queens World Trade Center Health Program for 9/11 first-responders. She said in a phone interview that the concerns raised by female 9/11 first-responders were valid.

"I think certainly we don't have the numbers in the responder cohort that might give us the statistical power to be able to look at something and answer some of these important questions more definitively,” she said. “So, while it is a challenge, it does not mean we are not going to look for conditions affecting female first-responders, but they are absolutely right—some of these issues may be unaddressable."

Dr. Moline said that she believed that medical researchers might be able to overcome the dearth of health data on WTC female first-responders by referencing the data collected by the World Trade Center Registry.  

The registry was developed by the city Department of Health and Mental Hygiene and the Federal Agency for Toxic Substances and Disease Registry (ATSDR).  Between 2003 and 2004, they amassed a volunteer registry of over 70,000 people composed of 43,000 building occupants, residents and workers and 31,000 first-responders. The participants are regularly surveyed.

As a consequence of the WTC Registry being weighted toward the civilian survivor population present in the WTC contamination zone, the gender ratio includes a much-higher percentage of women than does the first-responder cohort, with women making up just over 40 percent of those being tracked.

Dr. Moline said, “The ratio is more balanced from a gender perspective, so it can provide information regarding conditions that affected individuals with WTC exposures."

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