A federal health official is expected to decide within days whether to expand an aid program for anyone sickened by World Trade Center dust to cover cancer, a move that would be cheered by many former ground zero workers, but could also prove costly and come at the expense of people with ailments more conclusively linked to 9/11's toxic fallout.
An advisory committee recommended in March that the government open up the $4.3 billion program to people with cancers in 14 different broad categories, including nearly all of the most common forms of the disease.
To date, there is little hard evidence of unusual cancer rates among people exposed to the soot that fell on lower Manhattan after the attacks. But the panel, made up of occupational health specialists, toxicologists, union officials and health advocates, said there were enough carcinogens present at the site to create a plausible risk.
National Institute for Occupational Safety and Health director Dr. John Howard is scheduled to make a determination by Saturday, though his decision might not be announced until Monday.
Adding cancer to the list of covered conditions would make hundreds, or even thousands, of residents and rescue and recovery workers eligible for government-financed medical treatments and sizeable payments for lost wages and diminished quality of life.
But it might also put a severe financial strain on the program.
If Howard accepts the panel's recommendations in their entirety, there would likely be a surge of costly claims in a system now primarily helping people with conditions that aren't life-threatening, like asthma, chronic sinus irritation, sleep apnea or acid reflux disease.
The total number of people exposed to the dust is unknown, but 60,000 people have already enrolled in9/11health programs for people who lived or worked within the disaster zone, which covers most of Manhattan south of Canal Street.
Congress capped funding for the program at $1.55 billion for treatment, and $2.78 billion for compensation payments.
The special master overseeing applications for compensation, Sheila Birnbaum, said that unless Congress increases those amounts, she may have to prorate payments based on the number of people who apply and the severity of their illness.