Time intervals for new onset aerodigestive disorders
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Time intervals for new onset aerodigestive disorders

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    The James Zadroga 9/11 Health and Compensation Act of 20102 ("Act") authorizes treatment for enrolled responders and survivors whose health conditions are certified by the WTC Health Program as WTC-related health conditions. In order for a health condition to be certified, a Clinical Center of Excellence (CCE) or Nationwide Provider Network (NPN) physician must first make a determination that an individual's WTC exposure to airborne toxins, other hazards, or adverse conditions resulting from the September 11, 2001 terrorist attacks (9/11 exposure) is substantially likely to be a significant factor in aggravating, contributing to, or causing an individual’s health condition.

    The physician’s determination is transmitted to the Administrator of the WTC Health Program. If the Administrator finds that the health condition is included on the List of WTC-Related Health Conditions3 and concurs that the 9/11 exposure is substantially likely to be a significant factor in aggravating, contributing to, or causing the health condition, then the Administrator will certify the individual’s health condition as eligible for treatment by the WTC Health Program.4 The CCE/NPN physician’s determination and the Administrator’s certification decision must be based on an assessment of the following: (1) the individual's exposure to airborne toxins, any other hazard, or any other adverse condition resulting from the terrorist attacks; and (2) the type of symptoms and temporal sequence of symptoms.5

    Time Intervals for New Onset Aerodigestive Disorders is the second in a series of WTC Health Program policies that provide information about the temporal sequence of symptoms requirement for determination and certification of WTC-related health conditions. The first policy in the series, “Minimum Latency & Types or Categories of Cancer,” addresses the temporal sequence for cancers that are considered WTC-related health conditions and is posted on the WTC Health Program website at http://www.cdc.gov/wtc/policies.html.

    Time Intervals for New Onset Aerodigestive Disorders provides information about the minimum and maximum amount of time allowed between the individual’s WTC exposure and the onset of symptoms of an aerodigestive disorder6 for purposes of determination and certification of the disorder as a WTC-related health condition.7 For a WTC-related aerodigestive disorder, the time interval is the period of time between the last day of the individual’s 9/11 exposure and the earliest date of symptoms of the aerodigestive disorder under consideration.

    For each of the five categories of aerodigestive disorders, the Administrator has determined that no minimum time interval should be established. For four of the five categories of aerodigestive disorders—obstructive airways, upper respiratory diseases, gastroesophageal reflux disease (GERD) co-occurring8 with another WTC-related aerodigestive disorder, and isolated GERD9—the Administrator has determined that for certification a maximum time interval should not be exceeded unless highly unique exposure circumstances can be documented for that individual. However, for a fifth category, interstitial lung diseases, the Administrator has determined that no maximum time interval can be established. The specific exposure circumstances of each case will be considered in the determination and certification processes to decide whether the maximum time intervals specified in this policy are reasonable to apply to the particular case.


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