80 FR 32333 - World Trade Center Health Program; Petition 007-Autoimmune Diseases; Finding of Insufficient Evidence
DEPARTMENT OF HEALTH AND HUMAN SERVICES Federal Register Volume 80, Issue 109 (June 8, 2015)
Federal Register Volume 80, Issue 109 (June 8, 2015)
| Page Range | 32333-32334 | |
| FR Document | 2015-13914 |
[Federal Register Volume 80, Number 109 (Monday, June 8, 2015)] [Proposed Rules] [Pages 32333-32334] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2015-13914] ======================================================================= ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES 42 CFR Part 88 World Trade Center Health Program; Petition 007--Autoimmune Diseases; Finding of Insufficient Evidence AGENCY: Centers for Disease Control and Prevention, HHS. ACTION: Denial of petition for addition of a health condition. ----------------------------------------------------------------------- SUMMARY: On April 6, 2015, the Administrator of the World Trade Center (WTC) Health Program received a petition (Petition 007) to add certain autoimmune diseases, including rheumatoid arthritis and connective tissues diseases, to the List of WTC-Related Health Conditions (List). Upon reviewing the scientific and medical literature, including information provided by the petitioner, the Administrator has determined that the available evidence does not have the potential to provide a basis for a decision on whether to add certain autoimmune diseases to the List. The Administrator finds that insufficient evidence exists to request a recommendation of the WTC Health Program Scientific/Technical Advisory Committee (STAC), to publish a proposed rule, or to publish a determination not to publish a proposed rule. DATES: The Administrator of the WTC Health Program is denying this petition for the addition of a health condition as of June 8, 2015. FOR FURTHER INFORMATION CONTACT: Rachel Weiss, Program Analyst, 1090 Tusculum Avenue, MS: C-46, Cincinnati, OH 45226; telephone (855) 818- 1629 (this is a toll-free number); email [email protected]. SUPPLEMENTARY INFORMATION: Table of Contents A. WTC Health Program Statutory Authority B. Petition 007 C. Administrator's Determination on Petition 007 A. WTC Health Program Statutory Authority Title I of the James Zadroga 9/11 Health and Compensation Act of 2010 (Pub. L. 111-347), amended the Public Health Service Act (PHS Act) to add Title XXXIII \1\ establishing the WTC Health Program within the Department of Health and Human Services (HHS). The WTC Health Program provides medical monitoring and treatment benefits to eligible firefighters and related personnel, law enforcement officers, and rescue, recovery, and cleanup workers who responded to the September 11, 2001, terrorist attacks in New York City, at the Pentagon, and in Shanksville, Pennsylvania (responders), and to eligible persons who were present in the dust or dust cloud on September 11, 2001 or who worked, resided, or attended school, childcare, or adult daycare in the New York City disaster area (survivors). --------------------------------------------------------------------------- \1\ Title XXXIII of the PHS Act is codified at 42 U.S.C. 300mm to 300mm-61. Those portions of the Zadroga Act found in Titles II and III of Public Law 111-347 do not pertain to the WTC Health Program and are codified elsewhere. --------------------------------------------------------------------------- All references to the Administrator of the WTC Health Program (Administrator) in this notice mean the Director of the National Institute for Occupational Safety and Health (NIOSH) or his or her designee. Pursuant to Sec. 3312(a)(6)(B) of the PHS Act, interested parties may petition the Administrator to add a health condition to the List in 42 CFR 88.1. Within 60 calendar days after receipt of a petition to add a condition to the List, the Administrator must take one of the following four actions described in Sec. 3312(a)(6)(B) and 42 CFR 88.17: (i) Request a recommendation of the STAC; (ii) publish a proposed rule in the Federal Register to add such health condition; (iii) publish in the Federal Register the Administrator's determination not to publish such a proposed rule and the basis for such determination; or (iv) publish in the Federal Register a determination that insufficient evidence exists to take action under (i) through (iii) above. B. Petition 007 On April 6, 2015, the Administrator received a petition to add ``autoimmune diseases, such as Rheumatoid Arthritis'' to the List (Petition 007).\2\ The petition was submitted by a WTC Health Program member who responded to the September 11, 2001, terrorist attacks in New York City. The petitioner indicated that she has been diagnosed with rheumatoid arthritis, an autoimmune disorder, and is currently receiving treatment for a number of other WTC-related health conditions. The petitioner described an article published in the Journal of Arthritis and Rheumatology by Webber et al. [2015],\3\ which was designed to test the hypothesis that acute and chronic 9/11 work- related exposures were associated with the risk of certain new-onset systemic autoimmune diseases. --------------------------------------------------------------------------- \2\ See Petition 007. WTC Health Program: Petitions Received. http://www.cdc.gov/wtc/received.html. \3\ Webber M.P., Moir W., Zeig-Owens R., Glaser M.S., Jaber N., Hall C., Berman J., Qayyum B., Loupasakis K., Kelly K., and Prezant D.J. [2015]. Nested case-control study of selected systemic autoimmune diseases in World Trade Center rescue/recovery workers. Journal of Arthritis & Rheumatology 67(5):1369-1376. --------------------------------------------------------------------------- C. Administrator's Determination on Petition 007 The Administrator has established a methodology for evaluating whether to add non-cancer health conditions to the List of WTC-Related Health Conditions, published online in the Policies and Procedures section of the WTC Health Program Web site.\4\ In accordance with the methodology, the Administrator directs the WTC Health Program Associate Director for Science (ADS) to conduct a review of the scientific literature to determine if the available scientific information has the potential to provide a basis for a decision on whether to add the condition to the List. The literature review includes published, peer- reviewed direct observational and/or epidemiological studies about the health condition among 9/11-exposed populations. The studies are reviewed for their relevance, quantity, and quality to provide a basis for deciding whether to propose adding the health condition to the List. Where the available evidence has the potential to provide a basis for a decision, the ADS further assesses the scientific and medical evidence to determine whether a causal relationship between 9/11 exposures and the health condition is supported. A health condition may be added to the List if published, peer-reviewed direct observational or epidemiologic studies provide [[Page 32334]] substantial support \5\ for a causal relationship between 9/11 exposures and the health condition in 9/11-exposed populations. If the evidence assessment provides only modest support \6\ for a causal relationship between 9/11 exposures and the health condition, the Administrator may then evaluate additional published, peer-reviewed epidemiologic studies, conducted among non-9/11-exposed populations, evaluating associations between the health condition of interest and 9/ 11 agents.\7\ If that additional assessment establishes substantial support for a causal relationship between a 9/11 agent or agents and the health condition, the health condition may be added to the List. --------------------------------------------------------------------------- \4\ ``Policy and Procedures for Adding Non-Cancer Conditions to the List of WTC-Related Health Conditions,'' John Howard, MD, Administrator of the WTC Health Program, October 21, 2014. http://www.cdc.gov/wtc/pdfs/WTCHP_PP_Adding_NonCancers_21_Oct_2014.pdf. \5\ The substantial evidence standard is met when the Program assesses all of the available, relevant information and determines with high confidence that the evidence supports its findings regarding a causal association between the 9/11 exposure(s) and the health condition. \6\ The modest evidence standard is met when the Program assesses all of the available, relevant information and determines with moderate confidence that the evidence supports its findings regarding a causal association between the 9/11 exposure(s) and the health condition. \7\ 9/11 agents are chemical, physical, biological, or other agents or hazards reported in a published, peer-reviewed exposure assessment study of responders or survivors who were present in the New York City disaster area, or at the Pentagon site, or in Shanksville, Pennsylvania site as those locations are defined in 42 CFR 88.1. --------------------------------------------------------------------------- In accordance with Sec. 3312(a)(6)(B) of the PHS Act, 42 CFR 88.17, and the methodology for the addition of non-cancer health conditions to the List, the Administrator reviewed the evidence presented in Petition 007. Although the petitioner specifically requested the addition of certain autoimmune diseases such as rheumatoid arthritis and connective tissue diseases, the Administrator determined that the scope of the petition properly includes all of the autoimmune diseases identified in Webber et al. Accordingly, the ADS conducted a systematic literature search of the published scientific and medical literature for evidence of a causal relationship between 9/ 11 exposures and the autoimmune disorders described in Webber et al.\8\ Those autoimmune disorders include: Systemic lupus erythematosus, antiphospholipid syndrome, systemic sclerosis, inflammatory myositis, Sj[ouml]gren's syndrome, rheumatoid arthritis, spondyloarthritis, granulomatosis with polyangiitis (Wegener's), and eosinophilic granulomatosis with polyangiitis (Churg-Strauss). --------------------------------------------------------------------------- \8\ Databases searched include: PubMed, Health & Safety Science Abstracts, Toxicology Abstracts, Toxline, Scopus, and Embase. --------------------------------------------------------------------------- Other than the Webber study, the literature search yielded no relevant epidemiologic studies, and no direct observational studies.\9\ In accordance with the methodology described above, the ADS assessed Webber et al. for quality and found significant limitations. Those limitations include low statistical power (due to the small number of cases); lack of information about other key confounders (e.g., family history of autoimmune diseases, history of viral infections or vaccination preceding diagnosis of the autoimmune disease, use of pharmaceutical agents and non-WTC-related exposures, both work-related and recreational); and potential for measurement error of chronic exposure (i.e., because a month of 9/11-related exposures was represented by at least 1 day spent at the WTC site, the duration variable did not differentiate between those with one day and those with many days of exposure in a given month; however, this measurement approach was non-differential between the cases and controls). Finally, participants were from the Fire Department of New York cohort only and predominantly a white male population which raises concern for generalizability to other 9/11-exposed groups, including female responders and survivors. Thus, the ADS concluded that the available information did not have the potential to form the basis for a decision on whether to propose adding the following conditions to the List of WTC-Related Health Conditions: Systemic lupus erythematosus, antiphospholipid syndrome, systemic sclerosis, inflammatory myositis, Sj[ouml]gren's syndrome, rheumatoid arthritis, spondyloarthritis, granulomatosis with polyangiitis (Wegener's), or eosinophilic granulomatosis with polyangiitis (Churg-Strauss). --------------------------------------------------------------------------- \9\ Only epidemiologic studies of 9/11-exposed populations were considered to be relevant. --------------------------------------------------------------------------- The findings described above led the Administrator to determine that insufficient evidence exists to take further action, including either proposing the addition of the autoimmune diseases identified above to the List (pursuant to PHS Act, Sec. 3312(a)(6)(B)(ii) and 42 CFR 88.17(a)(2)(ii)) or publishing a determination not to publish a proposed rule in the Federal Register (pursuant to PHS Act, Sec. 3312(a)(6)(B)(iii) and 42 CFR 88.17(a)(2)(iii)). The Administrator has also determined that requesting a recommendation from the STAC (pursuant to PHS Act, Sec. 3312(a)(6)(B)(i) and 42 CFR 88.17(a)(2)(i)) is unwarranted. For the reasons discussed above, the request made in Petition 007 to add certain autoimmune diseases to the List of WTC-Related Health Conditions, including: Systemic lupus erythematosus, antiphospholipid syndrome, systemic sclerosis, inflammatory myositis, Sj[ouml]gren's syndrome, rheumatoid arthritis, spondyloarthritis, granulomatosis with polyangiitis (Wegener's), and eosinophilic granulomatosis with polyangiitis (Churg-Strauss), is denied. The Administrator is aware that another study of autoimmune diseases among World Trade Center enrollees is being conducted by the World Trade Center Health Registry; however, results from this study are not yet available in the scientific literature. The Administrator will monitor the scientific literature for publication of the results of this study and any other studies that address autoimmune diseases among World Trade Center exposed populations. Dated: June 1, 2015. John Howard, Administrator, World Trade Center Health Program and Director, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Department of Health and Human Services. [FR Doc. 2015-13914 Filed 6-5-15; 8:45 am] BILLING CODE 4163-18P
![Federal Register / Vol. 80, No. 109 / Monday, June 8, 2015 / Proposed Rules 32333
substantial direct costs on Tribal SUPPLEMENTARY INFORMATION: to the List (Petition 007).2 The petition
governments or preempt Tribal law. was submitted by a WTC Health
Table of Contents
Program member who responded to the
List of Subjects in 40 CFR Part 52 A. WTC Health Program Statutory Authority September 11, 2001, terrorist attacks in
Environmental protection, Air B. Petition 007 New York City. The petitioner indicated
pollution control, Carbon monoxide, C. Administrator’s Determination on Petition that she has been diagnosed with
Incorporation by reference, 007 rheumatoid arthritis, an autoimmune
Intergovernmental relations, Lead, A. WTC Health Program Statutory disorder, and is currently receiving
Nitrogen dioxide, Ozone, Particulate Authority treatment for a number of other WTC-
matter, Reporting and recordkeeping related health conditions. The petitioner
requirements, Sulfur oxides, Volatile Title I of the James Zadroga 9/11 described an article published in the
organic compounds. Health and Compensation Act of 2010 Journal of Arthritis and Rheumatology
(Pub. L. 111–347), amended the Public by Webber et al. [2015],3 which was
Authority: 42 U.S.C. 7401 et seq.
Health Service Act (PHS Act) to add designed to test the hypothesis that
Dated: May 28, 2015. Title XXXIII 1 establishing the WTC acute and chronic 9/11 work-related
Heather McTeer Toney, Health Program within the Department exposures were associated with the risk
Regional Administrator, Region 4. of Health and Human Services (HHS). of certain new-onset systemic
[FR Doc. 2015–13947 Filed 6–5–15; 8:45 am] The WTC Health Program provides autoimmune diseases.
BILLING CODE 6560–50–P medical monitoring and treatment
benefits to eligible firefighters and C. Administrator’s Determination on
related personnel, law enforcement Petition 007
DEPARTMENT OF HEALTH AND officers, and rescue, recovery, and The Administrator has established a
HUMAN SERVICES cleanup workers who responded to the methodology for evaluating whether to
September 11, 2001, terrorist attacks in add non-cancer health conditions to the
42 CFR Part 88 New York City, at the Pentagon, and in List of WTC-Related Health Conditions,
Shanksville, Pennsylvania (responders), published online in the Policies and
World Trade Center Health Program; and to eligible persons who were Procedures section of the WTC Health
Petition 007—Autoimmune Diseases; present in the dust or dust cloud on Program Web site.4 In accordance with
Finding of Insufficient Evidence September 11, 2001 or who worked, the methodology, the Administrator
AGENCY: Centers for Disease Control and resided, or attended school, childcare, directs the WTC Health Program
Prevention, HHS. or adult daycare in the New York City Associate Director for Science (ADS) to
disaster area (survivors). conduct a review of the scientific
ACTION: Denial of petition for addition of
All references to the Administrator of literature to determine if the available
a health condition.
the WTC Health Program scientific information has the potential
SUMMARY: On April 6, 2015, the (Administrator) in this notice mean the to provide a basis for a decision on
Administrator of the World Trade Director of the National Institute for whether to add the condition to the List.
Center (WTC) Health Program received Occupational Safety and Health The literature review includes
a petition (Petition 007) to add certain (NIOSH) or his or her designee. published, peer-reviewed direct
autoimmune diseases, including Pursuant to § 3312(a)(6)(B) of the PHS observational and/or epidemiological
rheumatoid arthritis and connective Act, interested parties may petition the studies about the health condition
tissues diseases, to the List of WTC- Administrator to add a health condition among 9/11-exposed populations. The
Related Health Conditions (List). Upon to the List in 42 CFR 88.1. Within 60 studies are reviewed for their relevance,
reviewing the scientific and medical calendar days after receipt of a petition quantity, and quality to provide a basis
literature, including information to add a condition to the List, the for deciding whether to propose adding
provided by the petitioner, the Administrator must take one of the the health condition to the List. Where
Administrator has determined that the following four actions described in the available evidence has the potential
available evidence does not have the § 3312(a)(6)(B) and 42 CFR 88.17: (i) to provide a basis for a decision, the
potential to provide a basis for a Request a recommendation of the STAC; ADS further assesses the scientific and
decision on whether to add certain (ii) publish a proposed rule in the medical evidence to determine whether
autoimmune diseases to the List. The Federal Register to add such health a causal relationship between 9/11
Administrator finds that insufficient condition; (iii) publish in the Federal exposures and the health condition is
evidence exists to request a Register the Administrator’s supported. A health condition may be
recommendation of the WTC Health determination not to publish such a added to the List if published, peer-
Program Scientific/Technical Advisory proposed rule and the basis for such reviewed direct observational or
Committee (STAC), to publish a determination; or (iv) publish in the epidemiologic studies provide
proposed rule, or to publish a Federal Register a determination that
determination not to publish a proposed insufficient evidence exists to take 2 See Petition 007. WTC Health Program: Petitions
rule. action under (i) through (iii) above. Received. http://www.cdc.gov/wtc/received.html.
3 Webber M.P., Moir W., Zeig-Owens R., Glaser
DATES: The Administrator of the WTC B. Petition 007 M.S., Jaber N., Hall C., Berman J., Qayyum B.,
Health Program is denying this petition Loupasakis K., Kelly K., and Prezant D.J. [2015].
mstockstill on DSK4VPTVN1PROD with PROPOSALS
for the addition of a health condition as On April 6, 2015, the Administrator Nested case-control study of selected systemic
received a petition to add ‘‘autoimmune autoimmune diseases in World Trade Center
of June 8, 2015. rescue/recovery workers. Journal of Arthritis &
FOR FURTHER INFORMATION CONTACT: diseases, such as Rheumatoid Arthritis’’ Rheumatology 67(5):1369–1376.
Rachel Weiss, Program Analyst, 1090 4 ‘‘Policy and Procedures for Adding Non-Cancer
1 Title XXXIII of the PHS Act is codified at 42 Conditions to the List of WTC-Related Health
Tusculum Avenue, MS: C–46,
U.S.C. 300mm to 300mm–61. Those portions of the Conditions,’’ John Howard, MD, Administrator of
Cincinnati, OH 45226; telephone (855) Zadroga Act found in Titles II and III of Public Law the WTC Health Program, October 21, 2014.
818–1629 (this is a toll-free number); 111–347 do not pertain to the WTC Health Program http://www.cdc.gov/wtc/pdfs/WTCHP_PP_Adding_
email NIOSHregs@cdc.gov. and are codified elsewhere. NonCancers_21_Oct_2014.pdf.
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![32334 Federal Register / Vol. 80, No. 109 / Monday, June 8, 2015 / Proposed Rules
substantial support 5 for a causal Other than the Webber study, the For the reasons discussed above, the
relationship between 9/11 exposures literature search yielded no relevant request made in Petition 007 to add
and the health condition in 9/11- epidemiologic studies, and no direct certain autoimmune diseases to the List
exposed populations. If the evidence observational studies.9 In accordance of WTC-Related Health Conditions,
assessment provides only modest with the methodology described above, including: Systemic lupus
support 6 for a causal relationship the ADS assessed Webber et al. for erythematosus, antiphospholipid
between 9/11 exposures and the health quality and found significant syndrome, systemic sclerosis,
condition, the Administrator may then limitations. Those limitations include inflammatory myositis, Sjögren’s
evaluate additional published, peer- low statistical power (due to the small syndrome, rheumatoid arthritis,
reviewed epidemiologic studies, number of cases); lack of information spondyloarthritis, granulomatosis with
conducted among non-9/11-exposed about other key confounders (e.g., polyangiitis (Wegener’s), and
populations, evaluating associations family history of autoimmune diseases, eosinophilic granulomatosis with
between the health condition of interest history of viral infections or vaccination polyangiitis (Churg-Strauss), is denied.
and 9/11 agents.7 If that additional preceding diagnosis of the autoimmune The Administrator is aware that
assessment establishes substantial disease, use of pharmaceutical agents another study of autoimmune diseases
support for a causal relationship and non-WTC-related exposures, both among World Trade Center enrollees is
between a 9/11 agent or agents and the work-related and recreational); and being conducted by the World Trade
health condition, the health condition potential for measurement error of Center Health Registry; however, results
may be added to the List. chronic exposure (i.e., because a month from this study are not yet available in
In accordance with § 3312(a)(6)(B) of of 9/11-related exposures was the scientific literature. The
the PHS Act, 42 CFR 88.17, and the represented by at least 1 day spent at the Administrator will monitor the
methodology for the addition of non- WTC site, the duration variable did not scientific literature for publication of
cancer health conditions to the List, the differentiate between those with one the results of this study and any other
Administrator reviewed the evidence day and those with many days of studies that address autoimmune
presented in Petition 007. Although the exposure in a given month; however, diseases among World Trade Center
petitioner specifically requested the this measurement approach was non- exposed populations.
addition of certain autoimmune diseases differential between the cases and
Dated: June 1, 2015.
such as rheumatoid arthritis and controls). Finally, participants were
from the Fire Department of New York John Howard,
connective tissue diseases, the
cohort only and predominantly a white Administrator, World Trade Center Health
Administrator determined that the Program and Director, National Institute for
scope of the petition properly includes male population which raises concern
for generalizability to other 9/11- Occupational Safety and Health, Centers for
all of the autoimmune diseases Disease Control and Prevention, Department
identified in Webber et al. Accordingly, exposed groups, including female of Health and Human Services.
the ADS conducted a systematic responders and survivors. Thus, the
[FR Doc. 2015–13914 Filed 6–5–15; 8:45 am]
literature search of the published ADS concluded that the available
BILLING CODE 4163–18P
scientific and medical literature for information did not have the potential
evidence of a causal relationship to form the basis for a decision on
between 9/11 exposures and the whether to propose adding the
following conditions to the List of WTC- DEPARTMENT OF HOMELAND
autoimmune disorders described in SECURITY
Webber et al.8 Those autoimmune Related Health Conditions: Systemic
disorders include: Systemic lupus lupus erythematosus, antiphospholipid
syndrome, systemic sclerosis, Federal Emergency Management
erythematosus, antiphospholipid Agency
syndrome, systemic sclerosis, inflammatory myositis, Sjögren’s
inflammatory myositis, Sjögren’s syndrome, rheumatoid arthritis,
spondyloarthritis, granulomatosis with 44 CFR Part 67
syndrome, rheumatoid arthritis,
spondyloarthritis, granulomatosis with polyangiitis (Wegener’s), or eosinophilic [Docket ID FEMA–2015–0001; Internal
granulomatosis with polyangiitis Agency Docket Nos. FEMA–B–7759, FEMA–
polyangiitis (Wegener’s), and
(Churg-Strauss). B–1138 and FEMA–B–1208]
eosinophilic granulomatosis with
The findings described above led the
polyangiitis (Churg-Strauss). Proposed Flood Elevation
Administrator to determine that
insufficient evidence exists to take Determinations for Lafayette Parish,
5 The substantial evidence standard is met when
further action, including either Louisiana, and Incorporated Areas
the Program assesses all of the available, relevant
information and determines with high confidence proposing the addition of the AGENCY: Federal Emergency
that the evidence supports its findings regarding a autoimmune diseases identified above Management Agency, DHS.
causal association between the 9/11 exposure(s) and to the List (pursuant to PHS Act,
the health condition. ACTION: Proposed rule; withdrawal.
6 The modest evidence standard is met when the
§ 3312(a)(6)(B)(ii) and 42 CFR
Program assesses all of the available, relevant 88.17(a)(2)(ii)) or publishing a SUMMARY: The Federal Emergency
information and determines with moderate determination not to publish a proposed Management Agency (FEMA) is
confidence that the evidence supports its findings rule in the Federal Register (pursuant to withdrawing its proposed rule
regarding a causal association between the 9/11 PHS Act, § 3312(a)(6)(B)(iii) and 42 CFR
exposure(s) and the health condition. concerning proposed flood elevation
mstockstill on DSK4VPTVN1PROD with PROPOSALS
7 9/11 agents are chemical, physical, biological, or
88.17(a)(2)(iii)). The Administrator has determinations for Lafayette Parish,
other agents or hazards reported in a published, also determined that requesting a Louisiana, and Incorporated Areas.
peer-reviewed exposure assessment study of recommendation from the STAC
responders or survivors who were present in the DATES: This withdrawal is effective on
(pursuant to PHS Act, § 3312(a)(6)(B)(i)
New York City disaster area, or at the Pentagon site,
and 42 CFR 88.17(a)(2)(i)) is June 8, 2015.
or in Shanksville, Pennsylvania site as those ADDRESSES: You may submit comments,
locations are defined in 42 CFR 88.1. unwarranted.
8 Databases searched include: PubMed, Health & identified by Docket Nos. FEMA–B–
Safety Science Abstracts, Toxicology Abstracts, 9 Only epidemiologic studies of 9/11-exposed 7759, FEMA–B–1138 and FEMA–B–
Toxline, Scopus, and Embase. populations were considered to be relevant. 1208, to Luis Rodriguez, Chief,
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Document Created: 2018-02-22 10:12:51
Document Modified: 2018-02-22 10:12:51
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Proposed Rules | |
| Action | Denial of petition for addition of a health condition. | |
| Dates | The Administrator of the WTC Health Program is denying this petition for the addition of a health condition as of June 8, 2015. | |
| Contact | Rachel Weiss, Program Analyst, 1090 Tusculum Avenue, MS: C-46, Cincinnati, OH 45226; telephone (855) 818- 1629 (this is a toll-free number); email [email protected] | |
| FR Citation | 80 FR 32333 |
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