NYC-WTC_000199621

NYC 9/11 Public Portal Document

New York City Department of Health

Resident Consent for Environmental Sampling

The New York City Department of Health is investigating the airl5orne and settled dust in residences around the World Trade Center (WTC) site. Participation in this investigation is voluntary. Your participation will help to determine if the air and dust inside your property can cause eye, nose, and throat (ENT) irritation. These tests will also help us tell if you or other residents are being exposed to airborne dust at levels that could cause long-term respiratory problems. They will also help us tell you if more WTC dust cleanup is advisable to protect your health. We will do these tests at no cost to the owners or tenants.

This investigation involves collecting indoor and outdoor air and settled surface dust samples from your property. The samples will be analyzed as follows:

Indoor and outdoor will be tested for: Crystalline silica and asbestos that can be inhaled. Gypsum, mica, and calcite that can be inhaled in dust.

Indoor and outdoor settled surface dust will be tested for: Asbestos, crystalline silica, pH, gypsum, mica, and calcite.

Participation

Again, your participation is voluntary. Participation involves allovving access to your property/ unit to collect air and dust samples and answering some questions about your building/unit. We will ask you for information to help us learn how the WTC collapse affected dust in your property. Giving us any information is voluntary and you may choose to stop participation at any time, even after you sign this consent form. If you choose not to participate, or to stop at any time, there will be no penalty or loss of benefits to which you are entitled.

While we are collecting air samples, we ask that no one smoke, burn candles or incense, fry foods or perform any other activities causing smoke. We ask you not to do any cleaning while we are sampling the air and dust. Please be present during the sampling. It's fine to freely move about your home. If you leave, please arrange for someone to be there while we are sampling. We ask you to continuously run the fan on your heating, ventilating, and air conditioning system while we are collecting air samples. If this cannot be done, we ask that you run a large fan to keep air circulating.

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