The Department of Health and Human Services observed the anniversary of the September 11, 2001 attacks by extending coverage of a program for first responders sickened by their work at Ground Zero, the Pentagon and the Flight 93 crash site in Shanksville, PA to cover some 50 cancers.

The action expands the World Trade Center Health Program, established by Congress in 2010 after a long and bitter legislative battle over what World Trade Center site recovery workers and conditions, if any, should be covered.

The attacks 11 years ago coated a substantial chunk of Lower Manhattan with dust from the pulverized buildings, including asbestos and a host of hazardous chemicals and chemical groups – 287 in all, as tabulated by a 2011 CDC report. A subsequent study conducted by the Fire Department of New York found an elevated risk of melanoma, thyroid and prostate cancer, and non-Hodgkin lymphoma among firefighters that worked on “The Pile” at Ground Zero. The health program’s Scientific and Technical Advisory Committee said in April that “exposures resulting from the collapse of the buildings and high-temperature fires are likely to increase the probability” of cancers, citing the presence of 70 known and potential carcinogens in the dust and smoke of the site.

Despite a dearth of environmental data from the immediate aftermath of the towers’ collapse, HHS said in a June Federal Register notice that “The committee considers that the high prevalence of acute symptoms and chronic conditions observed in large numbers of rescue, recovery, cleanup and restoration workers and survivors, as well as qualitative descriptions of exposure conditions in downtown Manhattan, represent highly credible evidence that significant toxic exposures occurred. Furthermore, the salient biological reaction that underlies many currently recognized WTC health conditions – persistent inflammation – is now believed to be an important mechanism underlying cancer through generating DNA-reactive substances, increasing cell turnover, and releasing biologically active substances that promote tumor growth, invasion and metastasis.”

The expansion of the program was greeted with praise from advocates for the sickened workers and New York officials, though it was tempered by concerns about funding. The program is funded only through 2016 at $1.5 billion, and nothing extra was added to the pot to cover cancer screening and treatment. There are currently 55,000 enrolled in the program, including 5,000 survivors. Government number crunchers calculated the cancer-related costs at between $12 million and $33 million, projecting up to a 21% greater rate of cancer than the general population.

New York Mayor Michael Bloomberg told The New York Post: “Unless you believe the federal government is going to vote us more money – and I think to do that you probably have to believe in the tooth fairy as well – it looks like we have to deal with just this amount. It’s just a finite amount of money.”