And she said she believes illnesses killing first responders can be blamed on the city's lack of action.

"I'm not a scientist ... but I do [believe that]," she told WNBC's Brian Thompson.

"I mean, we wouldn't have been saying that the workers should wear respirators if ... we didn't think there might be health consequences."

She said the city had the responsibility to make sure workers wore respirators. But many took them off, complaining of heat. She said workers without respirators were barred from cleanup efforts at the Pentagon.

"We were certainly frustrated at not being able to get people to wear respirators because we thought that was critically important to workers on The Pile," Whitman said.

"Every day, there would be telephone calls, telephone meetings and meetings in person ... with the city when we repeated the message of the necessity of wearing respirators."

The autopsy guidelines, which were submitted for review by outside experts on Sept. 15, follow the release last month of treatment guidelines for sick workers, issued by New York City health officials.

The draft autopsy guidelines from the federal government describe which parts of the lungs should be examined, and urge the creation of a "tissue bank" so that certain organs and body fluids are preserved for later testing.

Tissue and fluids should be collected not just from the dead, but from the living, the draft said.

"Ideally, this 'tissue banking' system would also be able to accommodate biopsy specimens taken as part of diagnostic workups on patients, since such specimens could be as, or even more, informative than autopsy specimens," the draft says.

Dr. Robin Herbert, co-director of the Mount Sinai Medical Center program that found thousands of ground zero workers were still sick 2 1/2 years after the attacks, said the release of the guidelines is an important step as the government decides what to do about the ongoing illnesses among firefighters, police officers, and construction workers.

Doctors at Mount Sinai Medical Center, which conducted the study, said the results prove that working in the toxic gray dust at ground zero made many people sick, and some will likely suffer the effects for the rest of their lives.

"There should no longer be any doubt about the health effects of the World Trade Center. Our patients are sick," said Dr. Robin Herbert, co-director of the group that investigated the long-term effects from exposure to dust at the site.

Almost 70 percent of World Trade Center responders had new or worsened lung symptoms after the attacks.

Among responders who had no health symptoms before the attacks, 61 percent developed lung symptoms while working on the toxic pile.

One-third of those tested had abnormal lung function tests.

Only one responder's death-that of New York City police detective James Zadroga, who succumbed to respiratory failure in January-has been directly linked by a medical examiner to his exposure to environmental toxins at Ground Zero. But at least six other deaths (from causes ranging from heart failure to lung cancer) have been reported among responders in their 30s and 40s who worked at the World Trade Center site. And thousands more are struggling with health problems far worse than officials initially anticipated. "People think that it's just a few guys from 9/11 suffering," says Feal, "but there are literally thousands of us."

It's too early to know with certainty how many deaths may result from the cocktail of asbestos, mercury, silica, fiberglass and other potentially hazardous materials released when the twin towers collapsed. Nor is it possible to say with certainty which health problems are related to the responders' work in the rubble of the trade center. But it's clear that many of the estimated 40,000 police, firefighters and other workers who came to the site to assist in rescue and recovery efforts have begun suffering from similar and sometimes serious ailments during the past four and a half years. "You can't witness and be exposed to what these people were exposed to without it taking a toll," says Dr. Stephen M. Levin, codirector of the World Trade Center Worker and Volunteer Medical Screening Program at Mount Sinai Hospital in New York. "To listen to how life has become for some patients, it’s absolutely horrifying."

Dr. John Howard, who was appointed in February as federal coordinator of 9/11 health issues by the Bush administration, has said that the government will likely need to monitor the health of those who were at or near Ground Zero for 20 to 30 years. How much money—and manpower-that will require is unclear. But it’s likely more than the $125 million initially allocated by the federal government for 9/11 responders as part of a $20 billion federal aid package for areas affected by the terrorist attacks. "I don't think we're prepared to come up with a number [yet]," said Howard earlier this spring.

The government's point man on Sept. 11 health programs said he is worried that an autopsy linking a retired detective's death to recovery work at ground zero may be a warning sign of other life-threatening cases.

Dr. John Howard also said it will take time to determine whether there is a scientific link between deaths and exposure to toxic dust. Some epidemiologists have said it will take 20 years or more to prove such a link.

Howard, who is to meet in New York this week with congressional leaders about ground zero health issues, was tapped by the Bush administration in February to coordinate the federal response to ongoing Sept. 11 health programs.

But Robin Herbert, who directs a medical-monitoring program at Mount Sinai Medical Center for more than 14,000 ground zero workers, said "certainly it is not inconceivable" that a person could die of respiratory disease related to Sept. 11.

Karin DeShore said she does not need scientists to tell her what caused the death of her friend Keller, 41. DeShore was a Fire Department captain who took Keller to the trade center on Sept. 11, and barely escaped the south tower's collapse.

"He came back coughing" two days later, she said. Faeth said that Keller told him that he coughed up debris so violently he could barely breathe on Sept. 11, and later developed emphysema.

Keller went home to Levittown on medical leave in March. He died on June 23 of heart disease complicated by bronchitis and emphysema, the Nassau County medical examiner's office said.

David Worby, an attorney representing more than 5,000 plaintiffs suing those who supervised the cleanup over their illnesses, said 21 of his clients have died of Sept. 11-related diseases since mid-2004. He said he was not authorized to release their names, but represented people who toiled at ground zero, at the Fresh Kills landfill in Staten Island where trade center debris was moved, and at the city morgue.

"This is just the tip of the iceberg," Worby said. "Many, many more people are going to die from the aftermath of the toxicity."