When President Bush draped his arm around New York firefighter Bob Beckwith, picked up a bullhorn and vowed to catch those who had destroyed the World Trade Center, it was a photo image seen around the world, a symbol of America's response to the terrorist attacks.
But now, on the eve of Bush's State of the Union address, that 16-month-old picture has become a symbol of partisan wrangling over Bush's response to Sept. 11 -- and growing concerns over the long-term health problems of some 40,000 rescue and volunteer workers who spent months cleaning up the site's wreckage.
The health-care issue surfaced last year, when Sen. Hillary Rodham Clinton (D-N.Y.) won approval for $12 million to fund an initial health-care study of these workers, many of whom have developed unusually persistent respiratory ailments, according to a preliminary report issued Monday.
Because those funds will pay for the screening of only 9,000 workers and are scheduled to run out in July, Clinton and others have been lobbying the Bush administration to back a $90-million, five-year study of all rescue workers.
That proposal, however, has been caught up in protracted budget wrangling, prompting Clinton and other critics to charge that the administration is ignoring the problem.
Bush administration officials have responded that the proposed $90-million program was originally included in a $5.1-billion optional spending package that the president killed because he opposed other elements of the legislation. During an appearance Sunday on NBC's "Meet the Press," Andrew H. Card Jr., the White House chief of staff, pledged that if funds were included as a separate item in the budget for fiscal year 2003, which Congress has yet to finally approve, "we will get the money distributed."
The dispute intensified Monday when Beckwith revealed that Rep. Carolyn B. Maloney, a Democrat who represents Manhattan, last week invited him to attend Bush's speech tonight.
What he didn't know at the time, he said, was that she and other administration critics hoped to use his presence to protest the lack of funding for the health-survey funds.
Beckwith told the New York Daily News that he has decided not to attend because he is a lifelong Republican and has no intention of politically embarrassing Bush.
"I decided not to go," he said. "I didn't know that I was taking a seat from a Democrat. I'm not going to change parties."
Although Beckwith plans to watch the speech at home, at least eight other New York rescue workers are planning to be in the audience as the guests of Democratic lawmakers who want to call attention to the lack of full funding for the ground zero health-care study. House Minority Leader Nancy Pelosi of San Francisco is one of the Democrats who has given a gallery ticket to a rescue worker.
John Feehery, a spokesman for House Speaker J. Dennis Hastert (R-Ill.), said Republicans are not taking offense at the Democratic attempt to highlight the issue.
"No one has done more for New York City and rebuilding New York City than President Bush," Feehery said, noting that Hastert might support more funding for ground zero health studies if it is attached to budget legislation.
Monday's release of a preliminary survey of 250 New York rescue and volunteer workers who responded to the trade center site after the attacks also escalated the controversy.
These workers, who were screened from July 16 to Aug. 29, 2002, showed "disturbing" levels of long-term health problems, according to the survey -- which was conducted by the Mount Sinai Medical Center in New York and the National Institute for Occupational Safety and Health.
More than half had respiratory, throat or mental health ailments for longer than 10 months after the attacks. The preliminary screening found that 73% had ear, nose and throat problems, while 57% had lung ailments.
The ongoing health-care survey, which so far has offered free and confidential medical screenings to about 3,500 workers, is being closely watched by national experts.
And many health-care officials have said the full five-year study is essential because the unusually high prevalence of symptoms among workers nearly a year after the attacks "is alarming," said Dr. Robin Herbert, who helped coordinate the study.
Speaking at a hospital news conference on Monday, she said the early data "clearly demonstrate the need for the immediate screening of WTC responders, as well as the provision of medical follow-up."
Without a comprehensive study, she and others said, the full ramifications of exposure to the air around ground zero will never be known.
Rescue workers began complaining about health problems almost immediately after the Sept. 11 attacks, and one of the first symptoms was a deep, hacking cough that resisted antibiotic treatment and persisted for months, physicians said.
But health problems soon worsened for many, because numerous workers who raced to the site were exposed to a toxic cocktail of cement and glass dust, asbestos, fiberglass, PCBs, dibenzofurans and other volatile organic compounds, according to the report.
The majority of workers who have been surveyed to date were working at the trade center or the landfill to which debris was taken, either on Sept. 11 or the following day.
Nearly 50% of them were in the midst of the billowing cloud of dust created by the destruction of the two World Trade Center towers; an additional 31% were exposed to large amounts of the dust in the aftermath of the attacks.
Amid the partisan sniping, some experts are trying to rise above the fray. Philip McArdle, a health and safety officer for the New York firefighters union, said: "This isn't a Democratic or Republican problem. This is an American problem, and we're interested in fixing it."
Times staff writer Nick Anderson, in Washington, contributed to this report.