| From the early days of Gulfwatchers there have been questions raised about toxicity and air quality, dispersant safety and long term health effects related to the gushing Macando well. News from local sources reported persistent health problems among clean up workers and those living close to the spill. For example, Wee Mama wrote a special Organic Chemistry Mothership explaining the compounds involved and why they might be dangerous.
Yet it took the federal government over 6 months to propose a study that is largely inadequate and possibly underfunded. In a population that already has limited access to healthcare, As one reporter put it, it's "a mess".
While the ecological effects of the spill (marshes,dead coral, plumes, marine mammals and oiled birds) demanded our attention and attracted BP funding. Sick clean up workers and residents relied on local healthcare workers and activists for support. Physicians, like Dr. Mike Robichaux in Raceland,LA, are seeing similar symptoms among patients, many of whom he sees pro bono, A pattern of respiratory, skin, and neurological symptoms are emerging.
James Diaz, director of environmental and occupational health sciences at Louisiana State University Health Sciences Center in New Orleans, said he's "not surprised at all" by many of the current chronic symptoms being reported because they are consistent with exposure to polycyclic aromatic hydrocarbons and volatile organic compounds, chemicals in crude oil and dispersants.
Diaz, who worked for 16 years as an occupational medical doctor on an emergency flight team that treated injured offshore oil workers and is an expert on chronic and carcinogenic effects of chemical exposure, believes the "most serious" early phase chronic illnesses will be neurological.
"These agents are water soluble, attack the irritative membranes," he explained, "Then when they get into the body, they're lipophilac, which means they love to concentrate in tissues that have a lot of fat -- the brain, the covering of nerves."
Diaz said that, as opposed to respiratory, skin and ocular disorders, there are few options for treating neurological disorders, which include reported symptoms such as balance issues and memory loss.
The Louisiana Bucket Brigade and Tulane University's Disaster Resilience Leadership Academy recently published a health survey of Louisiana residents.
A recently published health survey of 954 Louisiana residents living in seven oil-impacted coastal communities found that nearly three-quarters of those who believed they were exposed to crude oil or dispersant reported feeling symptoms. Nearly half of all respondents reported an "unusual increase in health symptoms" consistent with exposure, including coughing, skin and eye irritation, and headaches.
There was an early acknowledgement of the mental health issues faced by Gulf residents, many of whom were likely still rebuilding their lives post Katrina. BP had provided money for the study and treatment of mental health problems, and only for mental health. However, these solid, hardworking folks will go to a doctor to be treated for physical symptoms, not always understanding or accepting that there is a psychological component.
Christi Julian, program manager of the Catholic Charities outreach program, said that the state received $15 million in funding from BP and provided $6.7 of that to Catholic Charities.
But the state designated this BP money to Catholic Charities on the condition that all of it is used solely to treat mental health impacts related to the Gulf oil spill, not physical ones.
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Elmore Rigamer, a psychiatrist who is director for Catholic Charities in New Orleans, which is performing ongoing mental health outreach to the most oil-affected coastal communities in Louisiana, is witnessing this firsthand.
He said anxiety over livelihood is a primary concern of these residents, who have one main skill: fishing. The astonishing number of them who've yet to return to the only work they've ever known supports his assessment.
As of March 31, out of 466 heads of household interviewed by Catholic Charities during outreach in the parishes of St. Bernard, Plaquemine, Jefferson and Lafayette, nearly 80 percent said they have not been able to return to fishing.
Rigamer said he's also witnessed the convergence of psychological and physical impacts in these communities, in which many have reported upper respiratory problems they say they've never had prior to the spill or preexisting conditions, such as asthma, which have grown much worse since.
Physicians, like the earlier mentioned Dr. Robichaux, are frustrated because they can only treat symptoms, prescribing antibiotics and corticosteroids, because they are not experts in chemical exposure. But the effects of exposure to crude oil have been documented in studies of previous tanker spills. A recent New England Journal of Medicine article lists 14 studies from 6 different spills. Those studies showed that many of those exposed exhibited similar symptoms to those exposed in the Gulf of Mexico cleanup.
James Diaz of LSU, who recently published a report in the peer-reviewed Journal of Disaster Medicine that predicts potential chronic health effects from the Gulf oil spill, stressed that everyone exposed, heavily or lightly, should be screened by physicians trained to treat chemical exposure.
Diaz pointed out that studies of two prior oil spills, the 1989 Exxon-Valdez oil spill off the coast of Alaska and the 2002 Prestige oil spill off the coast of Spain, provide peer-reviewed, evidence-based results on some of the long-term health effects of exposure to these chemicals. He cited these studies in his Journal of Disaster Medicine report.
One study, for example, found that 14 years after the Exxon-Valdez spill, workers with high exposure to weathered crude oil and dispersants had a significant increase in respiratory disease, neurological disorders and multiple chemical sensitivities.
Wilma Subra, biochemist and MacArthur genius award winner, says that if this were a Superfund or chemical waste site, federal agencies (in the past) would send in medical specialists. State and federal budget cuts have made it unlikely that anything like that will happen.
BP is currently denying any help with medical care as they try to minimize their liability. And don't look to the National Institutes of Health for any closure. The study to follow clean up workers over 10 years won't necessarily be funded.
Edward Trapido, associate dean for research and professor of epidemiology at Louisiana State University Health Sciences Center,is currently leading an LSU study on the physical and mental health of 2,000 wives and female partners of the most heavily oil-and-dispersant exposed male cleanup workers, which has received initial funding by the National Institute of Health (NIH).But even long-term studies such as this and the NIH oft-referenced "10-year" study of cleanup workers have no guarantee they'll be sufficiently funded and carried to completion.
In fact, Trapido revealed that at a recent meeting at the Institute of Medicine, he addressed the issue directly with Francis Collins, the head of the NIH, whom Trapido said had justified the projected 10-year study "on the basis that we don't have any long-term results."
Yet Trapido, who has worked at the NIH and knows intimately its vulnerability to transient -- and potentially partisan -- political appointees, as well as budgetary limitations, said that when he asked Collins if he could guarantee the NIH study will last more than five years, he replied, "No."
In fact, LSU only received enough funding to draw the blood specimens for the study, Additional funding will be necessary to actually run the tests.
While the NEJM article is basically a review of what we know and not a research study, it draws its conclusions from government reported data, (Environmental Protection Agency (EPA) and National Institute for Occupational Safety and Health Education and Information (NIOSH)). For instance, they downplay the exposure to toxins by inhalation.
A review of the many hundreds of air samples obtained by the Environmental Protection Agency (EPA) showed that no samples had concentrations of benzene or other volatile organic hydrocarbon ascribable to the Gulf oil spill that were above health-based standards.
Other scientists, however, point out discrepencies in the way air quality was measured.
The oil and dispersants generated air contaminants with potentially serious health effects including benzene (a known human carcinogen), naphthalene (possible carcinogen), toluene, xylene, and hydrogen sulfide (neurotoxic chemicals), and 2-butoxyethanol (respiratory irritant) (1, 2). Burning of oil generated particulate matter (PM), which causes premature mortality, and cardiovascular and respiratory morbidity (2).
Air monitoring equipment was deployed during the oil spill response without the capacity to measure health-relevant levels.
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The oil spill affected two EPA regions and multiple states which varied in their baseline air monitoring infrastructure. A weak pre-existing network in Louisiana meant that low-level monitoring for carcinogens such as polycyclic aromatic hydrocarbons (PAHs), naphthalene, and benzene lagged behind that of neighboring states despite Louisiana’s proximity to the spill site. Effective air monitoring for these pollutants was not achieved in Louisiana until more than six weeks into the spill response.
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Offshore cleanup workers were potentially exposed to higher levels of air contaminants and for protracted periods of time due to long shifts (2). These workers were not provided with respiratory protection because workplace limits were not exceeded.(OSHA standards)... Measured levels of benzene exceeded the EPA health screening level onshore twice, but 71 exceedences occurred in offshore monitoring conducted by BP (3, 5). These disparities raise equity concerns about adequate protections for workers and highlight the need for more health protective workplace monitoring and standards.
Regarding worker safety, the NEJM article states,
As a result of the WTC experience, much attention was paid to training the Gulf spill response workers,particularly regarding heat stress and the use of personal protective equipment appropriate for minimizing exposure to chemicals. The extent of overall compliance is not yet known.
Yet over the course of the spill, Gulfwatchers reported many times, from local sources, that workers were not given respirators.
The NEJM article claims that many of the reported problems come as a result of preexisting conditions, since workers did not receive health screening prior to being hired.
Gulf Coast populations affected by the oil spill include communities with a history of disparities in health (as compared with other regions of the
United States), environmental-justice concerns,recurrent impacts of natural disasters, and poor health metrics. Among the 50 states, Louisiana ranks 44th to 49th (depending on the metric used, with 1st being best) in the overall health of residents; rates of infant death, death from cancer, premature death, death from cardiovascular
causes, high-school graduation, children living in poverty, health insurance coverage, and violent crime.
Given the amount of money Jindal spent on "Bobby's berms" and the amount of healthcare that money could have provided, those statistics should be evidence of a crime against the citizens of Louisiana.
There does appear to be some consensus among experts that research studies have begun too late and are poorly funded. Among those exposed to the toxins of the spill, consensus is that BP should fund some kind of clinic where people could get treatment from doctors experienced in environmental medicine. Like that is going to happen!
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