Nov 15, 2013
More than 2.6 million miles of oil and gas pipelines currently snake through the U.S., overseen by only 135 inspectors from the Transportation Department's regulatory agency--a safety system the top pipeline safety official recently described as "kind of dying." That's particularly alarming considering plans for new pipelines such as the Keystone XL, which, if approved, will increase the mileage of oil-bearing pipes in the U.S. by 1,700 miles and carry millions of gallons of particularly toxic tar sands oil right through the heartland of America. A spate of U.S. pipeline ruptures in recent years underscores how ill-prepared we are to address the health needs of residents following oil spills, and how poorly we document the health impacts so as to develop better responses to future spills.
When ExxonMobil's Pegasus pipeline ruptured last March and flooded a Mayflower, Ark., neighborhood with an estimated 210,000 gallons of heavy crude oil, our National Contingency Plan (NCP) for responding to hazardous substances, including oil spills, was set into motion.
In a nutshell, this is how the plan operates: The company that spilled the oil works with federal, state and local agencies to stanch the flow, and then eventually begins the daunting task of cleaning up the mess. All parties work in concert to monitor air and water quality, which is supposed to limit residents' exposure to toxic and carcinogenic chemicals found in the oil. The Environmental Protection Agency is the official on-scene coordinator for inland areas, the Coast Guard for coastal or major navigable waterways.
You may notice what's missing from this plan: what happens when people actually get sick. The plan doesn't prioritize responding to the acute, chronic and long-term medical health of exposed local populations--including prompt screening for baseline signs of disease, which public health experts say is crucial for both proper medical treatment and effective research on human health effects. That's left largely up to state and local agencies, which invariably don't have the expertise or the resources to adequately carry out the task. So in spill after spill, emergency responses vary, citizens often suffer the health consequences with little or no recourse, and there continues to be a dearth of data on the health impacts.
Public health experts with experience in oil spill response who spoke with In These Times stressed the need for the NCP to utilize the type of specialized medical teams that are sent to areas during such disasters as catastrophic storms or infectious disease outbreaks.
"That's where the gap is," said Aubrey Miller, a senior medical advisor and captain in the U.S. Public Health Service who helps coordinate intergovernmental relations on health and medical matters, and who is an expert on the inner workings of the NCP.
Asked by In These Times to comment on the medical and scientific gaps in its plan, the EPA replied in a statement: "An On-Scene Coordinator leading and/or supporting an oil spill response can access assets such as those available through HHS [Health and Human Services] and its agencies, including the Centers for Disease Control, U.S. Public Health Service, and Disaster Medical Assistance Team."
In other words, the EPA could bring in medical teams with specialized knowledge of the health risks associated with oil spills. But according to Miller, "in reality" that's not in the plan's budget. On the rare occasion that medical emergency teams are brought in, he says, they do not comprehensively and systematically attend to the medical health needs of exposed populations or provide timely screening of disease markers for research purposes.
Shockingly little research exists in the U.S. on the long-term health effects from oil spills. This may come as no surprise considering that traditionally much of the funding for studies related to oil spills is provided by oil companies, who can influence everything from a study's parameters to its timeliness.
"So if you have exposures with an oil spill," said Miller, "and you're really worried about the long-term health effects--in kids or women or old people or people with lung conditions--there currently is no federal funding for long-term health research that addresses those issues."
That's a problem for researchers like Edward Trapido, associate dean for research and professor of epidemiology at Louisiana State University Health Sciences Center, who is overseeing two separate National Institute of Environmental Health Sciences (NIEHS) studies related to the Deepwater Horizon spill. Both studies have to be performed without any baseline information because, under the NCP, Gulf Coast residents were not effectively screened for early biomarkers of disease. Nor was baseline screening conducted after the 2010 oil spill in Salt Lake City, Utah, and the July 2010 spill in Michigan's Kalamazoo River.
Nowhere to turn
Research isn't the only place health interventions fall short; immediate and long-term medical care also falls through the cracks.
Talk to the Arkansas Department of Health (ADH), the agency charged with public health in Mayflower after the oil spill, and they will assure you that they and local officials handled the evacuation of residents and addressed their related health needs in an "appropriate" fashion. Twenty-two households in the Northwood subdivision, through which the oil flowed, were evacuated after the spill and put up in hotels by ExxonMobil. Multiple ongoing air sampling was conducted by various agencies, including an ExxonMobil independent contractor, and the ADH analyzed all air samples for any discrepancies between the results, of which they found none. A Poison Control Center hotline was set up for 24-hour access.
But this response failed to protect exposed residents who weren't evacuated but lived as close as 350 yards from the impact zone or from where the spill had pooled in a retention pond. These residents weren't entitled to medical attention, short- or long-term, under the plan if they fell ill.
Nor were they provided information on the potential dangers of remaining in their homes, or access to a central health clinic to be screened by physicians trained to diagnose, treat and monitor petrochemical exposure. Instead, if they happened to spot the Poison Control Center hotline number in fine print on the bottom of an ExxonMobil flyer, they could call it--but even that led to little help.
April Lane of the Faulkner County Community Advisory Group--who went knocking door-to-door to check on exposed nearby residents--noted that the Poison Control Center, when called, would merely direct residents to visit their primary care physician, rather than a specialist who is trained to recognize oil exposure symptoms.
The ADH confirmed and defended this protocol, saying that having a medical problem "addressed in a careful fashion" with a primary care physician is the proper course of action. "Because sometimes," said Dr. William Mason, chief of preparedness and emergency response for the ADH and an expert in treating chemical exposure, "medical problems that people call about may or may not be related to a chemical spill."
Mason also defended the lack of evacuation of those residents, saying that the results of the air sampling didn't warrant it. "We felt comfortable that these individuals did not need to be evacuated, that there was not a threat to their health," he said. Yet as InsideClimateNews reported, the ADH allowed acceptable levels of certain chemicals in the air--such as benzene, a known carcinogen--at exposures that experts agreed were "alarmingly high." Additionally, federal guidelines for acceptable chemical exposure in oil spill areas can vary dramatically and are based on the general population rather than on the most vulnerable, such as pregnant women, children, elderly and those with suppressed immune systems.
James Diaz, director of environmental and occupational health sciences at Louisiana State University Health Sciences Center, notes that benzene can cause acute and chronic respiratory, dermatologic, ocular and neurological effects. In the long-term, the toxic stew of chemicals found in conventional crude and tar sands oil--polycyclic aromatic hydrocarbons and volatile organic compounds--can cause multiple forms of cancer, including cancer of the lungs, liver, kidney, blood and colon. Benzene is a VOC of particular concern from air inhalation and has been linked to leukemia and other blood disorders.
Several Mayflower residents outside the evacuation zone who became ill after the spill with precisely the types of petrochemical effects that Diaz and other public health experts describe say that they struggled with primary care physicians to take them seriously if they suggested their symptoms appeared to be from the oil spill.
When Ann Jarrell's 3-month-old grandson began having trouble breathing, she sent him and her daughter off to his pediatrician with the Material Safety Data Sheet, which describes the chemicals in the type of crude oil that spilled and their potential health impacts. "His pediatrician wouldn't even look at them," said Jarrell, 55, who lived with her grandson and daughter right behind the subdivision, 350 yards from where the pipeline ruptured. "He just said, 'Oh, he's got a cold.'"
Two weeks later, her grandson became worse, wheezing and choking when he coughed. This time, she told her daughter to take him to the emergency room, but not to mention the spill. There, says Jarrell, he was diagnosed with a severe upper respiratory infection and sinus infection and put on antibiotics and an electronic suction device, and later, an asthma inhaler mask, without which the doctor said he could contract pneumonia and die.
Linda Lynch, 65, whose home also lies right behind the Northwood subdivision, said she got a similar runaround. When she went to the emergency room for symptoms, including shortness of breath, migraines, a hacking cough and rapid heartbeat--none of which she said she had experienced before--her doctors said they didn't know anything about the oil spill. After Lynch voiced direct concerns about the effects of the fumes from the spill, the head emergency room doctor said she called the ADH but was told, "Everybody still in Mayflower is in no danger." Lynch was then sent home.
'This is a no-brainer'
So what if our national response plan started treating oil spills like the human health disasters that they are? What if it dispatched specialized medical teams to effectively screen and monitor, and diagnose and treat, local populations for petrochemical exposure in the short- and long-term, addressing and documenting the full scope of human health impacts? Experts note that it would not be in the best interest of the company that spilled the oil. The lack of timely biomarkers and adequate diagnoses weakens the causality not only for an exposed citizen seeking medical support or legal recourse down the road, but also for the scientific research that may provide more direct links back to the petrochemicals.
"This is a no-brainer," noted Diaz, pointing out that related diseases such as cancer, as well as other lung and neurological diseases, "have long latency periods over decades, are expensive to treat and have bad outcomes."
This is why oil companies tend to follow the same course of action regarding health effects and culpability, Diaz continued: "Offer settlements for obvious confirmed health effects--acute symptoms like skin rashes or even depression or a heart attack in a cleanup worker--but require indemnification against any further health effects down the line."
Miller agreed that this current hole in our national response to spills is a win-win for oil companies.
"Only work that's done to document individuals' health status pre, post and over the long-term affords them the opportunity to make a case with regards to culpability," he said.
In September, five months after the oil spill in Mayflower and under pressure from the local community, Mason and the ADH started to offer free health assessments to residents. But these assessments entail first being screened by a nurse with no experience diagnosing exposures from oil spills and then, only if recommended, being referred to meet with specialists from University of Arkansas Medical Sciences for "telemedicine" via videoconferencing. No community-wide, door-to-door health assessments or long-term studies on Mayflower residents are currently planned by the ADH.
Some residents believe this is too little too late and question the motives of the ADH. "If you close your eyes, Exxon's statement that all visible oil has been removed from the community becomes accurate," Emily Harris, of the Faulkner County Community Advisory Group, told the Arkansas Times in August. "This may be an attempt for the ADH to make the same sort [of] statement with a report in six months claiming all assessed individuals were found to be healthy."
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