The tragic BP oil disaster in the Gulf of Mexico has taken 11 lives. The immediate economic and environmental damages are still unfolding as the 7,500 square mile oil slick oozes toward the Atlantic Ocean. But Louisiana’s vibrant fishing and seafood industries have been shut down in anticipation of oil contamination.
The oil gusher also poses a less visible, but just as dangerous, threat to public health from the oil, its fumes, and the dispersants—the chemicals used to clean up the oil. All can be highly toxic and harm the health of those exposed to them, especially volunteers and workers engaged in cleanup operations and those with respiratory ailments, the elderly, and young children living on the Gulf Coast.
There is no clear public health infrastructure to monitor and address these potential human health hazards or any others that may arise in the future. So we need to learn from the health disasters of the past, such as those that occurred from the Exxon Valdez spill in 1989 and the World Trade Center attack of 2001, and not wait for this to become a public health emergency before responding.
The human health problems evolving from the BP oil disaster are insidious and unknown. The first and most obvious are the health effects from the oil itself. This is mostly a risk for those in the immediate Gulf region and the cleanup workers. More concerning is the ill effects that may come from the way that BP cleans up these oil disasters using dispersants. These are chemicals sprayed directly on the oil slick to break it up into much smaller particles. This does not remove the oil, but the dispersal makes it less visible and prevents it from washing up on the shoreline by breaking the oil into droplets that then often sink to the ocean floor.
First, consider the effects of the oil itself. We know that Exxon Valdez cleanup workers faced average oil mist exposure that was 12 times higher than government-approved limits, and those who washed the beach with hot water experienced a maximum exposure 400 times higher than these limits. Many of those workers suffered subsequent health problems and in 1989, 1,811 workers filed compensation claims, primarily for respiratory system damage, according to National Institute of Occupational Safety and Health. The cleanup efforts in Louisiana’s coastal marshes may look very different, but cleaners can also face heavy exposure to oil mist. In fact, some are reporting that EPA studies now show that airborne levels of dangerous chemical compounds from the oil far exceed pre-determined safety standards.
But what may be an even larger problem are the unknown, long-term health effects of the dispersants. BP has reportedly bought up more than a third of the world’s supply of these dispersants. The issue is that we do not actually know what chemicals are in many of these dispersants, or what their long-term effects will be since their exact makeup is kept secret under competitive trade laws.
There are some things we learned after the dispersants were used following the Exxon Valdez spill. Studies performed on organisms exposed to these chemicals after the cleanup found that the dispersants accumulate in living organisms at very high concentrations and harmed the developing hearts of both Pacific herring and pink salmon embryos. The salmon appear to have recovered in the years after the Exxon Valdez disaster, but the herring were not as fortunate. The herring population has never rebounded, even 20 years after the spill, due to a combination of issues including disease and poor nutrition from decreased plankton production. How sure can we be that these chemicals will not also affect humans? And what happens when oysters in the gulf harvested for consumption are exposed to the dispersants and eventually consumed?
BP has taken an unprecedented step of testing these chemicals underwater at the source of the oil in a desperate attempt to stem the flood of oil coming from the ocean floor. This has never been done before, and the EPA has authorized BP to test and monitor this approach. But are we letting the fox guard the hen house by letting the oil companies determine the safety of these cleaning agents?
Although the exact chemical content of the dispersants is not public, the National Academies of Science 2005 report on these dispersants included several sobering cautions, including how the chemicals are tested in the first place. Most lab studies use the fluorescent lighting usually found in the labs when they test toxicity and chemical breakdown, but research conducted under conditions more equivalent to natural sunlight indicate that toxicity increases significantly after sun exposure—by 12 to 50,000 times as much. Worse still, The New York Times reports that BP chose to use dispersants manufactured by a company with which it shares close ties, "even though other U.S. EPA-approved alternatives have been shown to be far less toxic and, in some cases, nearly twice as effective."
As the President’s Cancer Panel recently noted, exposure to chemicals in the air, food, and water pose a serious risk to Americans’ health. The panel notes that dangerous chemicals in the environment are a much larger threat to the nation’s health than was previously identified, and calls for a new national strategy to focus on these threats. The panel found that federal chemical laws are weak, funding for research and enforcement is inadequate, and regulatory responsibilities are split among too many agencies. The panel called for a new national strategy to focus on these threats.
President Obama will likely soon appoint an independent commission to investigate the BP oil disaster soon. Part of its responsibility should include assessing the on and offshore health risks posed by the oil gusher and efforts to stop it. This should include finding out what is in those dispersants and whether there were cleaner, safer alternatives. The House Energy and Commerce Committee has begun the process of overhauling the Toxic Substances and Control Act, an important step in protecting public health by setting government standards for safe chemical exposure in workplaces and the environment based on the most up-to-date science. This will require appropriate enforcement authorities and resources. But this important regulatory reform will come too late for those involved in the gulf oil cleanup and those who live nearby.
It is not too early to implement an ongoing monitoring program aimed at ensuring the utmost minimization of negative health effects. This will require intensive, long-term testing and monitoring of people, food, water, and air; timely analysis of the data; and transparent communications with the people most exposed and most likely to be harmed. It will also require the coordinated, best efforts of a raft of federal and state agencies working together with businesses and local groups. Strong leadership from the very top of government and an ongoing commitment of needed revenue are essential. An integral part of this monitoring program must be a mechanism for people who may have been affected to report their health problems and have them addressed.
Many agencies are ramping up monitoring particular effects of this disaster—including the EPA and the Centers for Disease Control and Prevention—but none are ultimately responsible for the overall coordination of what could be a public health emergency. We saw in the aftermath of the World Trade Center attack that haphazard responses were not enough to adequately address health problems for the first responders and workers. No one could predict at the time of the building collapse what effect the dust would have on those at the scene. What followed were numerous hearings, studies, and pieces of legislation to mount the proper federal response, including a number of new programs at CDC’s National Institute for Occupational Safety and Health. And many still wonder if we’ve done enough.
We were also worried about what health effect the flood waters would have after Hurricane Katrina, yet the federal government left this monitoring up to the local governments. Despite the lessons from these very real public health emergencies, we are now facing what some are calling the worst-ever ecological disaster without an appropriate public health response in place.
The good news is that there has recently been a major increase in federal investment in public health infrastructure and workforce. The public is reassessing the importance of the public health system after the disasters of 9/11 and Hurricane Katrina and the threatened pandemics of Avian Flu, SARS, and H1N1.
The recently enacted health care reform legislation provides additional tools to begin to ramp up the nation’s public health infrastructure. It establishes a National Prevention, Health Promotion, and Public Health Council to help coordinate activities across agencies and numerous provisions to strengthen the public health workforce. These include a public health services educational track to train health care professionals that will emphasize public health, epidemiology, and emergency preparedness; a public health workforce loan repayment program; and a Ready Reserve Corps within the Public Health Commissioned Corps for service in times of national emergency. These are the people with the expertise and the mission to protect the public’s health.
But there is much more that needs to be done to protect public health at times of natural and man-made disasters. The principal aim at this time must be for the federal government to act quickly and put monitoring and response systems in place in the threatened Gulf communities. These can be models of a system that could routinely be implemented at such times, regardless of where in the United States it occurs. We can hope that these systems are not needed and that the cleanup work can be done quickly and safely with no adverse after effects. But as we learn more about this disaster, this does not seem to be the case, and action now must occur to ensure that there is no public health version of shutting the stable door after the horse has bolted.