U.S. Gulf oil spill poses public health threat: Response targeting workers, residents, food and air quality
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* Kim Krisberg

Described as the worst environmental disaster in U.S. history, the massive oil spill in the Gulf of Mexico poses serious risks to human health too — risks that could persist far into the future and about which little is known.

Since the spill began in April, public health workers have been ramping up surveillance and monitoring systems in the five states so far affected, educating residents and clean-up workers, and developing a voluntary roster of thousands of response workers to track their health and eventually add to the little data that is available on human health and oil spills. Health threats arising from the spill include air, water and seafood contamination as well as occupational hazards facing response workers who come in contact with fresh oil and the chemical dispersants used to break up the spill.

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[Figure1](http://www.thenationshealth.org/content/40/6/1.1/F1)

In Orange Beach, Ala., in June, Pete Duchok and his daughter, Maddie, look over residue washed ashore from the Gulf oil spill.

Photo by Joe Raedle, courtesy Getty Images

As of late June, more than 160 oil spill-related health complaints had been reported to the Louisiana Department of Health and Hospitals, the majority coming from response workers and involving respiratory, eye and skin irritation. Hundreds of workers have been responding to the spill, which followed an explosion on an off-shore drilling rig leased by the oil company BP.

To aid in the response effort, an Interagency Oil Spill Health Monitoring and Research Workgroup was established with representatives from agencies such as the National Institute for Occupational Safety and Health, National Institute of Environmental Health Sciences, Substance Abuse and Mental Health Services Administration and Agency for Toxic Substances and Disease Registry. The workgroup is tasked not only with aiding immediate response efforts, but with driving additional research efforts related to oil spills and human health. In June testimony before members of the Senate Committee on Health, Education, Labor and Pensions, Aubrey Miller, MD, MPH, senior medical advisor at NIEHS, noted that “while experts agree that potential for human health hazard exists, since both crude oil and chemicals being used to fight the spill contain harmful substances, understanding and quantifying these effects requires further study.”

“One of the most important take-away messages from our current and ongoing review of the science regarding human health effects of oil spill disasters is that there is a clear need for additional health monitoring and research to underpin our collective understanding and public health decisions,” Miller said.

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[Figure2](http://www.thenationshealth.org/content/40/6/1.1/F2)

At a June news conference, Gulf Coast residents show off jars of oil-contaminated water that were collected in Louisiana and Alabama waters following the April oil rig disaster.

Photo by Alex Wong, courtesy Getty Images

From the limited amount of studies now available, researchers know that oil spill clean-up workers usually report the highest exposure levels and have the most acute symptoms. Regarding long-term effects, studies have chronicled serious psychological problems, such as anxiety and post-traumatic stress disorder, among workers and community members. For example, a 1993 study in the *American Journal of Psychiatry* examining Alaskan communities after the Exxon Valdez oil spill found that the “oil spill’s impact on the psychosocial environment was as significant as its impact on the physical environment.”

Louisiana State Health Officer Jimmy Guidry, MD, said the state’s health department has requested $10 million from BP to fund additional mental health services for residents and workers. While the department works to mitigate immediate health risks from oil exposure, the spill’s effect on mental well-being will likely linger the longest, Guidry said.

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[Figure3](http://www.thenationshealth.org/content/40/6/1.1/F3)

A worker cleans up oil on a beach in Grand Terre, La., in June. Environmental and public health workers are among those addressing the spill.

Photo by Ann Marie Gorden, courtesy U.S. Coast Guard

“We’re trying to minimize the exposure, but we know (residents’) exposure to this is probably not much worse than in urban areas where cars are spewing out petroleum byproducts,” he told *The Nation’s Health.* “But from a mental health perspective, people really don’t know when they’re getting back to work, they don’t know how to provide for their family, they don’t know if the (oil clean-up) work they do choose to do will affect their health in the long-term. They don’t know when the light’s going to show at the end of the tunnel.”

In addition to requesting needed funds from BP, Guidry said the health department is sending crisis intervention teams to work with affected communities, offering not only mental health services, but helping families navigate the claims system, so “they can make ends meet until their livelihoods come back.”

“The same thing happened after (Hurricane) Katrina,” he said. “People want to help clean up, are willing to hire on to help and are then told that there’s risk involved. They have to choose to go without a paycheck or help clean up this oil. If I’m not wealthy, I don’t have much of a choice.”

LuAnn White, PhD, director of Tulane University’s Center for Applied Environmental Public Health in New Orleans, said the oil spill will not be a short-term health event — “even if they stopped the leak today (in late June), we’d still have to worry about the oil that already exists and right now, we don’t have an outer boundary on it.” Fortunately, the state’s public health system is in full response mode, said White, who has a background in toxicology and works closely with the Louisiana health department.

“The state has everybody who can possibly work on this working on it, so it means longer hours, it means working weekends… there’s just not a day off,” White told *The Nation’s Health.* “The whole state is really pulling together and trying to do whatever anybody can to respond to this.”

Expanding on the state’s current public health systems is at the root of much of the response effort, White said. In the seafood surveillance arena, she said the Louisiana health department expanded its already large and ongoing seafood safety program to include the chemicals found in the oil as well as the dispersants. The strategy for preventing contaminated seafood from making it to market is three-tiered: closing fishing and oyster harvesting waters with visible oil, inspecting seafood at processing plants, and conducting chemical tests before waters are reopened to fishing.

“This is basic prevention,” White said. “And because we can respond through existing infrastructures, it’s much more effective.”

Still, the crisis response adds even more pressure on an already stretched public health infrastructure. Gina Solomon, MD, MPH, senior scientist at the Natural Resources Defense Council and a professor at the University of California-San Francisco, said BP should pick up the tab.

“There is a huge role for public health,” Solomon said. “And in my opinion, BP should be paying for every bit of public health activity around this oil spill. The entire burden should not fall on an already-stressed public health system.”

Solomon traveled to Louisiana’s Gulf Coast shortly after the oil spill to reconnect with local community groups she had worked with in the aftermath of Hurricane Katrina in 2005. She said an immediate concern for residents was air quality, which “remains an issue as long as fresh oil is bubbling up from the ocean.” Residents also report “heavy petroleum” odors, Solomon said, and while the odors may not be hazardous, it creates anxiety for local residents not sure of what they are smelling. As the oil spill source is about 50 miles off the coast of Louisiana, it is not likely dangerous air contaminants will make it far inland, and as of June, the U.S. Environmental Protection Agency had not detected contaminants at levels that would be dangerous to human health.

“All across the Gulf Coast, data needs to be collected centrally and that’s difficult,” Solomon told *The Nation’s Health.* “I’m sympathetic because it’s hard to get these systems up and running, which is the reason we need a stronger public health infrastructure in the first place.”

State health officer Guidry noted that “there’s not much of an infrastructure in public health for a surge — it’s very difficult to protect people when we’re constantly dealing with crises.” Even though the state’s public health work force is working around the clock, Guidry said the best way to help is for people to bring their vacation money to Louisiana’s coast.

“There’s a lot of expertise here and you can put yourself at risk (helping) if you’re not properly trained,” he said. “The way to help is to come and support us economically — stay at our hotels, eat our seafood. We need that support.”

For more health information on the oil spill, visit [www.dhh.louisiana.gov](http://www.dhh.louisiana.gov), [http://emergency.cdc.gov/gulfoilspill2010](http://emergency.cdc.gov/gulfoilspill2010) or [www.osha.gov/oilspills](http://www.osha.gov/oilspills).

*   Copyright The Nation’s Health, American Public Health Association