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CMAJ. 2010 September 7; 182(12): 1290–1292.
PMCID: PMC2934792

Gulf oil spill exposes gaps in public health knowledge

The Gulf of Mexico oil spill set in motion an army of health professionals deployed by Washington, states and centres of medical learning, all dedicated to helping Americans stay well in the throes of the catastrophe and its aftermath.

For all that effort, an unsettling reality sank in even before the undersea rupture was staunched: Science knows precious little about the human hazards of exposure to crude oil. Researchers have a better understanding of oil’s perils for pelicans and marshlands of the Louisiana bayou.

In the short term, the health effects have been most obvious among the thousands of workers scrambling to contain and now clean up the spill. They’ve worked in brutal heat for months, face to face with the primal sludge, in conditions too steamy for many to wear full protective gear. They’ve experienced respiratory problems, skin irritation and plenty of heat stress.

Much less clear is the impact the chemical cocktail in Gulf crude will have on the public in years to come. Gulf states have now become a living laboratory as teams of medical professionals lay the foundation for long-term monitoring of the population.

At congressional hearings in Washington, DC, and an Institute of Medicine conference convened in New Orleans, Louisiana, as the oil still flowed, experts expressed frustration that they know little about the health risks of a substance that courses so ubiquitously through daily life.

“While extensive data exists on the effects of oil spills on wildlife and ecosystems, the effects on human health from these exposures have not been well studied,” Dr. Aubrey Miller, senior medical adviser to the National Institute of Environmental Health Sciences and the National Toxicology Program, told Congress.

Says Dr. Lynn R. Goldman of the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland: “This disaster is bigger than anyone could have predicted and no governmental agency anywhere in the world has been prepared to address health surveillance and monitoring.”

Of nearly 40 sizable oil spills in recent decades, most from supertanker breaches, only seven were subjected to epidemiological studies of any import. One of those, the infamous 1989 Exxon Valdez disaster in Alaska, was examined primarily for its psychosocial effects. Vagaries in geography, oil type and circumstance have made comparisons with the Gulf spill of limited use.

Miller’s agency is recruiting a cohort of up to 20 000 spill workers and Gulf residents, backed by an initial US$10 million from the National Institutes of Health, to study their medical history, oil exposure and future immunological, neurobehavioral and respiratory health.

Much rides on what is found. Unlike in the Exxon Valdez aftermath, when recovery payments stretched out over decades of litigation and awards ultimately were slashed by the US Supreme Court, BP LLC agreed to set up a US$2-billion fund for Gulf residents, businesses and the environment. Physical ailments now and in the future qualify for compensation.

Mental health suffering, however, an inevitable consequence of the disaster, yet one that is difficult to quantify, might be frozen out of the fund. Kenneth Feinberg, the blunt independent arbiter of the fund, says mental health might be a step too far.

“If you start compensating purely mental anguish without a physical injury,” he told legislators, “we’ll be getting millions of claims from people watching television. You have to draw the line somewhere.”

Grounded fishermen, owners and employees of shuttered businesses and other residents close to the crisis have been exhibiting signs of acute anxiety, depression, increased and excessive drinking, and suicidal ideation, Louisiana state counselling teams reported.

Those conditions, behaviours and more — domestic violence, post-traumatic stress disorder, broken marriages and community discord — were the legacy of the Exxon Valdez, the worst spill in US history until the Deepwater Horizon drilling rig exploded in the Gulf on April 20, killing 11 crewmen.

The rig’s Macando well spewed as much as 700 million litres before a temporary plug finally worked in mid-July. Now, BP is readying a permanent kill.

Researchers at the New Orleans conference heard evidence that cleanup workers in Spain’s far smaller 2002 spill, from the sinking of the tanker Prestige, suffered DNA damage, although of a kind that reversed itself.

Dr. John Howard, director of the National Institute for Occupational Safety and Health, told Congress that oil is a skin and lung irritant but over the long term, it is “unlikely” to damage health as far as is known.

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Workers hired to clean up the Gulf oil spill have experienced respiratory problems, skin irritation and heat stress.

Still, uncertainties persist, from fumes in the air, tar balls on beaches, chemical dispersants used on the slick, contaminants consumed by sedentary sea life that could not get out of the way, and more.

Children — “low-living, thin-skinned, risk-taking humans,” as they were called at the New Orleans conference — are of special concern, for they have higher respiratory and metabolic rates than adults, relatively undeveloped immune systems and greater sensitivity to toxins in the atmosphere.

“What might be annoying to an adult could be a real problem for a child, particularly if the child is an infant or toddler who has pre-existing conditions,” Howard said.

He joined other top US health policy authorities in testifying to a Senate committee on the health effects of the spill.

“We don’t have the world’s literature here that’s able to tell us what happens when there’s this much oil around populated sites,” he said. “As we’ve said all this afternoon, we just really do not know a lot of things here. And the only way to find out is to be able to study.”


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Articles from CMAJ : Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association