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Leading on public health

The federal government must have full responsibility, leadership, and oversight in monitoring and managing the public health consequences of the BP oil disaster. Lesley Russell and Ellen-Marie Whelan of CAP’s Health Policy team explain why.We must have a coordinated response to the known and potential health problems resulting from this spill for the sake of the health of the clean-up workers and volunteers, the people living in affected communities, and Americans who, even though distant from the problem, might consume contaminated seafood.

That response can only be lead by the highest levels of the federal government. This is an issue that reaches beyond the purview and abilities of local and state health authorities, although their expertise and advice must undoubtedly be harnessed. It is an issue that requires coordination of a wide range of agencies and authorities. And the evidence is very clear that we cannot afford to leave any part of this important response to the very corporation that caused the problem in the first place.

It is now expected to be late summer or fall before the spill is finally contained, and it will be years before the contamination””both oil and dispersants””is cleared from the environment. Thousands of workers and volunteers will be involved during that time. Many of these will handle the oil residues and dead animals and sea life, and attempt to restore the affected marshlands without adequate training or protective gear. There have already been reports of clean-up workers needing medical attention, and there are concerns that coastal communities are breathing oil fumes and are at risk of eating seafood that may be contaminated.

Likely oil disaster health problems

We can hope that the health effects will be slight and will not extend into the community at large, but there are logical reasons to be concerned. Crude oil contains a mix of compounds hazardous to human health, including benzenes, which are known cancer-causing agents, and others that are toxic to the brain and central nervous system, such as polycyclic aromatic hydrocarbons. It can also contain poisonous heavy metals.

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We know that inhaling oil vapors or aerosolized particles can cause headaches, dizziness, nausea, vomiting, irritation of the eyes and throat, and difficulty breathing. High-dose inhalation may cause chemical pneumonia, which can require hospital care. People with asthma or other lung diseases could have these conditions exacerbated by oil fumes. Some of the volatile chemicals in crude oil have been linked to miscarriage, low birth weight, and preterm birth. Direct skin contact with crude oil can cause various kinds of skin rashes and possibly skin cancers.

Oil is not the only health concern. The manufacturer of Corexit, the dispersant being used to clean-up the oil, warns against contact with eyes, skin, or lungs. This product is somewhat volatile and some formulations contain the carcinogen 2-butoxyethanol, so it is critical for clean-up workers and volunteers to wear personal protection equipment at all times when applying the dispersant or working near where it has been applied. It is possible that dispersants will be diluted by the time they reach the shore and won’t pose a threat for communities, but there is no certainty of this. The highly dispersed oil particles that remain either at sea in large plumes, or on the ocean floor, may pose an ongoing and unseen threat to sea life, including those which may enter the human food chain.

There are two key reasons why the federal government must have total responsibility for the health issues around this disaster: We cannot trust BP, and we need a long-term, coordinated response.

We cannot trust BP

We should not entrust an oil company to oversee the health effects and clean up of this massive disaster. BP’s long record of breaking environmental, safety, fraud, and antitrust laws clearly demonstrates that it should not have control of any aspect of overseeing the health implications of the disaster it created.

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Recent media reports have shown how pervasive these problems are. BP’s own internal investigations highlighted to senior BP managers that the company repeatedly flouted safety and environmental rules, pressured employees not to report problems, and cut short or delayed inspections to reduce production costs. No effective action was ever taken, and the result is an atrocious record of accidents, environmental contamination, and employee deaths. The Center for Public Integrity reported that just two BP refineries have accounted for 97 percent of all safety violations found in the refining industry over the past three years.

Two types of problems have already arisen in BP’s handling of the health effects of the gulf oil spill. First, BP has trained workers in the cleanup effort and says it provides protective gear for workers directly handling oil, but there are accounts and photos of people working without such protection. Second, BP has reportedly taken hundreds of air and water samples and has said that all levels were within federal safety standards. But BP won’t make the data publicly available.

Viewed in this light, BP’s claims that “we will make this right” somehow ring false.

We need a long-term, coordinated response

There are a host of federal and state agencies involved in the cleanup operations. All of them are involved in collecting information and data, some of it specifically health-related, some of it tangentially so. This work needs to be coordinated to ensure that nothing important is missed, and that all relevant data is collected, assessed, and made publicly available in a timely and consumer-friendly fashion.

There is a paucity of data about the long-term human health effects of oil spills and their cleanup. It’s time to remedy that situation and have a well-coordinated regional and national public health effort to assess the health effects.

The need for better data and a coordinated response is highlighted by several findings:

  • Participation in clean-up activities of the Prestige oil spill off the coast of Spain in 2002 resulted in prolonged respiratory symptoms lasting one to two years after exposure.
  • Oil from the Exxon Valdez spill has persisted in the environment well beyond a decade in surprising amounts. Oil that is buried on beaches can remain toxic and biologically available for many years. And when a disturbance such as burrowing animals or a severe storm reworks the beach, this unweathered oil is reintroduced into the water and can create long-term biological exposure risks for some species.
  • We are still dealing with illnesses in the first responders and clean-up workers at the World Trade Center. Such workers should be protected from any increased risk they face.

The key focus now and into the future should be the health and wellbeing of the people in the affected communities. They need information, advice, and the ability to have their concerns, issues, and health problems addressed. These health problems will include not just physical symptoms, but the anxiety, stress, and mental health problems that come when livelihoods and neighborhoods are turned upside down. These were some of the most detrimental effects from the Exxon Valdez oil spill.

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The efforts needed include monitoring air, water, and soil quality, as well as ensuring compliance with regulations regarding clean-up workers’ training and equipment. Efforts should also reach to increased seafood inspections for much of both the gulf and east coasts of the United States, providing advice to those already suffering from chronic respiratory conditions, teaching pregnant women and families with small children how to mitigate their exposure, and collecting observational data about patients’ health from health care providers.

The Gulf Coast is an area of the United States that is already medically under served, and one that will need the federal government to ensure provision of needed health care services in the short to medium term. Secretary of Health and Human Services, Kathleen Sebelius, has already announced that the National Disaster Medical System has been activated to provide additional medical care in the five gulf states, and a federal mobile medical unit has been sent to Louisiana to help treat anyone complaining of illness.

Protecting public health has always been the responsibility of the federal government

These efforts are not, and never have been, taken on by companies. Corporations cannot be relied upon to put the long-term interests and needs of these affected communities ahead of their business concerns.

The protection of public health has, however, always been a key responsibility of the federal government. This responsibility reaches back to law signed in 1798 by President John Adams to create hospitals for sailors along inland and coastal waterways, and today the Public Health Service Commissioned Corps is an essential and readily mobilized component in the largest public health program in the world.

We cannot afford to leave something as important as Americans’ health to a corporation that has such a bad history of ignoring health and safety requirements, hiding information, and dissembling the extent of ongoing problems. This is already a disaster of unprecedented proportions; the government must act now to ensure that public health is protected so that the disaster does not linger through longstanding ill health effects long after the oil spill is cleaned up.

Lesley Russell is a Senior Fellow and Ellen-Marie Whelan is Associate Director of Health Policy and Senior Health Policy Analyst at the Center for American Progress. This is a CAP repost.For more in public health and the BP disaster, see: