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EAST PALESTINE -- The National Academies of Sciences, Engineering, and Medicine (NASEM) released its summary this week of a two-day virtual public workshop held Nov. 6 and 7 on health research and surveillance priorities related to the East Palestine train derailment and highlighted the gaps in the training and available data needed to deal with such a disaster.
Citing lack of "necessary environmental health training to address community concerns regarding exposures and related health impacts by clinical responders," the summary zeroed in on the unknown health implications left behind in the wake of the disaster, the inability to explain the immediate acute symptoms experienced by residents and the void of "playbook" to follow when tracking and treating symptoms.
To better grasp the immediate impacts of the disaster as well as long-term implications, the workshop featured local and expert voices. Local speakers included East Palestine Fire Chief Keith Drabick, Columbiana County Mental Health and Recovery Services Board Executive Director Marcy Patton, Columbiana County Health District Health Commissioner Wesly Vins, First United Presbyterian Church of East Palestine pastor Harold "Fritz" Nelson, Columbiana County residents Christa Graves and Jess Conard. Expert panelists included Assistant Professor of Medicine at University of Pittsburgh Juliane Arteel-Beier, Adjunct Professor at Department of Environmental Sciences and Engineering at University of North Carolina Linda Birnbaum, Agency for Toxic Substances and Disease Registry Region 5 Office Regional Director Motria Caudill, U.S. EPA Region 5 Response Coordinator Mark Durno, Michigan State University Associate Dean for Public Health Mona Hanna-Attisha, New Brighton Area School District nurse Dr. Nicholas Newman of Cincinnati Children's Hospital Medical Center and National Institute of Environmental Health Sciences Director Richard Woychik.
The NASEM synopsis broke down the workshop testimonies, offering perspective from both community members who lived through the derailment and medical providers.
The summary noted that residents described the evacuation process as "chaotic and poorly communicated" and expressed disappointment "with the lack of transparency and access to data from officials." Residents also voiced concerns about potential long-term effects such as cancers, hormone disruption and respiratory impacts as well as mental health effects like "trauma, a loss of trust, and feelings of abandonment by failing systems meant to protect them."
Providers also explained the mental impacts of the disaster. According to the summary, mental health professionals Kristen Barefield, a family therapist at Metta Wellness, and Patton reported that the derailment took a major emotional and psychological toll on many East Palestine residents, both immediately and in the long term. Increased anxiety, depression and post-traumatic stress disorder (PTSD) symptoms and ongoing stress for those still displaced months later were noted.
Gretchen Nickell, the chief medical officer at the East Liverpool City Hospital and the medical director for the Columbiana County Health District, described acute physical symptoms of the derailment as rashes, eyes, ears and throat irritation and nausea but that "gaps in research on the specific chemical exposures from the derailment make it impossible to definitively link symptoms to the event."
All providers concurred that "clinicians lacked training on responding to environmental disasters and exposures."
The summary reported that over 200 exposure-related calls regarding East Palestine flooded the Poison Control Center (PCC) hotlines and one panelist said that while PCC scrambled to put together a fact sheet to refer to, expanded clinical guidance with updated research on management decisions, diagnosis and treatment recommendations for physicians dealing with potential exposures, particularly for children and pregnant women.
Workshop panelists also discussed challenges in disaster risk characterization and risk communication, the critical issue of assessing health risks from cumulative exposures, studying disease progression, mental health impacts, and multigenerational effects of the derailment, more robust research to advance disaster preparedness particularly for volatile organic chemicals and systemic challenges in connecting science, public health practice, community needs in the wake of catastrophes like the derailment and what can be learned from East Palestine.
The summary, titled "Public Health Research and Surveillance Priorities from the East Palestine Train Derailment, Proceedings of a Workshop in Brief," can be viewed at nap.nationalacademies.org.