Will Gulf Coast ecosystem restoration include restoring the health of its people?

By Elizabeth Grossman

It's now almost eleven months since the BP/Deepwater Horizon drilling rig exploded, killing 11 workers, and almost eight months since the damaged well was capped. While the emergency phase of this disaster is over, the assessment of and response to its long-term impacts are just now getting underway. On February 28th, the Gulf Ecosystem Restoration Task Force held the second of its five planned meetings - this one in New Orleans - and the National Institute of Environmental Health Sciences (NIEHS) launched its long-term study to evaluate health effects of the oil spill disaster response work. And on March 3rd, the Louisiana Bucket Brigade (LABB) released its survey of the disaster's immediate health and economic impacts on coastal Louisiana communities, a study that LABB founding director Anne Rolfes describes as "the first step in a process."

The oil may have stopped gushing from the Macondo well, but as evident from comments voiced by Gulf Coast residents at the Gulf Ecosystem Restoration Task Force meeting in New Orleans, the disaster is far from over. Emotions rose to the surface as public participants - many of them leaders of regional community groups - shared their concerns about the restoration process and long-term impacts of the oil during the hour of the day-long meeting devoted to public comments.

• "The elephant in the room is the health effects that are happening right now to the people of the Gulf. How can you talk about restoring the ecosystem if the health of the people is deteriorating?" said a woman who identified herself as a New Orleans native.
• "If you go out to the marsh now it is silent. The marsh is not supposed to be silent. It is supposed to be filled with dragonflies and grasshoppers and little seed-bugs that feed on the marsh grasses. But it was silent all summer. It is silent this winter and it is going to turn into a silent spring," said Linda Hooper-Bui, associate professor of entomology at Louisiana State University.
• "All these people and these cameras don't mean nothing to me - this coast does," said a woman who identified herself as the wife of a commercial fisherman in Venice, LA. "We live here, we want our place to be sustainable...I won't eat the seafood and I won't feed it to my kids."
• "Citizens need to be actively involved," said Casi Calloway, executive director of the Mobile Baykeeper, a recommendation offered by many of those who spoke who, like Calloway, expressed concern that as currently structured, the federally led restoration effort would leave locals on the margins.

Created by President Obama with an Executive Order on October 5, 2010, the Gulf Ecosystem Restoration Task Force has been directed to develop a Gulf-wide restoration plan within a year. The Executive Order defines "ecosystem restoration" to include all activities that initiate or accelerate "the recovery of an ecosystem, or the services it provides" in order to "strengthen [the Gulf's] ability to support the diverse economies, communities, and cultures of the region," but it does not explicitly mention human health. Residents at the New Orleans meeting made it clear that to succeed, a Gulf Coast restoration plan must include human health and welfare.

Or as Anne Rolfes said during a conference all discussing the organization's new study, "The people who live on the Gulf Coast are part of the ecosystem."

Bucket Brigade report highlights gaps and offers recommendations
For its report Bucket Brigade staff and volunteers interviewed 954 people in 15 coastal Louisiana communities between July 26 and October 1, 2010. The study offers a snapshot of community health and includes respondents' recommendations for addressing the problems they report. Among the report's key findings:

• Nearly half of all respondents reported an unusual increase in health symptoms, including coughs, headaches, and skin and eye irritation; as a corollary, about one-third of those surveyed said they'd used over-the-counter medications more than usual in response to their symptoms
• There are limited treatment options because few local medical providers are trained to diagnose and treat chemical exposure
• 44% of those said their household's primary income-provider had been impacted by the disaster; about 25% said they needed but had not received financial assistance
• 64% expressed concern about seafood contamination

What the findings point to are "gaps - problems that seem abundant but where there's not been much follow up," said Rolfes, noting that this can be said of both economic and health problems. Key gaps identified by LABB are a lack of local medical expertise in diagnosing and treating health effects of chemical exposures and a lack of baseline information on Gulf Coast residents' ongoing exposure to chemical contaminants in a region with a high concentration of oil refineries and petrochemical plants, as well as work that may put people in proximity to oil-related contaminants. At the top of respondents' lists of suggestions for addressing these issues:

• Create access to long-term health care for mental health and ex¬posure-related illnesses;
• Don't study people - treat their health problems; "Residents are tired of being studied. The need for health care has been clearly expressed....Work regarding the oil spill should have a treatment component."
• Train and hire local residents to conduct environmental monitoring and restoration work, including seafood sampling;
• Pursue a restoration economy

"The Gulf ecosystem task force was here on Monday and it not clear to me if they have a process for deeply engaging with people deeply to create a restoration economy," said Rolfes, expressing a sentiment at the heart of most of comments made by public participants at the task force meeting on the 28th. "I've been doing this work since 1999," said Rolfes, and "historically I've never seen the state intervene proactively."

An ambitious federal study
Whether this will change as a result of what's learned through the NIEHS Gulf Worker health effects study or what the Gulf Ecosystem Restoration Task Force learns in the course of its regional meetings, remains to be seen. But Dale Sandler, chief of the NIEHS epidemiology branch and principal investigator on the BP/Deepwater Horizon response-worker health study also cited the lack of local medical expertise in working with chemical exposures and lack of baseline data as key challenges for the study.

"This will be the largest study ever conducted on the health effect of an oil spill," said Sandler, who explained that health effects studies have only been done for eight of the 40 large oil spills that occurred over the past 50 years.

With the aim of enrolling 55,000 people who participated in cleanup work, the study will reach out to some 100,000 with the aim of following about 20,000 participants on a yearly basis over the course of ten years. Anyone over 21 who participated in any type of cleanup work - including support work - for at least one day is eligible to participate. Everyone who went through a response-worker safety training program will receive a letter inviting participation. At the end of April, NIEHS will assess recruitment progress to see how many people have responded and if additional such efforts need to be made.

For those in the annual-contact group, the study will involve a home visit; questions about work history, and lifestyle (including fish consumption); collections of blood, urine, toenail, hair, and house dust samples; and clinical measurements that will include glucose levels, lung function, and blood pressure. Mental health will also be part of the survey. This data will be analyzed for correlations with environmental monitoring data and with "what people did where and when" during cleanup activities, explained Sandler, while noting the challenge of separating potential exposure to oil-spill related contaminants and stressors from those otherwise experienced by Gulf Coast residents. Medical referrals will be offered, but these will be focused on health conditions that include cardiovascular disease and diabetes.

While accident, illness and injury records compiled during the height of the response - by NIOSH, BP, the Louisiana Department of Health and Hospitals, among others - logged in hundreds of health complaints, currently there is no apparent organized scientific or medical study that has already begun to document systematically any long-term health effects of the clean-up work or related contaminant exposure. What the Louisiana Bucket Brigade has documented in its survey, and what Gulf residents said to the Gulf Ecosystem Restoration Task Force last week, make it clear that contaminant exposure resulting from the oil disaster is an urgent and ongoing concern - one that needs immediate attention.

Elizabeth Grossman is the author of Chasing Molecules: Poisonous Products, Human Health, and the Promise of Green Chemistry, High Tech Trash: Digital Devices, Hidden Toxics, and Human Health, and other books. Her work has appeared in a variety of publications including Scientific American, Salon, The Washington Post, The Nation, Mother Jones, Grist, and the Huffington Post. Chasing Molecules was chosen by Booklist as one of the Top 10 Science & Technology Books of 2009 and won a 2010 Gold Nautilus Award for investigative journalism.