The Delta Grassroots Caucus (DGC) is a broad coalition of grassroots leaders in the eight-state Delta region. DGC is also a founding partner of the Economic Equality Caucus,
which advocates for economic equality across the USA.

Health Conference in New Orleans--3rd in a Series of Reports on the Oil Disaster

Posted on June 28, 2010 at 02:23 PM

NEW ORLEANS–The oil disaster will inflict serious but still uncertain health problems for the clean-up workers, and vastly larger numbers of people will be affected from the economic impact of job losses that will cause stress, mental health issues, and inability to keep up health insurance for populations still not recovered from Hurricane Katrina, according to experts from around the country at an Institute of Medicine conference in New Orleans in late June.

Several Delta Caucus partners were at the conference, including Lee Powell and Dr. Aaron Shirley of the Jackson Medical Mall Foundation, and some participants agreed that the Community Health House Network would be helpful in dealing with the long-term health impact of the oil disaster.

This is the third in a series of reports by Lee Powell from the Louisiana coast. It is in-depth and very detailed, but many of those with a strong interest in the disaster said they found the earlier reports informative.

The oil disaster will be one of the key issues dealt with at the upcoming Sept. 21-23 Delta conference in Washington, DC, which will include a fundraiser to aid victims of the oil leak on the third day of the conference, Sept. 23, Thursday morning, 8:30 a,m, to 12:30 at the sanctuary of the historic Lutheran Church of the Reformation on Capitol Hill. Key issues for the Sept. 21-23 conference will include the oil disaster, job creation/recovery from the recession, health care, FEMA’s ill-advised plan to unjustifiably escalate flood insurance costs throughout the Delta, and support for the excellent new leadership of the Delta Regional Authority, Federal Cochair Chris Masingill (who was confirmed by the Senate on June 25) and Alternate Federal Cochair Mike Marshall.

SEPT. 23 FUNDRAISER FOR OIL DISASTER VICTIMS–The Sept. 23 fundraiser’s proceeds will go to nonprofits working in the Gulf region. Tentatively we are planning for two major recipients to be the Every Child Is Ours Foundation, which has done work in New Orleans in the past after Katrina and is headed by Jan Paschal, a former high-ranking Clinton administration appointee in the US Department of Education. Those proceeds tentatively will go toward hunger and nutrition efforts for oil disaster and Katrina victims. The other major recipient will be the network of Lutheran philanthropic organizations to be used as they see fit to aid those suffering in the Louisiana coast. The Lutherans are highly regarded for their philanthropic work in the region and their connection is logical since the fundraiser will be held at the Lutheran Church of the Reformation in DC.

LONG-TERM IMPACT OF OIL EXPOSURE–Experts at the health care conference in New Orleans acknowledged that there is a great deal that is still unknown about health problems caused by benzene and other pollutants found in crude oil. Research suggests that the long-term effects may be severe DNA degradation that can lead to cancer, birth defects, and irreversible neurological damage. An additional concern is that chemical dispersants that are considered more caustic than oil have now reached a usage level of about 1.5 million gallons. Children and senior citizens are especially vulnerable to the toxic effects.

The duration and extent of the leak are key variables, and as of June 23 the total oil spilled was up to 125 million gallons, according to government estimates. This means that the oil disaster may already be over 10 times larger than the second largest spill, the Exxon Valdez, which released an estimated 11 million gallons. This leak is continuing over a longer period of time, as it has already lasted 71 days and will continue for at least another two months or longer, depending on how long it takes to drill the relief wells that are expected to stop it.

Some of the effects may take months or years to appear. The effects are strongly related to an individual’s level of exposure, but genetic factors mean that some will be more susceptible to others and there is no way to predict that. One study from a spill in Spain reported persistent respiratory tract problems.

PROTECTIVE GEAR ISSUE–Wearing protective gear reduces the risk of exposure, but local community advocates reported that BP is discouraging cleanup workers from using masks or other protective exposure. BP has downplayed the health risks of exposure, and utilizing protective gear would be an admission that the risk is there and pose legal problems for the oil company. John M. Hosey, Clergy and Mental Health Coordinator for the nonprofit, faith-based Mississippi Coast Interfaith Disaster Task Force, and other community leaders along the coast reported that some BP officials were actually ordering its cleanup workers to NOT wear any protective gear or they would be fired.

Needless to say, the conference participants responded with utter disgust at the reality that BP was actually not only discouraging use of protective gear but threatening termination to its employees if they used it. In previous disasters the problem was that the heat and humidity may become unbearable for some workers and they remove it.

As a matter of reality, there is also a tendency for those along the Coast to downplay the health risks–at least in what they say to visitors–because they are afraid of worsening the already alarming impact on the tourist industry. When I went out on a boat into the Gulf before the conference, everybody there assured me there was no problem and no reason to wear a mask, even though of course we wanted to get close to the oil to view the situation firsthand. I did have flu-like symptoms after being on the coast several days and out in the Gulf. My exposure was of course minimal to what the workers and residents will face.

For example, one fishermen said he had headaches but dismissed it, saying it was “probably just the stress”–which may or may not have been the case. Others will acknowledge sore throats, dizziness and feeling tired, but say “it’s not that bad, you just need to not stay outdoors too much.” Another fisherman who took us out in the Gulf below Grand Isle said he felt no effects, and given the fact that he was young and very healthy-looking, that was possible at that point. As his exposure lengthens, however, the IOM experts indicate that some health impact will be inevitable. The effects will vary depending on each individual.

The great level of uncertainty flows from the reality that after the Exxon Valdez and other previous oil leaks, research on the long-term impact of exposure to oil did not take place, due to complications caused by the massive litigation after that disaster, and the difficulty of coordinating the research among so many agencies, companies, and people.

The storm season is now upon us, and at the moment winds from Tropical Storm Alex may blow the oil farther inland. The forecast is for an unusually severe storm season.

The Institute of Medicine (IOM) experts indicated that the victims of the Deepwater Horizon leak may be guinea pigs for the scientific community’s first comprehensive effort to measure the health impact of spill-related toxic exposure and stress over time. From the many residents who were present, there was considerable shock that at this late date so little is known about the long-term impact, and understandably they were disturbed at being guinea pigs in the first comprehensive research of this kind. The notion that this will help victims of the next disaster naturally did not console those who are suffering through the second disaster for this region, only five years after Katrina.

SHORT-TERM IMPACT OF OIL EXPOSURE: The short-term problems are much better understood. Those who were exposed for longer periods and the cleanup workers who were closer to the source experienced more severe symptoms, including respiratory and hematological malfunction, eye irritation, and loss of musculoskeletal coordination. One study of a spill off of Spain’s coast indicated that DNA damage did repair itself after several months of non-exposure. However, the chemical mix of each spill is different, and the most serious unknown are the much longer-term impact.

In Louisiana the Department of Health and Hospitals has already reported over 140 cases of respiratory, gastrointestinal, skin-related symptoms, throat problems, vomiting and heat-related problems. IOM experts emphasized that the cleanup workers are doubly at risk because of the extreme heat in the Gulf, and the chemical exposure and heat stress have a synergistic impact that makes them more dangerous together than either would be separately.

Most residents and workers I have talked to report headaches, respiratory problems, exhaustion and similar problems from the toxic fumes. I had similar symptoms after having been down here a while on the coast. I am not aware of any impact in New Orleans, although some in east New Orleans say they can smell the oil at times at night.

ECONOMIC IMPACT AND STRESS, MENTAL HEALTH AND LACK OF HEALTH INSURANCE: Many of the experts expressed equally grave concern about the fallout from the job losses and the rippling economic impact of the disaster. The oil and seafood industries are embedded in the economy, with Plaquemines, LaFourche, Terrebonne, St. Bernard’s, Jefferson and other southernmost parishes suffering massive job losses, and as far as New Orleans we have already seen significant layoffs of oyster shuckers.

Dr. Irwin Redlener of Columbia University School of Public Health, US Surgeon General Regina Benjamin, Dr. Maureen Lichtveld of Tulane University’s School of Public Health and many others at the two-day conference emphasized the psychological toll of the disaster is probably at least as serious as the direct chemical exposure. Health departments and social workers are already reporting higher levels of alcohol and drug abuse, domestic violence, depression, and other stress-related problems caused by job losses or other economic impact of the disaster.

BP is moving far too slowly on claims, is paying much lower amounts of money to fishermen as cleanup workers and others than they would have made in a normal year. Many experts said that people who have suffered through one catastrophe–and especially children–may suffer long-term psychological problems, and those damaged by the long-term recovery after Katrina will now be dealing with a double layer of what they called “toxic stress.”

Some of the lower-income people on the coast not only make their living from fishing, but also rely on it for subsistence when their money runs low. If they didn’t have money for dinner before the disaster, they could go out and catch their dinner. Those people cannot do that any longer.

Dr. Redlener, a long-time colleague and friend of Dr. Shirley, poignantly said that “Living on the Gulf Coast has become a trial that many of us could not have imagined several years ago.” The stress has been counteracted thus far because of the unique history, culture and sense of place of New Orleans and the Gulf Coast, but the destruction of habitats that supported the lucrative fishing, oil, oystering and other ways of life may undermine some of that cultural and psychological resilience, along with the “double toxic stress” of two disasters.

Another colleague of Dr. Shirley’s at the conference was Surgeon General Regina Benjamin is from Alabama and is a daughter of the region, said that the extent of loss felt by the population is more than just an itemized list of grievances, but about losing a way of life–“It’s hard to explain what the water really means to us, because it’s really in our blood.”

Dr. Sheldon Cohen of Carnegie-Mellon University said “I’d be concerned with the loss of community and purpose in life. There are a lot of cultural and community issues that have major implications for psychological distress and being able to cope.”

PLEASE KEEP COMING DOWN TO THE NEW ORLEANS AREA–I would like to give an enthusiastic endorsement to what Edward Overton, LSU emeritus professor at LSU’s School of the Coast and Environment, challenged all the participants at the conference to say to the country: Keep coming to New Orleans because it is just as much a tourist attraction as ever. Of course it is 75 miles or more to the coast and the toxic effects do not get that far. The only thing that could change that would be a hurricane, and that is always a risk and visitors should watch the weather reports at every storm season. But the seafood here at restaurants is safe, and the musical, historical, cultural and visual magic of New Orleans is as vital as ever for tourists. President Obama was right to encourage people to visit areas on the Coast that are not directly affected.

As the storm season progresses, there will inevitably be a need for volunteers to work here. The Delta Caucus partners responded generously to our call for volunteers after Katrina and we know the response will be good this time as well.

EATING SEAFOOD HERE–As far as the seafood in restaurants here, we need to be accurate about what the impact is and isn’t, at least thus far. Prices may go up and selection will be increasingly restricted, but the seafood that is here is safe–perhaps even safer than usual because it is so much more closely scrutinized than usual. Yes, the seafood industry will suffer a major blow and huge areas are closed for fishing. But there is still seafood from other areas of the vast Gulf that are coming in.

I have eaten many oysters–still caught in the Gulf–as well as fish caught in the Gulf while I have been here. I have not had the slightest ill effects as far as stomach problems were concerned. The only health issues I had were respiratory, headaches, and exhaustion from being on the coast. It is true that the oyster supply will dwindle as time goes along. Some seafood here is imported from the East Coast and other distant places.

Needless to say, the beach at Grand Isle and other beaches were the oil has already hit are closed.

In all fairness I could not recommend that people go out in the Gulf unless your job requires it, and if you visit places like Venice and Grand Isle that are closest to the leak, you should not spend too much time out of doors. On the other hand if you are on the Coast and wanted to make a short visit and eat at one of the restaurants, they would appreciate it and a brief time there is not likely to be harmful except for especially vulnerable populations like children, senior citizens, and those with preexisting respiratory conditions.

The hotels and restaurants on the coast are actually not suffering at the moment, because the influx of Coast Guard and other personnel working on the cleanup has offset the negative effects. Hotels in Venice and Grand Isle generally do not have any vacancies nowadays so you have to find a place farther north. I found a hotel in Grand Isle and stayed there a while, but only after looking a long while.

PROBLEMS OF SUSPICION OF FEDERAL GOVERNMENT AND OTHER “OUTSIDERS”–Many of the experts at the conference constantly emphasized the problem that Gulf Coast residents are suspicious of the federal government and other “outsiders” who are coming here to help with responses to the disaster. This is understandable after the inept federal response by FEMA and other government responses during and after Katrina.

This will be a key issue, because information about what the risks are needs to be disseminated widely and rapidly. There will need to be a central coordinator, with the Centers for Disease Control, HHS, state agencies, local government and others all playing a role.

Dr. Redlener and Surgeon General Benjamin are familiar with Dr. Aaron Shirley and the Community Health House Network and agreed that it would be a good way to surmount the suspicion of federals and other outsiders. Once the central repository of information has disseminated the information, there is the problem of how to get it to the receiving end–those in all the local communities and neighborhoods–and get them to understand it, have confidence in it, and utilize the information–a series of community health houses would be ideally suited to do that.

I will follow up with a separate article on how the Community Health House Network would be helpful in getting the cooperation and confidence of the communities, but in a nutshell, the community empowerment, preventive care and cost reduction advantages of this approach are paramount. Each Health House is run by four or five health workers who live in the community and have the trust of the local people. For the large numbers of Hispanic and Vietnamese communities in the region, the language barrier would be overcome because the local health workers already speak the language. Getting information out at times of storms will be important, as will disseminating information about how to reduce the health risks of chemical exposure.

The community health houses will be highly valuable in dealing with not only the environmental but the stress and mental health issues caused by the oil disaster. Having local, trusted residents monitoring the depression, substance abuse, domestic violence and other stress-related fallout from the job losses and economic impact will be highly useful. If federal experts and medical professionals do not have the confidence of the local people they will not follow prescriptions, resulting in constant missed opportunities to engage in preventive care, excessive use of emergency rooms, unnecessary re-hospitalizations from failure to understand and/or follow medical recommendations for recovery, and there will be similar missed opportunities in prenatal care, nutrition, early detection of chemical exposure and a wide range of other issues.

The Institute of Medicine is an independent nonprofit agency that is not connected to the government and thus has no ax to grind. I will follow up with the fourth report soon. We hope these reports are useful in getting people better informed about the oil disaster. Thanks–Lee Powell, executive director, MDGC (202) 360-6347