Yesterday, it was reported that the National Toxicology Program determined that the crude MCHM which contaminated the Elk River last year was not “toxic” at the levels present. Like the declaration last year that the water was “safe” saying that the level of chemicals present was not “toxic” is ambiguous. Great nobody died or is expected to die. A glaring issue for me is that inhalation exposure still has not been considered by the powers that be. The National Toxicology Program’s findings essentially reaffirms the drinking water standard put in place last year. The possibility of inhalation exposure is not just mere conjecture. The safety data sheet for crude MCHM notes potential respiratory irritation from elevated temperatures.
We were told to flush our faucets, all of our faucets, for 15 minutes on the hot water and only 5 minutes on the cold. (http://bcove.me/bety99p3). Anecdotal information suggests that the chemical may have reacted differently in the hot water. This is consistent with the warning regarding elevated temperatures. We have too many unknowns. Carl Sagan said “the absence of evidence is not the evidence of absence.” We can’t just ignore something merely because there is no readily available evidence of its existence. The fact that there is no evidence or available information is more reason to study something. None of the responsible entities have ever tried to develop an inhalation screening level. The most common reasons given for the failure to develop an inhalation screening level, was the lack of data on the chemical and the “lack of a method to analyze an actual amount of MCHM in the air.”
Inhalation is a basic exposure pathway. Ignoring it is a problem. If there was not a mechanism to measure MCHM in the air it should have been developed, or adapted from another process if possible. But to not even try is ridiculous. And in some cases possibly negligent. Disregarding people’s lived experience should not be permitted in a matter of public health and safety. It’s so great that everyone can pat themselves on the back. The Drinking water advisory has been vindicated. But the fact that NO ONE considered inhalation exposure is still a problem. Failure to acknowledge this oversight is an ongoing failure in the public health response. Admittedly, the Drinking water advisory never considered inhalation, even after there were reports of people getting sick at area schools after flushing.
This is personally frustrating. As a former resident exposed through the flushing process I am concerned about long-term health effects. I gained 25+ pounds from the several rounds of steroids and other medications I was prescribed to treat my respiratory ailment later categorized as adult onset asthma. While I wasn’t a skinny woman before, I could hold my own without chest pain and breathing difficulty. I’ve never needed to use an inhaler or other medication. My chest tightens and burns when I walk. I’m glad I knew to keep my son away because of his asthma. But I didn’t think I would develop issues as a result of proceeding through the flushing process. I did what I was told. There was no one to call or reach out to when the flushing did not work. There was no one to check to make sure we were doing the process the right way. Given the information provided at the time and the failure to acknowledge possible inhalation exposure, I exposed myself three times through the flush process. However, by the third time I knew to ventilate my house and wait outside.
In an April 2014 article, Dr. Gupta (former head of the Kanawha-Charleston Health Department) reportedly said “based on data from local physicians, show those initial numbers were misleading about the health impact of the spill because not everyone who was affected went to the hospital or even sought medical treatment for symptoms like burning eyes, itchy hands or difficulty breathing.”. As people were told from the outset that there were no problems related to our exposure to crude MCHM, many did not stop to consider that the itchy throat, cough, headache, or other respiratory issue could be related to exposure. Of those who did think there could be a connection, many were not see in Emergency Rooms but were treated by local doctors or in urgent care facilities. People who left the affected area and sought medical treatment were not properly captured.
We still do not have a plan in place for long-term health studies, medical monitoring, or other longitudinal review. People haven’t even been encouraged to self-monitor. Research begun at Purdue and Northeastern University provide some insight into beginning inhalation toxicity studies. There is enough information to warrant analysis of the potential for inhalation exposure after the spill. (See Maya Nye’s letter to the National Toxicology Program).