Interim Report #1
On May 28, 2010, the National Institute for Occupational Safety and Health (NIOSH) received a request from BP for a health hazard evaluation (HHE). The request asked NIOSH to evaluate potential exposures and health effects among workers involved in Deepwater Horizon Response activities. NIOSH sent an initial team of HHE investigators on June 2, 2010, followed by additional teams. To date, 14 HHE investigators have been on-scene; the investigation is continuing.
NIOSH Oil Spill Worker Health Evaluation Interim Report #1 499.20 KbThis report (Interim Report #1) includes several discrete components of our investigation. For each, we provide background, describe our methods, report the findings, and provide conclusions and, where appropriate, interim recommendations.
The components included in this report are as follows:
- 1A - Evaluation of May 26, 2010, Hospitalization of Seven Fishermen
- 1B - Evaluation of June 4-5, 2010 M/V International Peace/MV Warrior Dispersant Mission
Centers for Disease Control and Prevention
Institute for Occupational Safety and Health
Health Hazard Evaluation of Deepwater Horizon Response Workers
HETA 2010-0115
Interim Report #1A
Evaluation of May 26, 2010, Hospitalization of Seven Fishermen
Sources of Information
- Hospital records from West Jefferson Medical Center (WJMC), Marrero, Louisiana
- BP Healthcare Provider Reporting Forms completed by nurse case managers
- OSHA preliminary Incident Report of Fishermen Evacuated Near Grand Isle Shipyard
- USCG investigator's report of the investigation of fishermen evacuated near Grand Isle Shipyard
- Preliminary Investigation of Vessel of Opportunity Worker Exposure Incident Occurring on May 26, 2010, by Center for Toxicology and Environmental Health (CTEH)
- Interview with captains of fishing vessels from Task Forces 1, 2, 3, and 4 by CTEH toxicologist
- NIOSH medical officer interviews with CTEH and OSHA investigators and nurse case managers
Initial investigations focused on exposure to dispersant based on patient reports. OSHA and CTEH reviewed dispersant application records from May 26, 2010; the patients' vessels were approximately 40-60 miles from the area of dispersant use. When oil was observed by the fishermen, the description was most consistent with emulsified crude oil, which, according to the CTEH report, does not contain free dispersant. All but one of the hospitalized fishermen reported extremely unpleasant odors. The reported odors included "concentrated soap" and "bad Clorox" as well as unspecified "chemical" odors. One patient reported a "pinesol" taste. The sources of the unpleasant odors or taste could not be determined by investigators after the event. Captains of vessels from Task Forces 1, 2, 3, and 4 reported to a CTEH toxicologist that the symptoms began after Pentene Clean had been substituted for the usual
citrus-based cleaner but this could not be confirmed in the review of other reports and records. Several of the patients had reported symptoms 3 to 7 days before hospitalization and one reported symptoms approximately 20 days before hospitalization. The most frequent signs and symptoms reported by the hospitalized fishermen were headache, upper respiratory irritation or congestion, nausea, elevated self-monitored blood pressure, fatigue, and chest pain or pressure. Two of the fishermen were hospitalized for evaluation of potentially serious medical problems that are common in the United States. The rest were hospitalized for observation because of their reported exposure to chemicals. Six patients were discharged within 1 day of admission; one was discharged after an additional day of testing.
Conclusions
Given the various descriptions and unspecified sources of the reported odors, the uncertain timing of the symptoms in relation to use of the substitute cleaner, and symptoms that could be related to a variety of causes, it is unlikely that a single specific trigger for the reported symptoms can be determined. Dispersant use appears unlikely to be the source of the symptoms based on the information reviewed by NIOSH investigators. The symptoms were more likely to have been aggravated by several contributing factors, including unpleasant odors, heat, and fatigue.
The early focus on dispersant as the cause of the fishermen's symptoms to the exclusion of other possible causes decreased the likelihood of finding satisfactory explanations for the symptoms. The varying descriptions of odors suggested more than one possible source but the lack of specific information about chemicals used on the vessels and nonchemical exposures precluded a thorough assessment. A detailed occupational exposure history is essential in identifying and assessing possible
explanations for an illness, particularly when more than one explanation is possible.
The potentially serious medical conditions that called for the hospitalization of at least two fishermen might have been identified by a pre-placement medical screening to assess fitness for duty. Additionally, useful pre-placement training topics for workers, particularly those unfamiliar with their new work, include descriptions of the types of oil and chemicals and how to differentiate them, in addition to the more typical topics of hazard recognition and protection.
Because of the amounts of oil involved and the continuing release of oil from the well, response efforts will involve large numbers of workers for long periods. The potential for ongoing exposure to occupational hazards exists and responsible parties, along with affected states and communities, need to be prepared to address the timely diagnosis, investigation, and reporting of work-related illnesses and injuries.
Interim Recommendations
BP should:
- Assure implementation of pre-placement medical screening to assess response workers' fitness for duty
- Provide training for response workers on the different types and appearances of oil they may encounter during the course of their duties, and provide regular communication to workers about response activities in their area of operation
- Coordinate occupational health activities relevant to oil response, such as the investigation and reporting of response-related illnesses and injuries, with state and local health departments
- Assist in identifying occupational medical resources available to local healthcare providers
- Assist in identifying local occupational health needs. This includes education programs to raise local healthcare providers' awareness of occupational health issues related to the oil industry in general and the specific hazards posed by the Deepwater Horizon response.
NIOSH Oil Spill Worker Health
Evaluation Interim Report #1 499.20 Kb
Oil_Spill_Health_Survey.doc
Oil_Spill_Health_Survey.pdf
