Earlier this month, a train carrying chemicals and combustible materials derailed in Ohio, releasing toxic gases into the environment of the surrounding areas. In the aftermath, some residents of the area have reported lingering side effects, and health experts have voiced concerns about the potential long-term health consequences of exposure to these gases.

Train derailment in Ohio releases toxic chemicals

On Feb. 3, a train operated by Norfolk Southern derailed in East Palestine, Ohio, a small town roughly 50 miles from Pittsburgh. According to the National Transportation Safety Board, 38 cars derailed before a fire occurred, which damaged another 12 cars.

After the derailment, smoke covered the town, and residents of the surrounding areas were ordered to evacuate for their safety. Several of the train's cars were carrying chemicals and combustible materials, including vinyl chloride, a toxic flammable gas.

On Feb. 6, authorities performed a controlled release of toxic materials from five tankers, diverting the contents to a trench and burning them off. Burning the vinyl chloride released other gases, including hydrogen chloride and phosgene, into the air, but authorities said this was necessary to prevent a potential explosion.

So far, environmental regulators, including the Environmental Protection Agency (EPA), have been monitoring the air and water in East Palestine and nearby communities, and have said the air quality and water supplies remain safe.

"Air monitoring since the fire went out has not detected any levels of concern in the community that can be attributed to the incident at this time," EPA said.

However, EPA administrator Michael Regan said that bottled water should be used until test on water supplies from private wells could be completed. Currently, the Ohio EPA is working on a two-stage cleanup process, removing materials from the derailment site before assessing a remediation plan.

But some residents have been skeptical of the veracity of the federal and state environmental tests, citing a lingering "sickly, plastic" smell in the air around their homes and businesses. Because of this, some residents have chosen to hire independent contractors to conduct their own tests.

"I'm not going to take that chance" and do nothing, said Maggie Guglielmo, a 67-year-old woman who owns a store a few blocks from the derailment site.

At a news conference, Ohio Gov. Mike DeWine (R) acknowledged there was "nothing wrong with healthy skepticism," but defended the federal and state tests, saying "[w]e believe the testing is accurate."

Norfolk Southern president and CEO Alan Shaw has also said the company is "working closely with Ohio environmental and health agencies on the long-term plan to protect the environment and the community." He also noted that local officials are "frustrated by the amount of misinformation circulating about their community and are eager to show that the air and water are safe."

So far, at least eight class action lawsuits have been filed against Norfolk Southern in Ohio, along with one in Pennsylvania. In one lawsuit, residents are calling for the company to cover medical screenings and related healthcare costs for anyone living in a 30-mile radius of the derailment.

Residents express health concerns following derailing

Following the derailment, there have been several reports of animals dying or becoming sick, and some people have complained that they feel unwell. According to CDC, short-term exposure to high concentrations of vinyl chloride can cause drowsiness, disorientation, nausea, headache, burning, or tingling.

Taylor Holzer, a registered foxkeeper who runs a dairy farm close to the evacuation zone, said that one of his foxes died after the derailment and the rest have experienced several unusual symptoms, such as a lack of appetite, lethargy, and abnormally puffy faces. In addition, 3,500 fish in streams and several chickens were reported dead in the surrounding areas.

Jenna Giannios, a wedding photographer who lives in nearby Boardman, said she has had a persistent cough for over a week now and is concerned about the quality of her water. Others have reported similar symptoms, as well as headaches and nausea.

"They only evacuated only 1 mile from that space [the derailment], and that's just insane to me," Giannios said. "I'm concerned with the long-term heath impact. It's just a mess."

However, acute short-term effects from the gas "have seemingly been minimal," Modern Healthcare reports, with hospitals in the area saying that they have not seen an uptick in patients reporting respiratory symptoms.

At Salem Regional Medical Center, a spokesperson said that, as of Thursday, its ED had treated fewer than 10 patients with respiratory symptoms, and all had been discharged. At Bon Secours Mercy Health, which is based in Cincinnati, Ohio, a spokesperson said the health system is continuing to monitor the situation and is in close contact with local, state, and federal authorities.

What are the potential long-term health impacts?

Amid growing concerns from residents, DeWine has requested CDC and HHS teams to assess the situation and provide guidance on any potential health impacts from the derailment.

"Some community members have already seen physicians in the area but remain concerned about their condition and possible health effects – both short- and long-term," he said.

On Monday, HHS and CDC plan to set up a clinic for residents to help address any of their medical concerns. The teams will also help assess any public health needs in the area.

Although EPA estimates suggest it is unlikely that residents were exposed to high concentrations of vinyl chloride in the air, it is not yet clear how people's health will be impacted in the long term.

Vinyl chloride is classified as a carcinogen by EPA, and routine exposure can lead to liver or nerve damage, as well as a weakened immune system. The National Cancer Institute also says that the gas has been associated with "an increased risk of a rare form of liver cancer (hepatic angiosarcoma), as well as primary liver cancer (hepatocellular carcinoma), brain and lung cancers, lymphoma, and leukemia."

According to Juliane Beier, an assistant professor at the University of Pittsburgh, low levels of vinyl chloride are unlikely to cause cancer, but they could make the disease progress more quickly if cancer cells are already present in the body.

"We won't know the long-term health effects for a while unfortunately because issues caused by vinyl chloride exposure are either silent in early stages or take a very long time to develop," Beier said, adding that she recommends officials continue to monitor vinyl chloride levels in the environment for at least a year.

Similarly, Silverado Caggiano, a hazardous materials specialist, said that "[t]here's a lot of what ifs, and we're going to be looking at this thing 5, 10, 15, 20 years down the line and wondering, 'Gee, cancer clusters could pop up, you know, well water could go bad."

"Get a record now of where your health stands so that moving forward, you'll have documentation of any possibly related effects to the train derailment," he said. (Hauser, New York Times, 2/17; Kernstine, NewsNation, 2/14; Tilley, Daily Mail, 2/15; Bendix/Li, NBC News, 2/13; Associated Press, 2/10; Wilson/Dickson, Yahoo News, 2/13; Kacik, Modern Healthcare, 2/16; Phillips, Washington Post, 2/7; Algar, New York Post, 2/10; Cochrane, New York Times, 2/19; Elamroussi, CNN, 2/17)