NTSB photograph of the 2023 Ohio train derailment

NTSB images

NTSB photograph of the 2023 Ohio train derailment

Early signs of the liver cancer caused by vinyl chloride are hard to detect, leaving thousands of East Ohio residents vulnerable to long-term health issues after a train accident in East Palestine earlier this month spewed the toxic chemical into the air.

Patients and healthcare providers typically have to navigate these disasters on an ad-hoc basis, given the difficulty of building a comprehensive disaster planning and response plan. Recovery and mitigation efforts often depend on litigation that determines who will foot the bill. That has meant more questions than answers in the community.

A Norfolk Southern Corp. train derailed in East Palestine Feb. 3, spilling thousands of pounds of combustible materials, including vinyl chloride, which the Environmental Protection Agency classifies as a carcinogen. The vinyl chloride from several of the train cars was intentionally released and burned to avoid an uncontrolled explosion.

According to the EPA’s estimates, it’s unlikely that East Palestine residents were exposed to high concentrations of vinyl chloride in the air, said Juliane Beier, an assistant professor at the University of Pittsburgh who studies liver diseases. While exposure to low levels of vinyl chloride is unlikely to cause cancer, it could expedite the disease’s progression if the cancer cells already are present, she said. Healthcare providers often look for fat accumulation in liver cells and enzyme production during regular checkups, and any irregularities typically won’t be identified, Beier said.

“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,” she said.

Officials should continue to monitor vinyl chloride levels in the air, water, homes and public buildings for at least a year, Beier added.

East Palestine residents claim in two lawsuits seeking class-action certification that Norfolk Southern should pay for health screenings and medical monitoring as well as ongoing inspections of their homes and businesses. The plaintiffs, who filed the suits in an Ohio federal court Wednesday, also seek damages for property value losses and revenue declines from business interruptions. 

After the Gulf Coast oil spill in 2010, BP agreed to pay people represented in the class-action lawsuits for specific conditions that could have been caused by exposure to the oil and related cleanups.

Norfolk Southern said in a statement that it does not comment on pending litigation, but cited a letter to East Palestine residents from CEO Alan Shaw, who pledged to “stay here for as long as it takes to ensure your safety and to help East Palestine recover and thrive.” Norfolk Southern said it has reimbursed residents for evacuation costs and set up a $1 million fund, among other safety and recovery efforts.

Acute short-term health effects have seemingly been minimal, as area hospitals haven’t seen many patients come into the emergency department with respiratory issues. But the long-term effects are harder to measure.

A spokesperson from the Salem (Ohio) Regional Medical Center said that as of Thursday, it had treated fewer than 10 patients who checked into the emergency department with respiratory symptoms. All were discharged.

Heritage Valley Health System, which has a hospital in Beaver, Pennsylvania, declined to comment. Liviona, Michigan-based Trinity Health, which has hospitals in eastern Ohio, and Ontario, California-based Prime Healthcare Services, which has a hospital in East Liverpool, Ohio, did not respond to requests for comment.

A spokesperson from nonprofit health system Bon Secours Mercy Health, which is based in Cincinnati, Ohio, said in a statement that it continues to monitor the situation and is in close contact with the Columbiana County Health District and Ohio Emergency Management Agency, among other local, state and federal agencies. 

Consuming low levels of vinyl chloride in water poses less of a threat than inhaling it and the amounts the EPA detected in the water were low, Beier said. Still, residents are worried the contamination could spread into the soil, the lawsuits allege.

On Wednesday, the EPA deemed the water from the East Palestine’s municipal water system safe to drink after tests showed no detection of contaminants in raw water from the five wells that feed into the system. But officials cautioned that unregulated private wells may be contaminated and urged residents to get them tested.

The EPA has tested around 500 homes for vinyl chloride and hydrogen chloride, and as of Monday there were no detections. However, those readings can fluctuate day to day, Beier said.

“What if one home was one of the first to be monitored, but then a day later vinyl chloride reached the groundwater?” she said.