Even as BP and US government officials continue to declare the oil spill over at Mississippi Canyon 252 and the cleanup operation an unqualified success, for the first time blood tests on sickened humans have shown signs of exposure to high levels of toxic chemicals related to crude oil and dispersants. Some of the individuals tested have not been on the beaches, were not involved in any cleanup operations or in the Gulf water -- they simply live along the Gulf Coast. Several of them are now leaving the area due to a combination of illness and economic hardship. As the media's attention has moved on and the public interest wanes, the suffering and hardship for people along the entire Gulf Coast of the United States from Louisiana to Florida continues to worsen. While BP and the government are scaling back cleanup operations and distancing themselves from legal liability for the environmental destruction, economic hardship, sickness and death resulting from the largest environmental disaster in our nation's history, the situation continues to deteriorate.
The use of the Corexit dispersant 9500 and the highly toxic 9527 by BP, with the approval and assistance of the US Coast Guard and EPA, has been the subject of intense scrutiny and criticism. Never before has such a huge quantity of the toxic compound been used anywhere on the planet. Most countries including NATO allies ban it's use and will only grant approval as a last resort after other methods have failed. Britain has banned its use altogether. The NOAA provided extensive information summarizing other nation's policies in regards to Corexit after Senator Barbara Mikulski demanded the information from EPA administrator Lisa Jackson during congressional hearings in July. While the dispersant serves to break down crude oil on the surface and thus makes the oil invisible from the air, it is highly toxic and bioaccumulates in the marine food chain. In humans it is a known carcinogen and its use was widely condemned after Exxon/Valdez and the horrifying health effects on the populations exposed to it there. As it evaporates and becomes airborne, the toxic compounds have moved on shore, creating health impacts that, although apparently large from the numbers of people affected, the full extent is unknown. BP and the US government have effectively been performing the largest chemical experiment in history on a civilian population without their knowledge or consent.
Dispersant and crude in Gulf
Within two days after arriving in the region in mid-July, everyone on our team began getting sick. After our first day out on the water with Captain Lori of Dolphin Queen Cruises touring the lagoons around Orange Beach, Alabama, we all had extreme headaches. During our boat tour, dispersant was visible covering the water everywhere. That evening I developed a gagging, coughing reflex that was so intense and persistent it was impossible to speak to my daughter on the phone. The symptoms typical for high levels of chemical exposure such as burning, itching eyes, constantly runny nose, chronic coughing, burning sore throat, chest congestion, and lethargy progressively intensified. Over the next several weeks these symptoms continued to worsen until I developed chemically-induced pneumonitis. Before leaving the area I had blood tests initiated to determine if the levels of exposure were high enough to be be detected. The musical activists Sassafrass and the tireless efforts of Michelle Nix allowed myself and several local residents to have blood drawn and tested by Metametrix for chemical exposure. Project Gulf Impact and the Coastal Heritage Society have also contributed greatly to air and water testing in the Gulf region affected by the spill. Project Gulf Impact has set up a dedicated medical help phone line at 504-814-0283. It has proven extremely difficult to find medical care providers who are willing to see patients who have been impacted by the oil spill due to the tremendous pressure exerted against hospitals, clinics, and physicians by BP. In numerous cases BP has provided financial payments to institutions and individuals in exchange for them agreeing not to allow their physicians or staff to see, advise, or treat anyone sickened as a result of the well blowout.
I spoke at length with Michael R. Harbut, MD, MPH, who is clinical professor of Internal Medicine and director of the Environmental Cancer Program at Wayne State University's Karmanos Cancer Institute. Board Certified in Occupational and Environmental Medicine, Harbut was Chair of the Occupational and Environmental Health Section of the American College of Chest Physicians, was Medical Coordinator of the Kibumbe Refugee Camp during the 1994 Civil War in Rwanda, where the death rate for patients under his care was 1/3 that of the remainder of the camp and was Chief US Medical Advisor to Poland's Solidarity during the Cold War. His research has been published or presented in venues ranging from the New England Journal of Medicine to the White House.
JC: I wanted to speak with you and see what you thought of the test results we got back. As you know, some of the locals actually came back even higher than mine.
MH: First you have to remember the setting -- this is New Orleans and the Gulf Coast; there is a history and a context in which things need to be placed. In my specialty, which is occupational and environmental medicine, there are not many of us who are board certified who actually take care of patients. The bulk of the physicians in our specialty are medical advisors or medical directors to large corporations, and many have never met a chemical they didn't like. Sort of like Will Rogers. Part of the context is there is a physician whose name is Victor Alexander who was a specialist in my field. He worked in New Orleans at the Oxnar clinic and was seeing a lot of patients who worked for the petroleum companies and was reportedly fired for all of the work he did for his patients as opposed to the petroleum companies -- what a doctor is supposed to do. So Victor Alexander then goes into private practice and the New Orleans police came and arrested him for robbing a bank.
MH: Yea, it gets way crazier. This is a guy who was doing very well personally, economically -- it came out in trial that he had a half a million dollars in the bank and was making plenty of money. It is unlikely in terms of motive that he would rob a bank for 2,500 dollars. The video from the bank was analyzed by the retired chief of criminal identification for the FBI; he said there was no way it could have been Dr. Alexander robbing this bank. He went to trial twice, the judge threw out a lot of evidence that would have exonerated him and he was sent to prison for robbing a bank. The Louisiana State Medical Society refused to take away his license. Many physicians who do work or potentially could do work or have knowledge of the area in New Orleans know the story about Victor Alexander. The message is quite clear: Don't mess around with the petroleum industry.
JC: I have been working mainly in the Orange Beach/Gulf Shores area of Alabama, and that's where I got sick.
MH: Have you had a CAT scan?
JC: Not yet, although they want to do one at the National Jewish Respiratory Center in Denver.
MH: You have to do that. I was chairman of the Occupational and Environmental medicine section of the American College of Chest Physicians so I have a lot of experience in this. You really need to be seen by a physician who understands this is serious.
JC: It's on the schedule when I get back to Colorado. What do you see when you look at the test results from myself and the other people down here? What do they tell you?
MH: Let me tell you one more thing before I forget. I think that the only way to come close to getting the ultimate answer down there is to -- there has to be a federal task force if you will. A federal effort where there would be half a dozen or a dozen specialists in this field who would have the protection of the government either temporary commissions from the U. S. public health service or something like that. Who would be responsible for organizing all the science and all the medicine and trying to get people to deliver care down there. I just don't think you are going to get many volunteers unless they know they have the protection of the government. The annals of environmental diseases are strewn with stories about physicians who have had their lives ruined.
JC: The impacts of what is happening down here is are so big it's very hard to wrap your head around it.
MH: I will give you one other example while we are talking about it. In the early 1990s I had called a bunch of cases, I saw patients who were sick from their environment who worked for Dow and DOW Chemical and a couple of the steel mills. In an eighteen month period I had one Blue Cross Blue Shield audit, two Medicare audits, a Michigan Employment Security Commission audit, a USAID Inspector General's audit, and I was the target of a federal grand jury investigation. After two years and tens of thousands of dollars Medicare thanked me for teaching them how to catch a crook, apologized for bothering me -- I told them how they could catch crooks and they thanked me. The US government, the local FBI office actually called my attorney and said they really weren't able to find anything and my attorney who is a former US Attorney said that the government never calls when they have investigated somebody they just leave them dangling for the rest of their lives. The degree of harassment towards physicians is enormous, which I think is part of the reason -- because of the conflicting forces at work in the Gulf, because of the probably less than half truths that are floating around that there needs to be a federal task force of independent physicians and scientists who have the protection and full faith of the United States. The way the system works, I think it would mean temporary commissions in the public health service. I don't think even the oil companies that work down there would try and bump off a guy who works with the public health service.
JC: A number of people I have spoken to in Washington share that same opinion. Does it help to have test results in hand that show high levels of exposure from this event?
MH: I remember you had no Benzene but a lot of Hexane and a couple of Hexane metabolites. I am not sure what that means because where you see Hexane, Hexane causes what is called a dying back neuropathy, meaning the nerve cells in the arms and legs die back from the distal tips to the proximal end. You can end up with numbness, pain, all sorts of things. Hexane is a direct petroleum product so where you see Hexane you would expect to see Benzene. Now, that having been said I personally don't even do actual solvent levels anymore because they are fraught with error. Rubbing alcohol is the prototypical solvent, and if you put a cap of rubbing alcohol on a flat surface like marble or something it's usually gone before you would have a chance to get a paper towel it evaporates so quickly. So what happens with the organic solvents in general is that unless there is absolutely perfect control when they are drawn, there is a fair amount that will evaporate, if in fact not all of it. One of the dangers of people going to this lab (Metametrix), which I think is a good lab, is if they get the test drawn at a facility that lets it sit out for a little bit you are going to get a false negative result. In a case like yours, if you believe the sample is valid and it shows that you have Hexane and Hexane metabolites and also Octane in your blood, then it's a pretty good clinical indication of how to go about treating you, which is usually just drinking a lot of water and then treating the end organ damage. End organ damage meaning we know if you inhale this stuff, if you have it in your system, it will damage your nerves. so we take a look at the nerves. The nerves will not show up abnormal on a test until there has been 30% damage. So what I do here and what I teach my residents is that for most people who come in to see the doctor in this field with a problem you will get more yield in terms of finding pathology and being able to help them if you look for end organ damage rather than the presence of a solvent because the solvent could have evaporated after it has already whacked the brain or whacked the liver.
JC: I spoke to the founder of Metametrix and he said that the tests were designed to pick up these compounds in the body after part of it, particularly Benzene, has been flushed. He indicated that the Benzene would not show up for very long once you were exposed but that the other compounds, the Ethylbenzene, m. p.-Xylene, the Hexane, which was way high, the Methylpentanes and the Isooctane, all of those things indicated to him that we were exposed to significant amounts of Benzene.
MH: That's what I would think, too.
JC: When you look at these results is there reason to believe we might have sustained serious damage to our organs?
MH: In order to be scientific about this you have to have baseline data on a large population. What the oil company doctors, the professional experts that will ultimately be hired in these cases will argue is that you don't know what background is in the area. I have seen them do this. They will go out and check 90 people and they will find people with results less than yours or more than yours and they will say this is background so with this particular patient you can not rely on the validity of the testing. On a scientific basis that's true, I would prefer background. What happened to you right now is you have an indication that you breathed in harmful agents -- you have a marker. They are called bio-markers. A bio-marker is the Hexane, N-Hexane and the Octane. You have evidence that you inhaled it because it's in your blood. Nobody has correlated how much N-Hexane in your blood by PPM or PPB correlates with actual nerve damage. You need to have pulmonary tests, high resolution cat scans of your chest, liver function and cardiac function tests. What should happen with people with these exposures is at an absolute minimum, and I do not believe this is adequate, but at an absolute minimum the NIOSH recommended health monitoring tests should be done. Be certain to ask the doctor examining you if they have ever been paid or retained by a petroleum company or a chemical manufacturing company.
JC: I can do that.
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