Oil spills: Treating patients, counselling communities

During an oil spill crisis, community concerns can outpace the ability of physicians and public health agencies to provide evidence-based information. To assist clinicians, we provide resources for commonly encountered public concerns during an oil spill. This information is intended to supplement, not replace, risk communication to spill-affected communities.

What health effects are associated with oil spills?
Exposure is primarily via inhalation of vapor and skin contact during cleanup. Inhalation may cause headaches, nausea, respiratory effects, and irritated eyes, nose, or throat. Dermal contact may cause allergic reactions, redness, or rash.[1,2] Inhalation or dermal exposure to dispersants used in cleanup may elicit nervous system depression, nausea, narcotic effects, respiratory and eye irritation, and dermatitis.[2,3]

A review[2] of the health impacts of oil spills found that short-term neurological, respiratory, and gastrointestinal symptoms frequently occur among cleanup workers. 

Short-term effects may also occur in residents without direct contact with the spill. Finally, mental health impacts due to health concerns, income loss, and community disruption can be profound and long lasting. 

Do oil spills cause cancer or other long-term effects?
There is some evidence that cleanup workers may show respiratory, endocrine, or immunological effects years after the event, but the significance of these subclinical effects is unclear.[2] Although some components of crude oil have chronic toxic effects, there is no evidence to link oil spill exposure with cancer or teratogenic effects. 

What should patients do if experiencing symptoms?
Individuals experiencing symptoms should remove themselves from the source of exposure (if possible) and call the BC Drug and Poison Information Centre (1 800 567-8911) for further instructions. If the person is having a seizure, difficulty breathing, or chest pain, call 911.

Who should/should not participate in the cleanup?
Untrained volunteers who participate in beach cleanup or wildlife handling are at increased risk of toxic effects as well as sprains, falls, and lacerations.[2] The public should be encouraged to avoid the spill site, unless they can be equipped, trained, and supervised by appropriate authorities. Children and those with chronic respiratory disease may be at increased risk and their exposure should be minimized.[2] 

How do you decontaminate a patient who has been oiled?
Oiled clothing should be removed (without passing over the head or face), bagged, and stored outside. Oil can be removed with warm water and soap, baby oil, or any other skin-safe cleaner (not diesel or kerosene).[1] Oiled clothing is considered hazardous waste; call the Recycling Council of BC for disposal information (1 800 667-4321).

What should be done if a home or property has been oiled? 
Homeowners should call Emergency Management BC (1 800 663-3456) to report an oil spill, and may need to evacuate. Cleanup may require an approved professional, who will remove contaminated materials and remediate the site to standards set out in BC’s Contaminated Sites Regulation for a residential property.[4]

How will the public know when the environment is safe again?
Following a spill, agencies work together to establish environmental sampling plans that include air, water, sediment, beaches, and food sources (as appropriate). The decision to reopen beaches or allow certain activities is based on the quantification of remaining contaminants and comparing this to human health-based standards (if such exist). However, it should be noted that in some historically impacted areas it may be very difficult to distinguish previous contamination from that due to the most recent incident.
—Angela Eykelbosh, PhD
Environmental Health Scientist
—Tom Kosatsky, MD
Medical Director, Environmental Health Services

Acknowledgments
The authors acknowledge the contribution of conversations with BC’s First Nations Health Authority, BC’s Land Remediation Section, Fraser Health, Vancouver Coastal Health, and Health Canada’s Chemical Emergency Preparedness and Response Unit.

hidden

This article is the opinion of the BC Centre for Disease Control and has not been peer reviewed by the BCMJ Editorial Board.

References

1.    CDC. Light crude oil information for health professionals. CDC/ATSDR, 2010. Accessed 15 December 2016. www.cdc.gov/nceh/oil_spill/docs/Light%20Crude_Oil_Information_for_Health...
2.    Eykelbosh AJ. Short- and long-term health impacts of marine and terrestrial oil spills. Vancouver, BC, 2014. Accessed 15 December 2016. www.vch.ca/media/VCH-health-impacts-oil-spill.pdf.
3.    CDC. Oil spill dispersant (COREXIT ®EC9500A and EC9527A): Information for health professionals. CDC/ATSDR, 2010. Accessed 15 December 2016. www.cdc.gov/nceh/oil_spill/docs/Oil%20Spill%20Dispersant.pdf.
4.    Government of British Columbia. Contaminated sites. Accessed 15 December 2016. www2.gov.bc.ca/gov/content/environment/air-land-water/site-remediation/contaminated-sites.