Feds Still Working on Leak Impact Studies
27 February 2014
By Ken Ward Jr.
CHARLESTON, W.Va. -- A month after completing their work in West
Virginia, federal scientists are still working to finalize an
analysis of hospital records of residents who were treated after
last month's Elk River chemical leak, and are planning additional
work to help understand the leak's public health impact.
U.S. Centers for Disease Control and Prevention officials are
conducting a patient-chart review, which will give more detail
about how many residents exposed to contaminated water sought
hospital treatment and what types of symptoms they experienced.
The report is not necessarily designed to provide any concrete
answers about whether chemical exposure caused those symptoms, or
address claims by some state officials that such symptoms were
really related to the flu or anxiety about the chemical leak.
However, with a more definitive examination of the population's
potential chemical exposure and reported symptoms, scientists will
be better able to understand the leak's effects on public health.
"Generally speaking, the scientists would be looking for patterns
and associations, and sometimes suggestions for follow-up," said
CDC spokeswoman Barbara Reynolds. "The cause would not be captured
in the data collected in this Epi-Aid."
The phrase "Epi-Aid" is the CDC's term for epidemiological
assistance the agency provides to states. Epidemiology is the
study of patterns, causes and effects of health problems in
In this instance, the CDC is responding to a state request that
federal scientists help to assess the impact of the leak of the
coal-cleaning chemical Crude MCHM from the Freedom Industries tank
farm. The leak, just upstream from West Virginia American Water's
intake, contaminated the water supply of 300,000 people in nine
Loretta Haddy, state epidemiologist with the Bureau for Public
Health, said Thursday the CDC's report is based on the agency's
review of hospital records of the more than 500 people who sought
treatment after the leak.
The report will provide what Haddy called "descriptive
epidemiology," meaning it will outline what sorts of symptoms
patients experienced and what sorts of chemical exposures they
might have reported to doctors. Some of that information has been
made public before, in periodic state briefings and interviews
with local health officials. The CDC's analysis of the hospital
charts is much more methodical, officials said.
"It's a little more descriptive," Haddy said of the CDC report.
Haddy said the CDC analysis would "look closely for associations
of cause, but one of the limitations is that you cannot have
direct association of cause" based only on the hospital record
Five days after the leak, Haddy wrote to the CDC and its sister
agency, the Agency for Toxic Substances and Disease Registry, to
request assistance in performing what's called an Assessment of
Chemical Exposure, or ACE, to help understand the leak's impacts.
Among other things, Haddy asked for the hospital chart review and
a broader study called a Community Assessment for Public Health,
Haddy said Thursday that this project, scheduled to start in early
April, would involve a door-to-door survey of more than 200 homes
in the region. Residents would be asked a variety of questions
about the leak, including if they were exposed to the water and if
they experienced any health problems.
While the hospital chart review provides information about
residents who sought medical treatment, the door-to-door survey
will give scientists information about a more random selection of
residents, Haddy said.
In the days just after the chemical leak, the CDC repeatedly
dodged questions about how it developed a Crude MCHM screening
level that state officials and the water company used as a target
concentration for lifting the broad "do-not-use" order that was
Since then, after the Tomblin administration came under heavy
criticism for its response to the water crisis, state officials
briefly began pointing fingers at the CDC and the U.S.
Environmental Protection Agency, saying federal officials had not
provided the state with enough help.
Such comments have re-emerged in recent days. For example, a
state-hired water and plumbing system expert, University of South
Alabama engineer Andrew Whelton, publicly asked why the CDC's
report on health impact hasn't been released yet.
On Thursday, all five members of the state's congressional
delegation wrote to CDC Director Thomas Frieden to support a Feb.
18 request from Gov. Earl Ray Tomblin for federal help.
"This disaster has been ongoing for over a month now," the
congressional delegation's letter stated. "There is palpable
concern and frustration among our citizens, which we share. It is
clear that additional testing is necessary to protect the health
and safety of West Virginians, and to reassure the public."
It's not exactly clear, though, what specific studies Tomblin was
asking the CDC to perform. The governor's letter mentions,
"Further epidemiological and/or toxicological studies," as well as
"a specific need to address ongoing population surveillance or
Amy Goodwin, Tomblin's communications director, said the
administration wants the CDC to provide guidance on short- and
long-term monitoring of exposed residents and to provide money for
Reynolds, the CDC spokeswoman, said the agency does not do the
sort of toxicological testing that would expose lab animals to
Crude MCHM to develop more data about the chemical's health
impact. Reynolds said the CDC has not yet responded to the
governor's letter, but would do so.
Haddy said her agency is awaiting results of the CDC's hospital
chart study, which is undergoing internal review and should be
Under various versions of CDC guidelines -- all dated from the
1990s -- the chart review report was supposed to have been
completed within 14 days of CDC officials returning to their
offices from their field work in West Virginia. The CDC team was
in West Virginia from Jan. 16 through Jan. 30, Reynolds said.
CDC officials said the agency guidelines for Epi-Aid reviews have
not been updated and "may be outdated in practice."
The agency's "optimal goal" for such a report to be completed is
to have a draft within two weeks for internal review, Reynolds
Reach Ken Ward Jr. at kw...@wvgazette.com or 304-348-1702.