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A Study in Oil 

Alex Woodward on a new 10-year study that aims to track the health of Gulf Coast residents affected by the BP oil disaster

click to enlarge Contractors with the Deepwater Horizon response clean oil from a vessel of opportunity at a decontamination facility in Lafitte in October 2010. A new study aims to track the health of 55,000 people who worked on cleanup after the BP oil disaster. - PHOTO BY U.S. COAST GUARD PETTY OFFICER 3RD CLASS ANTHONY L. SOTO
  • Photo by U.S. Coast Guard Petty Officer 3rd Class Anthony L. Soto
  • Contractors with the Deepwater Horizon response clean oil from a vessel of opportunity at a decontamination facility in Lafitte in October 2010. A new study aims to track the health of 55,000 people who worked on cleanup after the BP oil disaster.

In case you missed last week's announcement: BP and the Coast Guard are wrapping up their cleanup business on the Gulf Coast. "Shoreline cleanup" is more or less completed. Despite the oil disaster that wrought (and continues to wreak) havoc up and down the coast, authorities declared the Gulf is ready for the next phase: "restoration."

Fittingly, another phase of cleanup is underway, though not one directly linked to BP and its network of Gulf Coast operatives: A potentially decade-plus-long study of coastal residents' and cleanup workers' health began earlier this year, and last week, its chief researchers met with Louisiana coastal communities to get people on board. It's aiming for 55,000 participants; so far study staff have conducted 5,000 phone interviews and completed 600 home exams.

The Gulf Long-Term Follow-Up (GuLF) is a project under the National Institute of Environmental Health Sciences (NIEHS), sponsored by the National Institutes of Health and the U.S. Department of Health and Human Services — a federally backed, long-term project studying health implications of handling (and exposure to) oil, dispersants and other chemicals in the cleanup operations that began last year following the disaster at the Deepwater Horizon rig.

"We hope to go more than 10 years," says Dr. Dale Sandler, the lead investigator and chief of the NIEHS Epidemiology Branch. Ideally we would do this for 20 years. If we are interested in (finding) really long-term implications for cancer, or other chronic diseases that occur later in life, we do need to go there. What will determine whether we can do that is how successful we are staying in touch with people."

That's the goal now: recruiting. The team has trekked the four Gulf states (Florida, Alabama, Mississippi and Louisiana) to meet with communities and their leaders to register participants. Those who take part likely be in for a years-long study with home visits, phone interviews and possibly other tests, like blood sampling. Agree to the home visits and you get a $50 gift card.

Oil disaster-related health complaints aren't anything new. Most recently they were the subject of a documentary (The Big Fix), and are a recurring nightmare illustrated in hundreds of lawsuits targeting BP and its claims administrators for denying coverage. Former cleanup workers point to rashes, respiratory problems, sores, headaches, nausea, seizures, blindness, bloody stools, bloody noses and a host of other symptoms related to chemical exposure.

In April, Sandler told Gambit her study had only just begun recruiting. It was still a long way from getting 55,000 participants from its target pool of oil cleanup workers and coastal residents impacted (or not) by the disaster. Planning for the study began in February, and interviews began in the following months.

The group held several community meetings last week in Lafourche, Terrebonne and Chauvin, as well as in Biloxi, Miss. in September, researchers met with Alabama cleanup workers in Orange Beach, Foley and Irvington.

"The point is to spread the word about the study, encourage workers themselves to join the study, answer their questions," Sandler says. "We've also been using it as an opportunity to hear what people care about. If there's a way to make sure our study addresses what they're interested in, we've added questions to our questionnaire. We've thought about additional groups of people who might be included in the study because they were working on the oil spill in some way we might not have known about."

In April, Sandler told Gambit the scope of the project could include "looking at respiratory effects and nonspecific complaints — dizziness and headaches," but it's also interested in the longer term, linking issues to chronic diseases and cancer.

The problem, Sandler says, is sorting through the stories — who's sick and who's not. The results need to include the full scope of coastal workers, including both people with and without health issues. "It's hard to know what to make of that and how to deal with it because we need the larger picture. How many other people walked into the Gulf and didn't get a rash or get sick. These are things we have to pay attention to," she says. "We are asking people in our study about their experience: Did they walk into the Gulf, what were they doing, were they standing in water, did they get rashes, did they get chemicals on their skin? If we get 55,000 people, we'll have the power of numbers — a lot of people. And we'll be able to make some sense of it."

Here's how it works:

People call a toll free number (855-644-4853) and take part in a phone interview. Each caller is asked what he or she was doing at the time of the disaster, whether he or she had health problems attributed to the disaster, and how he or she is feeling now.

"A general illness checklist," Sandler says. "We collect information about their other jobs, other exposures they might have. (If they're a) smoker, drinker, they have another job cleaning up after some other disaster — we need to know so we can interpret our results."

A home exam with a licensed medical care professional (not a doctor) follows, and that person will collect additional health information through mental health and diabetes screenings, blood pressure and lung health checks and recommend or help them find medical care or resources. Every six months, participants will be called to update health information. Smaller pockets of communities (especially in Louisiana) will undergo more extensive medical screenings and more detailed respiratory and neurologic health studies, led by a doctor. Home visit participants also receive a $50 gift card.

Chemical screenings won't happen immediately. Instead, Sandler wants to know "What happens when you're exposed for a month, or two weeks, or some random amount when things blow your way? ... We think it's worth asking."

Sandler says a study of this size (and scope) is unprecedented. Similar impact studies, like those with responders to the World Trade Center bombings and oil cleanup workers from spills in Spain, started years following the event itself. The GuLF Study began in early 2011. Ideally, she says, a study like this would be in the disaster response planning, ready to go immediately in the event of a disaster. "If there is a standard response and protocol that says, 'Before you put someone on the field and work, ask these five questions about their health and get a urine sample or blood sample.' Because it will be useful," Sandler says. "Researchers don't want to get in the way. There are more important things to do than research at that time," like getting responders out of immediate harm and plugging a leaking well.

The explosion in the Gulf happened April 20, 2010 — the study has its legs in Louisiana only now, more than a year after the event. Can this process happen faster?

"Normally it takes a year to get all the clearances you need, then design a study, get it scientifically peer-reviewed, go to an institutional review board to review the ethics of what you want to do, and the safety — before you can even do the first call telling people to join the study," Sandler says.

So, no it can't go faster, not yet. There still is no standing group or agency to help design studies and implement them in the event of a large disaster. "None of that really exists," Sandler says. "It takes effort and money to sustain it. And we only have limited dollars. You tend to deal with the problem at hand."

Sandler admits there is pressure to release data as it comes in. The group will begin regularly publishing some information on its website next month, keeping participants' personal information confidential. But it won't link to exposures and health.

The study also includes help from organizations working with impacted residents and responders; community groups and nonprofits forward information and act as "people on the ground," Sandler says. Cynthia Klein, community outreach coordinator for the study, says her group is partnering with 70 organizations along the coast, which are involved with planning and getting the word out to potential study candidates.

The study group itself includes telephone interviewers working at a call center in North Carolina, while teams of 40 to 50 home examiners are hired from the communities where they're working. "We're trying to do this confidentially and unbiased, but sometimes they may get a neighbor," Sandler says. "We work carefully so that doesn't happen. ... We've employed people right out of this community who are trained medical assistants; they're licensed to draw blood. They're well-trained in what to do when they get to someone's home. But they're not doctors. They're not there to provide care."

Advertisements and billboards will target affected communities. "We can be there next to the lawyer billboards," Sandler says, referencing the billboards along Highway 90 and elsewhere featuring bold-lettered ads for legal services targeting cleanup workers. "Ours start the same way."

SIDEBAR 1 OF 1

How to Participate

The Gulf Long-Term Follow Up Study will follow oil disaster cleanup workers for a decade, measuring health issues potentially linked to the disaster and exposure to related chemicals.

"We're interested in the everyday people who were out there cleaning up the beaches, out on the water lending their boats and having their boats out there," says Dr. Dale Sandler, who leads the study.

To participate in the GuLF Study, call (855) 644-4853 or visit the website: www.nihgulfstudy.org.

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