FAIRLAWN, Ohio — Providing long-term health monitoring for all affected by the East Palestine, Ohio, disaster may create a bit of a silver lining from a dire situation.
The history of past environmental disasters demonstrates the initial downplaying of health concerns, more often than not leading to a “too little, too late” decision. Long-term or intense exposures to toxins have been strongly linked to a higher incidence of respiratory diseases, cancers and risks to pregnant women and young children.
For example, studies have connected widespread ingestion of toxins in the immediate and long-term consequences of the September 11, 2001 terrorist attacks on a variety of diseases. Actually, more people died of attack-related illnesses that on that tragic day.
There is currently no way to definitively know after a disaster which individuals are being affected or how this may play out in the rest of their lives. Who gets a disease is likely as complicated as how individual genetics interact with those exposures.
Continued vision, cooperation and support from policymakers are essential to achieve a sustainable response – qualities in short supply these days.
There should be uniform and long-term health monitoring. We already have three models for connecting our best research and treatment with good policy to benefit those affected not only by the disaster of East Palestine, but for all Americans.
The James Zadroga 9/11 Health and Compensation Reauthorization Act created programs to provide support and compensation to people who can link their illness to being near the sites of the 9/11 disaster. For authority, lawyers looked to the stream US Department of Veterans Affairs policy on Vietnam veterans exposed to Agent Orange, among other program precedents. A presumption of service and contact with the toxic defoliant is sufficient to qualify for 100% VA disability.
We must do the same for people who are immediately or potentially in affected countries in connection with the disaster in East Palestine.
Until data prove otherwise, responses should include long-term health surveillance of persons living in the community, upwind or in its watershed. Furthermore, with air, water and land affected, extending and expanding the scope of the disaster, samples must be systematically collected and updated.
Currently, medical systems, states, and even some federal agencies have disparate data collection and communication systems, something that slows research collaboration. This ultimately impedes the flow of consistent medical and health information that can be applied to benefit patients today.
A valuable model can be found in Iceland Screens, Treats or Prevents Multiple Myeloma (iStopMM) study, a long-term project monitoring the population in Iceland for the presence of a blood marker that can develop into multiple myeloma, a relatively rare cancer of the plasma cells of the bone marrow. When people go to the doctor for check-ups, their blood is automatically tested for the presence of the marker and, if positive, patients are counseled and monitored more closely.
Iceland has the advantage of a small, relatively homogeneous population approaching 390,000 with universal health care and uniform laboratory systems and patient consent. Of the more than 60,000 screenings performed, 24 myeloma patients have been found and many more with the blood marker are monitored and, if diagnosed, offered appropriate care and opportunities to participate in clinical trials.
The region that stretches from Toronto to Morgantown, West Virginia, is similar in size to that of Iceland. Its population is larger and more diverse, but obstacles to creating a program worthy of building and reproducing are possible because the region is populated with many world-class research and medical treatment facilities.
Policymakers in the affected states, the federal government and Ontario, Canada, should use their expertise. Give them the resources and support to enable and foster effective cooperation to benefit not only the people of East Palestine and the region, but the nation as well.
Short-term activity and attention cannot be allowed to obscure the need for a long-term investment in public health monitoring following the toxic spill in East Palestine. This is a critical moment that we cannot let pass. Many lives are at stake.
Greg Brozeit of Fairlawn is program director for the Myeloma Foundation HealthTree Roundtables, a patient education program, and has worked in various roles in myeloma advocacy since 1998.
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