More than 80% of families surveyed in the wake of a massive spill of jet fuel that contaminated the drinking water in thousands of homes in Hawaii in 2021 reported ongoing health problems nearly one year after the leak.
Surveys conducted by the Centers for Disease Control and Prevention in January and February 2022 and again in September 2022 found that military personnel, their spouses and children suffered headaches, skin irritation and rashes, diarrhea, fatigue and dizziness they believe were caused by using contaminated drinking water at Joint Base Pearl Harbor-Hickam.
More than half sought medical treatment for their illnesses, including 152 children whose parents reported ongoing symptoms 10 months after the spill.
The surveys, conducted by the CDC's Agency for Toxic Substances and Disease Registry at the request of the Hawaii Department of Health, were meant to assess the health impact of a November 2021 leak of up to 5,000 gallons of petroleum at the U.S. Navy's Red Hill Bulk Fuel Storage Facility near Honolulu.
The leak contaminated the drinking water supply to the base, affecting schools, offices and 9,694 homes and displacing thousands of military and civilian families.
Research is available on petroleum fume exposure and those who have ingested kerosene, but "almost nothing is known of the long-term health effects" of jet fuel exposure, said Stacey Konkle, an epidemic intelligence service officer with the CDC, during a public informational session on Jan. 11.
The surveys were designed to study the scope of the issues among those affected and help build up data on such exposures, Konkle said.
The first survey, conducted online roughly two months after the spill, received responses from about 14% of the affected households. Nearly 90% of respondents said they developed health problems after using the water -- issues that included headaches and nausea, vomiting, burning eyes and throats, skin rashes and respiratory systems.
Thirty-seven percent said they sought medical care, and 17 people said they were hospitalized overnight.
The second survey, conducted six months later in September, was answered by 961 people. Roughly 80% reported having persistent health issues, while 79% said they had children who had consumed the water and were still sick.
Nearly 50% said they had a pet who had gotten ill after exposure.
Of 20 military personnel or family members who delivered babies during the time frame for the survey, eight said they had health problems such as preterm delivery, low birth weight and, in one case, congenital defects.
CDC officials said, however, that the small numbers limit drawing any conclusions about any potential tie between the fuel spill and difficulties during pregnancy.
Konkle said the strength of the survey results lies in the highly motivated community that responded and the engagement with area organizations, including the Hawaii Department of Health.
But, she noted, the surveys also have their limitations, including sampling bias -- those who were compelled to take the surveys may have been among the most concerned about their health, which could skew the results.
The surveys also were only given in English and were self-administered, meaning that no one was monitoring input as it was given.
Most notably, CDC officials said, surveyors had limited access to those who may have been most affected. While they posted notifications about the survey in public spaces and attended community events to promote the surveys, there were "barriers to outreach" that included the U.S. Navy.
"We were not military affiliated. We had to get permission and be escorted into base areas," explained Maureen Orr, an epidemiologist with the CDC, during the webinar.
The initiative prompted several recommendations from the CDC to the Defense Department, to include suggesting that the DoD review all medical records of those involved and provide environmental sampling data so the CDC can conduct public health assessments.
Konkle also recommended the creation of a third-party "Flint, Michigan-style registry" to identify and characterize long-term health effects in affected individuals.
The Flint Registry was created for the roughly 99,000 people who were exposed to high levels of lead in their drinking water for more than a year in Flint after the city switched water systems in April 2014. The voluntary register is designed to monitor health, child development, ongoing exposure and utilization of services.
More than 100 military families have filed a lawsuit against the DoD seeking compensation for illnesses and economic hardship they attribute to exposure to the contaminated water.
The Defense Department is moving forward with plans to remove all fuel from Red Hill and close the facility. The Environmental Protection Agency and the Defense Department will hold a town hall Wednesday in Honolulu on the plans for defueling and closing Red Hill, as well as Navy requirements for providing safe drinking water to residents of Joint Base Pearl Harbor-Hickam.
– Patricia Kime can be reached at Patricia.Kime@Military.com. Follow her on Twitter @patriciakime.