Identifying the known and unknown health hazard information for chemical disasters: a phased scoping review of the East Palestine, Ohio train derailment

Abstract

Introduction: In February 2023, people residing in the village of East Palestine (EP, Ohio, USA) and surrounding areas were exposed to toxic chemicals from a Norfolk Southern Railway train derailment and subsequent vent and burn.

Objective: To identify known health hazards and evidence gaps from these chemicals to inform disaster-response research.

Methods: We conducted a rapid phased literature scoping review. In Phase 1, we summarized major conclusions from eight authoritative sources across ~15 health hazard categories for 22 chemicals potentially related to the train derailment and response. In Phase 2, we conducted targeted literature searches in PubMed for higher-priority chemicals and outcomes with research gaps, considering the recency of authoritative reviews. Finally, we summarized findings from the retrieved studies and those from authoritative reviews to further characterize evidence gaps and the next steps.

Results: Eight higher-priority chemicals were skin and eye irritants, seven of which were also respiratory irritants, consistent with symptoms reported by East Palestine residents and workers. Five chemicals were human or animal carcinogens; two may cause adverse immunological or neurological effects, and one may cause damage to reproductive organs or the developing fetus. Vinyl chloride had the most comprehensive data. After Phase 2 literature searches, we suggested the need for primary studies for 12 chemical outcome pairs and a systematic review for two pairs.

Significance: Our rapid literature scoping approach can provide knowledge for researchers conducting community studies and public health officials who communicate with the affected community on the known and unknown health hazards of chemicals related to the East Palestine train derailment. It also informs global disaster-response-related research, as these chemicals are commercially important and have been detected in other chemical release incidents. Moreover, our rapid literature scoping phased approach can be leveraged for environmental emergencies when the need for health hazard information is urgent.

Impact: Our rapid literature scoping approach can provide knowledge for researchers conducting community studies and public health officials who communicate with the affected community on the known and unknown health hazards of chemicals related to the East Palestine train derailment. It also informs global disaster-response-related research, as these chemicals are commercially important and have been detected in other chemical release incidents. Moreover, the phased approach used for our rapid literature scoping review can be leveraged for environmental emergencies when the need for health hazard information is urgent.

Keywords: East Palestine derailment; Environmental contamination; chemical emergencies; human health hazards; rapid review methods; scoping literature review.

Fig. 1. East Palestine rapid review project timeline.

Overview of the timeline for the rapid review and phased approach, with information on potential points for early data release.

Fig. 2. Phase 1a Chemical identification and Phase 1b authoritative sources and health outcome categories.

Summary of Phases 1a and 1b to identify chemicals, search authoritative sources, and identify health hazard information. A list of the chemicals and their final priority structure is provided, along with a list of authoritative sources searched and categories of health hazards extracted in Phase 1b.

Fig. 3. Summary of findings from authoritative sources^a for 16 Primary East Palestine chemicals of interest and potentially related East Palestine Chemicals.

Summary of conclusions and other information from authoritative sources for 16 primary chemicals of interest and five PFAS chemicals and TCDD. See Fig. 2 and Tables S5 and S6 for more details. A list of authoritative sources is available in Fig. 2. For vinyl chloride and skin sensitization, one source reported Category 1 sensitization and another source reported that classification was not possible. “Conclusions available” relate to language used by authoritative sources as follows (see Fig. S2) : inadequate evidence (IE) = nonclassifiable (cancer); limited animal evidence (LA) = nonclassifiable (cancer); lower confidence or severity (LC) = possibly (cancer), suspected (noncancer), irritant category with other conflicting data, conflicting sensitizing data; moderate confidence or severity (MC) = probably (cancer), presumed (noncancer), animal data-derived risk estimate value, Category 3 (irritant), Category 1B (sensitizer); higher confidence or severity (HC) = known (cancer, noncancer), human data-derived risk estimate value, Category 1 and 2 (irritant), Category 1 A (sensitizer). 6:2 FTNO = 6:2 fluorotelomer sulfonamido amine oxide; 6:2 FTSHA = 6:2 fluorotelomer thiohydroxyammonium; 6:2 FTSAS = 6:2 fluorotelomermercap-toalkylamido sulfonate; 6:2 FTSA = 6:2 fluorotelomer sulfonic acid; 6:2 FTSA-PrB = 6:2 fluorotelomer sulfonamide alkylbetaine; PFAS = per- and polyfluoroalkyl substances; TCDD = 2,3,7,8-tetrachlorodibenzo-p-dioxin.

Fig. 4. Authoritative conclusions for 16 primary chemicals: A. irritation and sensitization, B. Noncancer outcomes, and C. Cancer outcomes.

Summary of irritant and sensitizer information, non-cancer and cancer outcomes from authoritative sources for 16 primary chemicals of interest. Detailed findings for each chemical × health outcome category are reported in Table S5 and Supplemental Excel Table S1. The “Other Organ” category includes double counts for two chemicals (acrolein and 2-butoxyethanol), wherein different conclusions were available for different organ systems NS = no or few studies, ES evidence suggestive, NL not likely to be irritating or sensitizing or risk for health outocme, LC lower confidence, MC moderate confidence or severity, HC higher confidence or severity. See Fig. S2 for more details.