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A pulmonologist shares what he's watching for after East Palestine derailment

ARI SHAPIRO, HOST:

There are two ways of looking at the situation in East Palestine, Ohio. That's where a train derailed, spilling hazardous chemicals more than two weeks ago. On one hand, the Environmental Protection Agency has been testing the air and water and says it has not detected levels of concern. Josh Shapiro is governor of neighboring Pennsylvania and spoke with NPR this morning.

JOSH SHAPIRO: I've authorized testing of all of the wells on the Pennsylvania side and the public water system to ensure that local residents have the comfort of knowing what's coming out of the tap is safe. We've seen no concerning readings yet, but we're going to continue to test for months and months and months if not years.

SHAPIRO: On the other hand, people who live in the area are reporting nausea, headaches, red eyes and rashes. The Centers for Disease Control and Prevention has opened a clinic in town to address those concerns. Dr. Nicholas Proia is a pulmonologist in the area and a professor at Northeastern Ohio Medical University not far from East Palestine. Thank you for joining us.

NICHOLAS PROIA: Sure thing.

SHAPIRO: What are doctors in East Palestine telling you about how things are there right now?

PROIA: You know, frankly, there aren't very many practices centered in East Palestine. It's a pretty small town. The largest city is just north of East Palestine. It's Youngstown. And there's another community hospital nearby in Salem, Ohio. And the practitioners down in that area have been very wary looking for signs of any type of disease. And what they've been telling me is they have not seen a whole lot of respiratory disease other than something they perhaps can attribute to something like a viral infection. They have seen some skin issues. But obviously, as a pulmonologist, I'm more interested in respiratory issues. And frankly, talking to the local emergency rooms, they haven't seen that substantial an increase in visits as a result of that.

SHAPIRO: All right. So if and when skin or respiratory diseases do arise, are there ways to tell if that is related to these chemicals or caused by something else?

PROIA: You know, that's going to be tough to do. I can't speak to skin being a pulmonologist, but what generally a toxic exposure will precipitate is something we call the reactive airways dysfunction syndrome. It's almost like a bout of asthma that comes out of nowhere on perhaps a nonasthmatic. Obviously, if you do have underlying lung disease, you're going to be at greater risk for a worse outcome. But what you would see is coughing, wheezing and perhaps some mucus production just reflecting irritation of the airway itself.

SHAPIRO: And given that it's been about two weeks since the spill, would you expect to see those symptoms by now? Or could they be longer term?

PROIA: You know, unless there's an ongoing exposure, perhaps in a closed space, I would have expected - especially because the weather here shortly after the controlled burn was rather windy. And that helped obviously dissipate much of the cloud that was there. I don't expect to see much in the future unless, like I said, there's a closed space that has not been aerated.

SHAPIRO: Well, this sounds like good news. Of course, people don't necessarily trust institutions. They may not believe what the EPA or government officials say. So what would you tell people living in the area? What would you tell patients in this moment of uncertainty?

PROIA: Just be vigilant. Personally, if I had a home in East Palestine, I would be more concerned about any contaminated groundwater. Some of the gases that were released are heavier than air and would tend to infiltrate the ground, etc. The gas that was burned is vinyl chloride, which is volatile, obviously, and that's how it burned. And it probably moved out relatively quickly. Any toxic exposure secondary to vinyl chloride would have been transient, and I don't think we're going to see anything now.

SHAPIRO: We heard Pennsylvania Gov. Shapiro talking about testing well water. What are you going to be watching for in the weeks and months to come?

PROIA: From a pulmonary standpoint, I'm going to be watching for any spike in respiratory disease. It's probably - I think - usually, when you have something like the reactive airways dysfunction syndrome - that's an acute illness - patients would have presented to the emergency room almost immediately. Now, before the evacuation order, there were some patients who were seen in emergency rooms after a toxic exposure. And that kind of makes sense. After the evacuation order, that number dropped off considerably.

SHAPIRO: You're talking about a potential spike in respiratory disease. And we're having this conversation as the country has already dealt with the triple whammy of COVID, the flu and RSV, all of which can manifest as respiratory diseases.

PROIA: Exactly, and as can any other virus that's out there. We've had a particularly warm winter in northeast Ohio. And actually, the incidence of respiratory disease, because people aren't gathered in closed spaces, has gone down considerably in northeast Ohio this time of the year.

SHAPIRO: Dr. Nicholas Proia, he's clinical professor of internal medicine at Northeastern Ohio Medical University. Thank you so much for talking with us.

PROIA: My pleasure. Thank you. Transcript provided by NPR, Copyright NPR.

Alejandra Marquez Janse
Alejandra Marquez Janse is a producer for NPR's evening news program All Things Considered. She was part of a team that traveled to Uvalde, Texas, months after the mass shooting at Robb Elementary to cover its impact on the community. She also helped script and produce NPR's first bilingual special coverage of the State of the Union – broadcast in Spanish and English.
Ari Shapiro has been one of the hosts of All Things Considered, NPR's award-winning afternoon newsmagazine, since 2015. During his first two years on the program, listenership to All Things Considered grew at an unprecedented rate, with more people tuning in during a typical quarter-hour than any other program on the radio.