Acute Health Effects After the Elk River Chemical Spill, West Virginia, January 2014.
On January 9, 2014, approximately 10 000 gallons of a mixture of 4-methylcyclohexanemethanol and propylene glycol phenyl ether spilled into West Virginia's Elk River, contaminating the potable water supply of about 300 000 West Virginia residents. This study sought to describe acute health effects after the chemical spill.



We conducted a descriptive analysis using 3 complementary data sources: (1) medical records of patients who visited an emergency department during January 9-23, 2014, with illness potentially related to the spill; (2) West Virginia Poison Center caller records coded as "contaminated water" during January 9-23, 2014; and (3) answers to household surveys about health effects from a Community Assessment for Public Health Emergency Response (CASPER) questionnaire administered 3 months after the spill.



In the 2 weeks after the spill, 2000 people called the poison center reporting exposure to contaminated water, and 369 people visited emergency departments in the affected area with reports of exposure and symptoms potentially related to the spill. According to CASPER weighted cluster analyses, an estimated 25 623 households (21.7%; 95% confidence interval [CI], 14.4%-28.9%) had ≥1 person with symptoms who felt that they were related to the spill in the 3 months after it. Reported health effects across all 3 data sources included mild skin, respiratory, and gastrointestinal symptoms that resolved with no or minimal treatment.



Medical records, poison center data, and CASPER household surveys were inexact but useful data sources to describe overall community health effects after a large-scale chemical spill. Analyzing multiple data sources could inform epidemiologic investigations of similar events.
1 Epidemic Intelligence Service, Office of Public Health Scientific Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.|2 Division of Infectious Disease, Office of Epidemiology Prevention Services, West Virginia Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV, USA.|3 Office of Environmental Health Services, West Virginia Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV, USA.|4 Career Epidemiology Field Officer Program, Division of State and Local Readiness, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Erica D
ED
Thomasson
5 Department of Clinical Pharmacy, School of Pharmacy, West Virginia University, Charleston, WV, USA.|6 West Virginia Poison Center, Charleston, WV, USA.
Elizabeth
E
Scharman
1 Epidemic Intelligence Service, Office of Public Health Scientific Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.|7 Environmental Health Tracking Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Ethan
E
Fechter-Leggett
2 Division of Infectious Disease, Office of Epidemiology Prevention Services, West Virginia Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV, USA.
Danae
D
Bixler
2 Division of Infectious Disease, Office of Epidemiology Prevention Services, West Virginia Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV, USA.
Sheri'f
S
Ibrahim
8 Environmental Health Surveillance Branch, Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Atlanta, GA, USA.
Mary Anne
MA
Duncan
1 Epidemic Intelligence Service, Office of Public Health Scientific Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.|9 Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Joy
J
Hsu
2 Division of Infectious Disease, Office of Epidemiology Prevention Services, West Virginia Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV, USA.
Melissa
M
Scott
2 Division of Infectious Disease, Office of Epidemiology Prevention Services, West Virginia Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV, USA.
Suzanne
S
Wilson
2 Division of Infectious Disease, Office of Epidemiology Prevention Services, West Virginia Bureau for Public Health, West Virginia Department of Health and Human Resources, Charleston, WV, USA.
Loretta
L
Haddy
6 West Virginia Poison Center, Charleston, WV, USA.
Anthony
A
Pizon
10 Health Studies Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Sherry
S
L Burrer
10 Health Studies Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Amy
A
Wolkin
10 Health Studies Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Lauren
L
Lewis
D000328:Adult; D055884:Chemical Hazard Release; D003510:Cyclohexanes / Q000506:poisoning*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D011039:Poison Control Centers / Q000706:statistics & numerical data; D045483:Rivers / Q000737:chemistry*; D011795:Surveys and Questionnaires; D014877:Water Pollution, Chemical / Q000009:adverse effects*; D014903:West Virginia
D003510:Cyclohexanes; C000607184:4-methylcyclohexanemethanol
chemical spill; disasters; environmental exposures; water