Residents and workers near the site where a train carrying hazardous chemicals derailed this month have been diagnosed with bronchitis and other conditions that doctors and nurses suspect are linked to chemical exposure.
Melissa Blake, who lives within a mile of the crash site in East Palestine, Ohio, said she started coughing up gray mucus and was struggling to breathe on Feb. 5, two days after the Norfolk Southern train derailed. That day she evacuated her home and also went to the emergency room, where she was diagnosed with “acute bronchitis due to chemical fumes,” according to medical records reviewed by NBC News.
“They gave me a breathing machine. They put me on oxygen. They gave me three types of steroids,” Blake said. She has yet to move back home since being discharged nearly three weeks ago.
At CeramFab, a manufacturing company adjacent to the derailment site, five of its 10 workers were too sick to work as of Tuesday, according to general manager Howard Yang.
Yang said the company suspended operations for about a week because of the derailment and subsequent release of vinyl chloride, a carcinogenic chemical onboard the train that was intentionally burned to avoid the risk of an explosion. Yang's employees resumed work on Feb. 13, he said, but after about two days, they “started dropping like flies.”
“People ended up with rashes, nausea, vomiting, bloody nose, eye issues. A lot of coughing, wheezing,” he said. “We sent a lot of workers to the hospital to get checked out and, sure enough, in most cases, it was a diagnosis of ‘chemical bronchitis.’ They were put on five different kinds of pills, including steroids. Some guys have to use inhalers. It’s pretty bad.”
NBC News could not independently verify the workers’ diagnoses.
Deborah Weese, a nurse practitioner at Quickmed Columbiana — one of the closest urgent care clinics to East Palestine — said she has listed “exposure to potentially hazardous chemicals” as a possible cause of bronchitis or other ailments for patients who live or work near the crash site.
Weese said she has been seeing about five to 10 people a day from the area who have symptoms consistent with chemical exposure.
“They’re complaining of burning to their lungs, nasal drainage, eyes burning, throat pain, unknown rashes that have started since they’ve been back to their homes,” she said.
Bronchitis is characterized by inflamed airways that often lead to coughing and wheezing. It is usually caused by a virus, but chemical bronchitis is caused by inhaling chemical irritants, according to Dr. John Balmes, a professor of medicine at the University of California, San Francisco, and spokesman for the American Lung Association.
“Whenever you burn chlorinated compounds, you get really nasty materials that are capable of causing chemical bronchitis,” Balmes said.
He added that the severity depends on the amount of chemicals inhaled and whether people have pre-existing conditions like asthma. Most people see their symptoms resolve within a few weeks to a couple months, and long-term effects are unlikely except in high-risk patients, according to Balmes.
Apart from breathing issues, some local residents have reported headaches, nausea and rashes. These can be symptoms of chemical exposure, according to the Centers for Disease Control and Prevention, which has sent a team to East Palestine to interview residents and investigate potential health issues starting Monday. But it’s difficult for doctors to make direct links between these ailments and particular chemicals.
"There's no lab test. There's no imaging test. It's really just a clinical suspicion of what it could be. It’s certainly reasonable to say if you have a rash, dry skin or dry eyes, dry nose, that it could be related. There really isn’t a way to tell for sure, unfortunately," said Dr. James Kravec, the chief clinical officer for Mercy Health in Youngstown and Lorraine, Ohio.
The Mercy Health network includes a primary care office in East Palestine and a hospital 20 minutes outside the town. Kravec said the network had seen more patients from East Palestine in the past few weeks than it had over the past few months.
Oral or topical steroids are usually the first line of treatment for people with rashes from chemical exposure, he said.
The full scope of health consequences related to the crash is not yet known. Some people in the East Palestine area have reported feeling ill but have not yet seen a doctor, and some long-term effects of chemical exposure, such as cancer, can take decades to manifest.
As of Monday, the Environmental Protection Agency said East Palestine's municipal water was safe to drink. Indoor air quality screenings from more than 550 homes did not exceed safety standards, and air quality in the community remains “normal," the EPA said.
Norfolk Southern Railway said in a statement that it is "committed to doing what’s right for the residents of East Palestine." The company has offered $8 million in donations or financial assistance thus far, including $3.4 million for local families and a $1 million community assistance fund. It has also committed to paying for all cleanup costs and continuing to test air, water and soil.
“If residents have or are experiencing symptoms with which they’re not accustomed, we would strongly encourage them to go see a trusted medical professional or visit the new health clinic that local, state and federal officials are standing up in East Palestine,” a Norfolk Southern spokesperson said.
Weese said some of her patients have demonstrated signs of continued chemical exposure.
"When they go back home, their symptoms get worse or their lungs are burning more or they feel like they can’t catch their breath, those kinds of things. So it’s showing consistently that when they leave, they’re better. When they go back home, they feel worse,” she said.
Salem Regional Medical Center, where Blake received care, said that as of Wednesday, its emergency department had seen about 10 patients since the train derailment who reported symptoms like sore throats or respiratory issues.
Wendy Snyder, a registered nurse who lives in East Palestine, said she has experienced a sore throat and a metallic taste in her mouth, which her doctor said “certainly seems related to her chemical exposure,” according to a physician’s note reviewed by NBC News.
Snyder said her headaches improve when she goes to work at a hospital in Pennsylvania, about 20 miles from her house.
“I don’t feel safe in my own home," she said. "I’m afraid to be here.”
At a Senate hearing in Pennsylvania on Thursday, Lonnie Miller, who has lived in East Palestine for nearly 30 years, said she has developed a rash on her face and experienced dizziness and burning eyes. Her home is located roughly one-third of a mile from the derailment site, she said.
"One of my very best friends has been diagnosed already with chemical bronchitis because she lives right next to the creek," Miller said at the hearing, referring to one of the town's contaminated waterways.
Melissa Boyer, who lives less than 250 feet from the derailment site, said her 19-year-old daughter is having difficulty breathing and has to use an inhaler several times a day.
Boyer said she herself has had a persistent headache and burning sensation in her mouth. On her medical chart, under issues addressed, her doctor wrote: "toxic effect of gas exposure."
"How can you say our air quality or our water is safe when we're having all these people with these symptoms and health issues?" Boyer said.