Two months after the Deepwater Horizon oil rig exploded in the Gulf of Mexico and created what has become the worst oil spill in U.S. history, the country is grappling to assess the impact of the spill on public health. RNs in Louisiana are working to address the long and short of it all, as the tragedy continues to unfold.
In the Short Run
Most of the patients who arrive at West Jefferson Medical Center in Marrero, La., after being exposed to the BP oil-spill environment report symptoms including cough, skin irritation, nausea or headache, says Jeffrey Louviere, RN, a clinical manager of the ED at West Jefferson. The majority of these patients are workers on boats who are assisting with cleanup efforts. Because they are working offshore, most need to be flown via helicopter to a hospital.
Patients who have been working near the oil spill first are sent to a decontamination tent outside the hospital to shower, if they can do so on their own, or be cleaned off by healthcare workers before entering the ED. Healthcare workers wear decontamination suits while working in the tent with patients.Jeffrey Louviere, RN
Louviere estimates West Jefferson has seen about 40 patients who have required treatment after working in the oil-spill environment. It hits home because I am treating people who have lost their livelihood as a result of the spill and are taking jobs as workers to clean it up, he says. Its heartbreaking to see these people who want to get back to their lives but may not have that in their future.
Although nurses such as Louviere may not know the cause of symptoms, exposure to the dispersant used to break up the oil may be the source of complaints such as skin and eye irritation or coughing. The most common symptoms, however, are those caused by heat exhaustion. The workers can get overheated from long hours in the hot, humid weather, as well as protective suits they wear while working, which can trap body heat.
Down the Road
Clair Millet, MN, APRN, PHCNS, BC, chief nurse at the Louisiana Department of Health & Hospitals, Office of Public Health, says the immediate consequences as far as public health have been surprisingly small. The state was working with the State Board of Nursing to ramp up rapid response efforts, but it became clear that this was not necessary because the main health complaints were somewhat minor. As a result, paramedics, rather than nurses, were used to triage the patients.
As of June 21, there had been 143 reports of health complaints believed to be related to exposure to pollutants from the recent oil spill, and 108 of those complaints were from workers, according to the Louisiana DHH. Thirty-five complaints came from the general population. The top complaints have been symptoms of heat stress, reactions to bug bites, shortness of breath and skin irritation, Millet says.
The Louisiana DHH also is preparing for the possibility that the multiple ongoing stressors from Hurricane Katrina combined with emotional and financial ramifications from the oil spill could increase the risk of mental health issues such as post-traumatic stress disorder.
We have people who are out at the sites providing support for fishermen and their families, and we continue to assess mental health, Millet says. So far, we have not seen cases of mental health disorders, but we are planning and preparing for it by raising awareness about what is available for people if they need these types of services.
One of the vital roles nurses play in the aftermath of the oil spill is patient education, Millet says. The Louisiana DHH employs about 300 public health nurses, and these nurses have been educating patients throughout the state about how to protect their own health. For example, the seafood is safe to eat and the air quality is good, but people should avoid areas that contain oil in the water.
Its important to get the word out early so we can mitigate stress and worry, Millet says.
Although the long-term impact on the industries and wildlife in Louisiana are yet to be determined and the immediate health impact seems minimal, Millet is working with teams that have been tasked with assessing the longer-term consequences of the oil spill. She represents the nursing perspective as she collaborates with epidemiologists, environmentalists, lab scientists, BP representatives, and local, state and federal government officials who are trying to determine, for example, whether the long-range impacts of the 1989 Exxon Valdez oil spill can shed light on what may happen in the future after the BP oil spill.
Because we are nurses, we see the whole picture and see things holistically, she says. It is the way we are trained.
Although emergency preparedness is Millets area of expertise, she acknowledges that oil spills are more rare and therefore the state is not as well-versed in how to respond or predict the future after the BP incident. We are learning about the various effects of the oil spill and through lessons learned, we will be better poised to prevent adverse human health effects if it happens in the future, she says.