Project Summary
This study seeks to understand early health effects in those exposed to toxins following the Feb. 3, 2023 East
Palestine, Ohio (EP) train derailment and subsequent (Feb. 6) controlled burn of toxins. It seeks to assemble a
cohort for longitudinal follow-up, securing survey information on exposures, symptoms and health effects and
in-depth information on relevant covariates to adequately incorporate potential confounders and effect
modifiers. It seeks to assess laboratory tests in a subset, tests previously reported to be affected by EP-
relevant toxins. It separately secures phlebotomy samples for archiving as a resource to benefit future
investigations. Additionally, it seeks to initiate longitudinal follow-up of symptoms/health outcomes. It then
seeks to assess how outcomes relate to EP exposures and to effect modifiers, to identify vulnerabilities and
protections.
We bring to bear our critical expertise from our longstanding work on chronic health consequences of mixed
toxin exposures in Gulf War illness (GWI). We hypothesize that, beyond possible specific effects of EP toxins,
shared mitochondrial toxicity mechanisms that transcend specific chemical class will lead to shared health
consequences. Our early EP findings already support this – with evidence of GWI-like multisymptom illness
and emergence of burn pit-compatible respiratory conditions. Proposed shared mechanisms also have
implications for factors that may mitigate development and severity of health problems. Some such factors can
be assessed as effect modifiers in analysis. It is our work that documented mitochondrial foundations for GWI
– and also affirmed randomized trial benefit of treatment (CoQ10) addressing this. Indeed, a critical benefit of
the study is a focus on vulnerable subgroups – which may be strongly affected even when an overall
population is not – and protective factors that may guide development of preventions and treatment.
Significant progress has already been made in the early stages of this project. A prerecruitment survey has
been conducted, identifying scores of EP residents who have expressed their interest in participating.
Furthermore, interviews with affected EP residents have been carried out, enabling the development of a
comprehensive survey instrument. Importantly, the study has received approval from the UCSD IRB. Moreover,
the acquisition of a $15K start-up award from the UCSD Academic Senate has allowed for project pilot testing,
troubleshooting, and refinement in advance. These proactive actions not only enhance cost efficiency but also
bolsters the project's prospects for success. If granted NIH funding, the study will be poised for a "full speed
ahead" launch, building on the foundation established during the jumpstart phase.
