The East Palestine Train Derailment Health Research Program - On February 3, 2023, a 150-car freight train derailed and caught fire in East Palestine, Ohio. Eleven of the 52 derailed rail cars contained hazardous materials, including vinyl chloride and butyl acrylate, which were released into the air, water, and soil. A controlled release and burn of five cars containing over 880,000 pounds of vinyl chloride was conducted on February 6th and residents were told it was safe to return to their homes on February 8th. However, they soon reported numerous symptoms following the derailment. Leveraging our more-than-10-year collaboration on environmental health research with community partners in Columbiana County, Ohio, our team launched the East Palestine Health Tracking Study on April 11 with and for the residents to assess health symptoms, markers of exposure, and indoor air quality. From these efforts, we have identified an alarmingly high rate of post-traumatic stress, which has persisted over time, elevated rates of respiratory symptoms, and an immune profile indicating immune dysfunction among the residents of these communities. To address these ongoing concerns and gaps in knowledge, we will conduct a community-engaged longitudinal epidemiological study to better understand the health impacts of these exposures. We will build on our existing robust community partnerships to accomplish the following goals: Goal 1: Conduct a comprehensive community health needs assessment through the involvement of key stakeholders. Using structured and unstructured strategies we will identify health needs from our study participants through serial surveys and journaling; our Community Advisory Board (CAB); and the experiences of our Clinical and Public Health (CPH) Taskforce. We will synthesize the concerns of the community to inform project direction with insight from our Scientific Advisory Board (SAB). Goal 2: Conduct longitudinal, high-impact research studies. We will expand our cohort to include children and residents impacted by the disaster who lived within 50 miles of the derailment and engage a comparison community to further examine the effect of the disaster. Using serial surveys as well as biological and clinical assessments, our team will investigate the impact of the disaster on mental health, including stress; respiratory function; immune function; cardiovascular health; and reproductive health. Hair will be analyzed for biomarkers of stress and alternations in the hypothalamic-pituitary-adrenal (HPA). We will examine medical diagnoses pre- and post-derailment and identify trends and geographic ‘hot spots’. These results will then be used to inform the education strategies we create for the community. We will also curate a biorepository for future research that includes hair, toenails, blood/plasma, DNA, and naturally deciduous teeth. Goal 3: Develop and implement a health research tracking system with data management infrastructure. Partnering with the Kentucky Center for Clinical and Translational Science and the Center for Applied Artificial Intelligence (AI), we will design and deploy a secure health research tracking system to integrate the health tracking survey data with electronic medical records of study participants. We will innovatively deploy HIPPA complaint-AI and the journaling data to help devise actionable insights that will be shared with community members. Goal 4: Provide training and educational materials as well as report-back of research findings to the community. Study findings will be co-developed with our CAB and CPH Taskforce with input from our SAB. Residents will join a Community Data Analyses Team and assist in creating graphics that convey our findings for broad sharing. Community partners will identify and implement strategies including newsletters, town hall meetings, website updates, podcasts, and open houses to disseminate our findings. The proposed East Palestine Health Tracking Study will provide critical, actionable insights into the short- and long-ter
