There were 66 oil-spill-related exposure calls to the Alabama Poison Center at the time of the workshop, including 57 describing minor symptoms (e.g., nausea, vomiting, diarrhea, skin rash) and 9 describing moderate symptoms. As with the syndromic surveillance data, most symptoms were inhalation related (50), followed by dermal contact (12) and ingestion (4).
Alabama is continually refining its surveillance activities. Williamson identified several areas of surveillance that need improvement. Many of the areas identified were also mentioned by representatives from the other Gulf States:
Surveillance is voluntary with no validation of exposure reports. Williamson said that he suspected that most exposures are not from the oil itself, but from the oil spill response efforts (e.g., 10 days before the workshop, 17 people on a barge fell ill, not from exposure to oil, but from carbon monoxide that the generator had been pumping into the air intake).
Monitoring systems that capture relevant data for examining long-term health effects need to be developed (e.g., population-monitoring systems that can capture increases in hypertension, cardiovascular disease, and other chronic diseases).
Mental health surveillance needs improvement so that the necessary interventions are available.
The current syndromic surveillance system has yet to differentiate between resident and worker status, although efforts are under way.
Worker health surveillance also needs improvement, with more information being communicated from BP to the state health departments.
Messages to the public need to clearly communicate uncertainty around potential adverse long-term health effects. For instance, noted Williamson, a lack of evidence for acute health effects does not mean that there are no adverse effects.