Acute Health Effects Associated with the Elk River Chemical Spill — West Virginia, 2014

BACKGROUND: On January 9, 2014, approximately 10,000 gallons of a mixture of 4-methylcyclohexanemethanol (MCHM) and ~ 7% propylene glycol phenyl ether (PPH) spilled into the Elk River contaminating the potable water supply of ~ 300,000 residents. Because knowledge is limited regarding acute health effects associated with MCHM exposure, we reviewed medical charts of patients seeking care for spill-related health complaints at hospital emergency departments (EDs).

METHODS: Demographic, clinical, and diagnostic data were abstracted from charts by using a standardized form. Charts were excluded from analysis if the patient left without being examined, did not report possible exposure, was asymptomatic, was examined previously for MCHM exposure, or had an alternative diagnosis to explain symptoms. Associations between route of chemical exposure and clinical symptoms were examined by using chi-square analysis.

RESULTS: Ten hospitals reported 584 ED visits during January 9–23. Of 369 patients included in the analysis, 356 (96%) were treated and released and 13 (4%) were admitted. The majority of admitted patients had chronic, underlying conditions; no deaths occurred. Mean patient age was 40 years (range: <1–87 years); 59% were female. The most frequently reported symptoms were: nausea (38%), skin rash (28%), vomiting (28%), abdominal pain (24%), and diarrhea (24%). Routes of exposure included direct contact with skin or mucous membranes (53%), ingestion (44%), and inhalation (15%); or multiple routes (18%). Ingestion was associated with gastrointestinal symptoms; direct contact with skin symptoms; and inhalation with respiratory symptoms (each, P<0.005).

CONCLUSIONS: Our findings indicate that MCHM and/or PPH exposure could possibly lead to gastrointestinal distress, respiratory symptoms, and skin rashes: however, illnesses were mild. Results will be used for local outreach efforts and education.