Two years have passed since the TVA Roane County fly ash disaster. Heavy rains resulted in failure of one of the dikes containing an 80 acre pond with fly ash sludge. The dike broke on December 22, 2008 just before 1 am and the ash-slide covered an estimated area of 250-400 acres and was up to 4-6 feet deep.
Because of concern regarding possible exposures to the contaminants of the fly ash, Oak Ridge Associated Universities partnered with Tennessee Poison Center’s medical toxicologists to provide medical evaluations of exposed citizens. It was estimated that approximately 200 people lived within the area of the spill, but anyone who wanted to be screened could sign up. Evaluations included a history and physical exam, chest x-ray, pulmonary function testing (PFT’s), basic metabolic profile, and heavy metal evaluation (urine and blood) for a mix of metals that are contained in fly ash. Approximately 200 people were evaluated between August 2009 and April 2010, not all from the immediate area of the spill. Some withdrew from evaluation initially, and another 14 had their lab work but declined the exam.
Respiratory complaints were the most common complaint and may be related to general dusts from the cleanup effort (road construction, retainer construction, etc) as well as fly ash dust. These dusts are suspected of being large particle size that do not enter the lower pulmonary tree. Environmental sampling revealed very little PM 10 dusts; these are dusts less than 10 micrometers in size that can penetrate deep into the bronchi and alveoli. Several people had abnormal PFT’s, but most of these had a smoking history. No abnormal metal screens were found that were related to fly ash contamination.
With our partners at Oak Ridge Associated Universities, we are negotiating with TVA for a re-evaluation of these residents at appropriate intervals (for example 2, 5, 7 years later) to determine any patterns of healthcare that may be impacted over time.
This question prepared by: John Benitez, MD, MPH Medical Toxicologist
I am interested in any questions you would like answered in the Question of the Week. Please email me with any suggestion at donna.seger@vanderbilt.edu
Donna Seger, MD
Medical Director
Tennessee Poison Center
Website: www.tnpoisoncenter.org
Poison Help Hotline: 1-800-222-1222