There have been many articles from news sources, experts, and organizations about the disastrous train derailment in East Palestine, Ohio, on February 3rd, 2023. I have been following the situation closely and as an Environmental Medicine doctor I feel the need to weigh in on some key issues, but most importantly, offer some accessible information on what residents in the area can do to protect their health.

Before I jump in, I want to acknowledge how devastating this train derailment has been for the residents in and around East Palestine, Ohio. I have read and heard how frightened and upset you all are, and I want you to know that my heart goes out to you. Furthermore, I hope that some of the information here is helpful.

I want to be thorough, so this is going to be a two-part blog post. First, I am going to outline what happened and the environmental hazards of this train derailment. The second post will be all about strategies to protect and treat yourself in the event of exposures.

These will be lengthy, in-depth articles.


Train Derailment

Key Takeaways

What happened:

On the evening of February 3, 2022, 38 cars on the Norfolk Southern train derailed. Many of the cars that were seriously damaged contained hazardous chemicals, and these chemicals spilled into the surrounding area (1, 2, 3, 4).

One of these hazardous chemicals is vinyl chloride, which is a carcinogen (2). Over concerns for possible explosions, the vinyl chloride was burned off. However, as a result of burning, other products were released, including phosgene, hydrogen chloride, formaldehyde, and dioxins. This may not be good news for your health.

Since then, the Environmental Protection Agency (EPA) has been monitoring air and water quality, and in response to concerns they have agreed to monitor for dioxin levels (5, 6, 7). They claim that they aren’t finding elevated levels of toxicants. However, the chemicals that were released can have both short-term and long-term health effects (5). If you are living in the affected area, it is important to take steps to protect your health.

Immediate steps to take in case of direct exposure:

  • Leave the area and get fresh air
  • Remove your clothes and wash your body with soap and water immediately
  • Call 911 and seek medical attention

What to do if you’ve been exposed:

  • Relocate, if possible.
  • Use a high-quality whole house air filtration system (44).
  • Use a high-quality whole house water filtration system (46).
  • Increase sweating through infrared sauna use and exercise (47, 49).
  • Hydrate by drinking lots of clean water (55, 56).
  • Alkalize your urine (58, 57, 59).
  • Drink green and black tea for polyphenols and epigallocatechin gallate (EGCG) (60, 61, 6, 63, 64).
  • Try intestinal binding agents, such as activated charcoal, chlorella, and bioactive carbons (65).
  • Try colon hydrotherapy and coffee enemas (80).
  • Support liver detoxification with N-acetyl cysteine (NAC) (85), amino acids, including glycine, taurine, and glutamine (84, 86, 87, 88), S-Adenosyl-L-methionine (SAM-e) (89), glutathione (90, 91), B vitamins (92, 93, 94), and magnesium (95, 96)
  • Support the detoxification process and reduce inflammation with turmeric (97, 98), quercetin (99, 100), resveratrol (101, 102) and phosphatidyl choline 103, 104 105).
  • Follow an anti-inflammatory, antioxidant-rich, and nutrient-dense diet. Get plenty of good sleep. Reduce stress. Move your body. Reduce other environmental toxin exposure.
  • Take care of your mental health.


Train Derailment

Ohio Train Derailment: What Happened?

On the evening of February 3, 2022, 38 cars on the Norfolk Southern train were derailed, causing a days-long fire in the area (1). Many of these cars contained hazardous chemicals, including vinyl chloride, which is a known carcinogen (2). At least 20 cars were seriously damaged and some of the chemicals were released into the surrounding area.

In addition to vinyl chloride, another gas called isobutylene was also released. Isobutylene is not only a carcinogen but it’s also a highly flammable gas (3). Along with isobutylene, 3 other solvents (liquids), known as ethyl hexylacrylate, ethylene glycol monobutyl, and butyl acrylate, were released (4).

Vinyl chloride was burned off by authorities to avoid any possible explosions. However, when vinyl chloride is burned, it decomposes into various gasses, including phosgene and other toxins. This may not be good news for your health.

Though residents of East Palestine were evacuated out of precaution initially, the evacuation order was lifted on February 8th. Since then, there have been a growing number of reports of people reporting various symptoms, including a burning sensation in their eyes, as well as their animals becoming ill (5).

The Environmental Protection Agency (EPA) has been monitoring air and water quality (6, 7). Furthermore, they claim that the area is safe. However, the chemicals that were released can have both short-term and long-term health effects (5). If you are living in the affected area, being proactive and taking steps to protect your health is vital.


Train Derailment

Concerns Related to the Ohio Train Derailment

I have a number of concerns about this event:

  1. There may be contamination of chemicals in the air, water, and soil in the local area (6, 7).
  2. A downstream plume of chemicals may have made its way to the Ohio River. The Ohio River flows through or borders 6 states and water drains into the Ohio river from 8 other states. It is a water source for more than 5 million people (8). Though it may not mean that the incident can affect all these areas, it is a potential concern to keep in mind.
  3. Safety measures for the railroads have been lax for years. This means that more train derailments and incidents may continue unless more stringent safety measures are enacted and maintained (9, 10).
  4. The primary chemical that the EPA mentions testing for is vinyl chloride, which is very toxic (6, 7, 11). However, vinyl chloride is not the only concern. Because it was purposely burned off to avoid explosions, it makes sense that very little vinyl chloride will be found in the EPA tests. However, byproducts of the burning may be lingering and causing toxicity issues.
  5. The Ohio Department of Natural Resources mentions that contaminated waterways have led to the death of 3,500 fish across 7.5 miles of streams (12). The Ohio Department of Agriculture claims that other animals were not affected and the livestock and food supply is safe in the area, despite reports from residents of dead cows, chickens, and pets (13, 14, 5).
  6. The EPA seems to be contradicting itself, saying that there aren’t any levels of concern but then confirming that the substances released were now detected in the Ohio River, various creeks, and other waterways (5, 6, 7, 15).


  • On the evening of February 3, 2022, the Norfolk Southern train derailed, causing a days-long fire in the area. Many of the cars that were seriously damaged contained hazardous chemicals and some of the chemicals were released into the surrounding area.
  • One of these hazardous chemicals, vinyl chloride, was burned off. However, breakdown products (chemicals) were released, including phosgene, hydrogen chloride, formaldehyde, and dioxins in the air.
  • Since then, the Environmental Protection Agency (EPA) has been monitoring air and water quality and claims that the levels found are of no concern (5, 6, 7). However, the chemicals that were released can have both short-term and long-term health effects.


Chemical laboratory with microscope and sample

What Chemicals are Concerning?

Now that you understand my general concerns about Ohio train derailment, I wanted to elaborate more on  the chemicals you need to be concerned about.


Ethyl Hexyl Acrylate

Ethyl hexyl acrylate is a liquid solvent. It is an eye, skin, and respiratory irritant that may be toxic to aquatic life. Short-term (acute) exposure to ethyl acrylate vapors may result in headaches, respiratory issues, drowsiness, nausea, and gastrointestinal (GI) issues, as well as allergic reactions in the skin. Long-term (chronic) exposure may increase inflammation of the nasal mucosa, promote weight gain, and according to the EPA, it’s a Group B2, probable carcinogen. (16, 17).


Ethylene Glycol Monobutyl

Ethylene glycol monobutyl is a liquid solvent. It may cause irritation to your eyes, skin, and respiratory tracts–with coughing, dizziness, weakness, drowsiness, headaches, nausea, and other GI issues upon inhalation. Furthermore, it may affect your kidneys, liver, blood, and central nervous system. It is also a known carcinogen (18, 19, 20).


Butyl Acrylate

Butyl acrylate is a liquid solvent. It is extremely flammable and can burn the skin and eyes. Symptoms include: irritation of the eyes, redness, tearing, scratchy throat, runny nose, difficulty breathing, redness or cracking of the skin, headaches, dizziness, nausea, or vomiting. It may also cause permanent lung damage. (21, 22).



Isobutylene is a highly flammable gas. It irritates the eyes, nose, and throat. Acute exposure may lead to dizziness, headaches, fatigue, and lightheadedness. It may cause lung and respiratory issues and GI problems. High levels of exposure to isobutylene could cause coma, death, or neurological impairment (23, 24).


Vinyl Chloride

This is the chemical you are hearing the most about, the chemical that was burned. Vinyl chloride is used in the plastics industry to make poly vinyl chloride or PVC. Vinyl chloride is a known carcinogen and can lead to a variety of health issues (2).

The half-life of a chemical reaction refers to the time it takes for the strength or amount of a substance to be reduced in half. The half-life of vinyl chloride in the atmosphere is 1 to 2 days (25). However, in the water, it is supposedly shorter, under an hour. In the soil, it can be 2 years. Although the damaged train cars containing vinyl chloride were set on fire to avoid an explosion, this wasn’t done immediately. This means that there was time for vinyl chloride to seep into the soil and groundwater and contaminate the area. Vinyl chloride breaks down in the air and can dissipate within a few days. However, it may persist in soil, affecting our soil, crops, and water supply. This is a particular concern since vinyl chloride can be highly toxic to humans (26, 27).

Exposure to vinyl chloride may lead to dizziness, drowsiness, headaches, sleepiness,  and loss of consciousness. It may lead to liver health issues, immune health issues, respiratory issues, neurological issues including nerve damage and developmental problems. Skin contact may lead to redness, blisters, or symptoms resembling frostbite. (28, 29, 30).

Exposure to low concentrations can get tricky. We may not see immediate effects, but it’s possible that exposure can lead to inflammation and chronic health issues over time. Chronic exposure to vinyl chloride can lead to liver disease and liver cancer. Extremely high levels can cause coma or death (28, 29, 30).


Hydrogen Chloride

When vinyl chloride is burned, it decomposes into various gasses, including hydrogen chloride and phosgene (31). Hydrogen chloride may cause irritation to your skin, eyes, throat, larynx, and nose. Long-term exposure may increase the risk of skin inflammation, chronic bronchitis, gastritis, dental discoloration, and dental erosion. (32, 33).



Formaldehyde is a flammable gas. This is the chemical used for embalming. It is present as a byproduct of burning vinyl chloride.  As a resuIt, it may cause irritation to the skin, throat, lungs, and eyes. (34).



Benzene is another highly flammable chemical. It is present as a byproduct of burning vinyl chloride. Two of the cars derailed also contained benzene.  As a result, it may cause dizziness, drowsiness, headaches, tremors, irregular heartbeat, and irritation of the skin, throat, lungs, and eyes. With these 3 chemicals, the level of health effects may depend on the dose and the duration of the exposure (35, 36).



Though dioxins were not spilled during the Ohio train derailment, they can be created when vinyl chloride and other chemicals are burned. Dioxins are a family of chemicals formed during the manufacture of  PVC plastics and other chemicals. They are highly toxic — dioxins are the primary contaminants in Agent Orange and were present in other environmental disasters, including Times Beach and Love Canal. Part of the reason they are so deadly and toxic is that they are persistent in the environment and our bodies. The half-life of dioxins is about 7 to 11 years, which means it takes that amount of time to degrade only half of it. Dioxins may cause skin lesions and liver function issues. Long-term, they may disrupt the immune system, endocrine system, immune system, and developing nervous system. They are also carcinogens (37, 38).



Phosgene was used as a choking (pulmonary) agent during World War I. The vast majority of the chemical warfare-related deaths during the war were attributed to phosgene  (39). Phosgene is heavier than air. This means that phosgene is more likely to be located in low-lying areas. After the Ohio train derailment, phosgene was released as a byproduct of burning vinyl chloride (31). You can be exposed to phosgene through the air, through contaminated water, or foods grown in contaminated soils (39).

You may develop certain symptoms after exposure to dangerous concentrations of phosgene. Immediate signs and symptoms of phosgene exposure may include coughing, burning sensation in the throat, burning sensation or irritation of the eyes, blurred vision, watery eyes, shortness of breath, difficulty breathing, nausea, vomiting, foamy sputum, chest pain, and skin lesion similar to burns or frostbite with skin contact. (39, 40, 41).

Exposure to high concentrations to phosgene may also lead to pulmonary edema (fluid build up in the lungs) within 2 to 6 hours after exposure. Delayed reactions may occur within up to 48 hours after exposure. However, these reactions can be very serious. Delayed effects for up to 48 hours may include coughing up white to pink-tinged fluid  (this is a sign of pulmonary edema), difficulty breathing, low blood pressure, and heart failure (39). Be sure to seek medical attention for any concerning symptoms in order to diagnose and treat the problem.



Chemicals to Be Concerned About

  • Ethyl Hexyl Acrylate
  • Ethylene Glycol Monobutyl
  • Butyl Acrylate
  • Isobutylene
  • Vinyl Chloride
  • Hydrogen Chloride
  • Formaldehyde
  • Benzene
  • Dioxins
  • Phosgene


Woman coughing

What Are the Potential Long-Term Effects of Exposure

Generally speaking, those who are exposed to phosgene and other bi-products of burning vinyl chloride tend to make a full recovery. However, some people may develop chronic bronchitis and emphysema as a result of exposure to phosgene. Additionally, there is also a risk of developing chemical sensitivity or even mast cell activation syndrome when experiencing acute or chronic exposure to any chemicals or toxins (39).


How Is Phosgene Exposure Treated?

According to a 2016 study on phosgene therapeutics published in Toxicology Letters, there is no treatment approach that can completely eliminate the risk of mortality related to phosgene exposure (42). There are a number of medications that may help to reduce mortality, but phosgene toxicity is complex and multi-faceted.


Modern chemist in gloves and uniform writing formulae of molecular entity on transparent board

Get More Information About Phosgene and Other Chemicals

Contact the (39):

  • Centers for Disease Control and Prevention (CDC)
    • Public Response Hotline (CDC): 800-CDC-INFO and 888-232-6348 (TTY)
    • Email:
  • Regional Poison Control Center: 1-800-222-1222

You may also check the CDC and National Institute for Occupational Safety and Health (NIOSH) Pocket Guide to Chemical Hazards


  • Generally speaking, those who are exposed to phosgene and other bi-products of burning vinyl chloride tend to make a full recovery. However, there is a risk of chronic bronchitis, emphysema, chemical sensitivity, and mast cell activation syndrome from both acute and chronic exposure. Chronic exposure may lead to various chronic health issues.
  • Steps to take in case of acute exposure:
    • Leave the area and get fresh air
    • Remove your clothes and wash your body with soap and water immediately
    • Call 911 and seek medical attention


The researchers are working in a chemical laboratory.

Testing for Chemicals:

What Is Happening

Currently, the government is performing real-time air testing for several contaminants in the areas affected by the Ohio train derailment disaster. They are reporting no vinyl chloride or hydrogen sulfide present. The problem is that vinyl chloride was burned off, therefore it is not expected to be present (6, 7).

Four weeks after the train derailment, the EPA agreed to start testing for dioxins amid pressure from residents. They cited cost and difficulty for the delay in testing for dioxins, and some experts believe the exposure to other chemicals are of more concern than dioxins (106).

What Should Be Happening

The EPA and Norfolk Southern should continue to look at all known contaminants in air, water, and soil, for the foreseeable future. However, testing for formaldehyde and continued testing for benzene may be a good idea as well, as they are carcinogenic byproducts of burning, whose long-term effects are associated with chronic illnesses, including pulmonary disease, cardiovascular disease, neurodegenerative diseases, and cancer (34, 35, 36, 43). It’s important that they not only test in the East Palestine, OH area, but also all surrounding areas, downstream, and downwind areas from the train derailment, as we have no idea how far these chemicals may travel.

We need long-term biomonitoring for potential health effects both among the population and the animals in the affected area. Quest Diagnostics may be able to test for vinyl chloride, but is currently unable to test for the other chemicals. While there are some functional lab tests that can check for toxicity from various chemicals, these tests are not considered standard of care, and therefore not automatically considered in cases such as this.

Testing Markers

Considering that these chemicals may lead to oxidative damage in the body, monitoring markers of oxidative damage, including malondialdehyde, 8 deoxyguanosine (8OH dG – a marker of DNA oxidative damage), oxLDL and F2 isoprostane may be a good idea. Testing markers for chronic inflammation and monitoring symptoms will also be helpful.

Many of these tests will not be covered by insurance, and most are not routinely run by physicians. If residents want this testing, they must request the testing from their doctor, but the out of pocket cost could be inaccessible. This is where the US government could step in and help. Additionally, many general practitioners are unfamiliar with environmental and oxidative damage testing, so residents may want to connect with an Environmental Medicine doctor – here is the provider directory for the American Academy of Environmental Medicine.


Unrecognizable psychologist comforting young woman

The most important takeaway from this entire article is that what you are feeling is valid.

However, the last thing I want to do is increase your fear and anxiety. I hope some of the information and suggestions I’ve included empower you to take what action you can to protect your health and the health of your loved ones and the East Palestine community. Continue asking the authorities for what you need, demanding that those responsible take care of you and make things right.

Tomorrow, I will post an article on more ways to protect your health and deal with the potential exposures of this train derailment. Until then, hug your family and know that I am thinking of you all.