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Long-term Adverse Health Effects from Long-term Adverse Health Effects from Exposure to Crude Petroleum Hydrocarbons Exposure to Crude Petroleum Hydrocarbons Fair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William Sawyer Fair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William Sawyer Mental Health Mental Health Biomarkers Biomarkers Bioaccumulation Bioaccumulation Lower Respiratory Lower Respiratory Latent Conditions Latent Conditions All data based on statistically significant human epidemiological studies (p=<0.05) Summary Summary

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Page 1: Long-term Adverse Health Effects from Exposure to … · Long-term Adverse Health Effects from Exposure to Crude Petroleum Hydrocarbons Fair-use images are representative only and

Long-term Adverse Health Effects from Long-term Adverse Health Effects from Exposure to Crude Petroleum HydrocarbonsExposure to Crude Petroleum Hydrocarbons

Fair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William SawyerFair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William Sawyer

Mental HealthMental Health

BiomarkersBiomarkers

BioaccumulationBioaccumulation

Lower RespiratoryLower Respiratory Latent ConditionsLatent Conditions

All data based on statistically significant human epidemiological

studies (p=<0.05)

SummarySummary

Page 2: Long-term Adverse Health Effects from Exposure to … · Long-term Adverse Health Effects from Exposure to Crude Petroleum Hydrocarbons Fair-use images are representative only and

Lower Respiratory Symptoms fromLower Respiratory Symptoms from Exposure to Crude Petroleum HydrocarbonsExposure to Crude Petroleum Hydrocarbons

Lower respiratory tract symptomsLower respiratory tract symptoms1,2,31,2,3 in the Zock, et al. (2007) cross-sectional human in the Zock, et al. (2007) cross-sectional human studies were measured at a statistically significant elevated rate among the 4,594 studies were measured at a statistically significant elevated rate among the 4,594 exposed men and 2,186 exposed women. These symptoms include:exposed men and 2,186 exposed women. These symptoms include:

● Wheezing & breathlessnessWheezing & breathlessness● Wheezing apart from coldsWheezing apart from colds● Nocturnal attacks of shortness of breathNocturnal attacks of shortness of breath

Persistent dose-dependant symptoms in the Zock, et al., 2009 follow-up study revealed Persistent dose-dependant symptoms in the Zock, et al., 2009 follow-up study revealed that among lifetime nonsmokers, exposed fishermen had significantly increased rates of that among lifetime nonsmokers, exposed fishermen had significantly increased rates of bronchial hyperresponsiveness (15% vs. 9%) and increased levels of 8-isoprostane bronchial hyperresponsiveness (15% vs. 9%) and increased levels of 8-isoprostane (48% vs. 20%) as well as vascular endothelial growth factor in exhaled breath (48% vs. 20%) as well as vascular endothelial growth factor in exhaled breath condensate. Persistent weakness was also reported in the Campbell, et al., 1994 studycondensate. Persistent weakness was also reported in the Campbell, et al., 1994 study

11 Rodriquez-Trigo, G, et al., “Health changes in fishermen two years after clean-up of the Rodriquez-Trigo, G, et al., “Health changes in fishermen two years after clean-up of the PrestigePrestige oil spill,” 2010, Annals of Internal oil spill,” 2010, Annals of Internal Medicine, Vol. 153, pages 489-498. Medicine, Vol. 153, pages 489-498. http://www.cdasystems.com/bp/r1.pdfhttp://www.cdasystems.com/bp/r1.pdf22 Zock, JP, et al., “Prolonged respiratory symptoms in clean-up workers of the Zock, JP, et al., “Prolonged respiratory symptoms in clean-up workers of the PrestigePrestige oil spill,” 2007, American Journal of oil spill,” 2007, American Journal of Respiratory and Critical Care Medicine, Vol. 176, pages 610-616. Respiratory and Critical Care Medicine, Vol. 176, pages 610-616. http://www.cdasystems.com/bp/z1.pdfhttp://www.cdasystems.com/bp/z1.pdf33 Zock, JP, et al., “Long-term health effects of the Zock, JP, et al., “Long-term health effects of the PrestigePrestige oil spill (Galicia, Spain),” 2009, Epidemiology, Vol. 20(6), pages 242-243. oil spill (Galicia, Spain),” 2009, Epidemiology, Vol. 20(6), pages 242-243. http://www.cdasystems.com/bp/z2.pdfhttp://www.cdasystems.com/bp/z2.pdf44 Campbell, D., et al., “Later effects of grounding of tanker Campbell, D., et al., “Later effects of grounding of tanker BraerBraer on health in Shetland,” 1994, British Medical Journal, Vol. 309, on health in Shetland,” 1994, British Medical Journal, Vol. 309, Pages 773-774. Pages 773-774. http://www.cdasystems.com/bp/c3.pdfhttp://www.cdasystems.com/bp/c3.pdf

Fair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William SawyerFair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William Sawyer

● Chronic cough and phlegmChronic cough and phlegm● Lower respiratory tract symptomsLower respiratory tract symptoms● Oral medication usageOral medication usage

Page 3: Long-term Adverse Health Effects from Exposure to … · Long-term Adverse Health Effects from Exposure to Crude Petroleum Hydrocarbons Fair-use images are representative only and

Long-term Mental Health Effects fromLong-term Mental Health Effects from Exposure to Crude Petroleum HydrocarbonsExposure to Crude Petroleum Hydrocarbons

● Psychological stressPsychological stress 1 1

● DepressionDepression 1 1

● Post-traumatic stress disorder among Post-traumatic stress disorder among indigenous peopleindigenous people 2 2

● Elevated rates of anxiety disorderElevated rates of anxiety disorder 3 3

Fair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William SawyerFair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William Sawyer

11 Sabucedo JM, et al., “Symptomatic profile and health-related quality of life affected by the Sabucedo JM, et al., “Symptomatic profile and health-related quality of life affected by the PrestigePrestige catastrophe, 2010, Disasters catastrophe, 2010, Disasters Vol. 34 Vol. 34 inin Solomon, GM and Janssen, S., “Health effects of the Gulf oil spill,” 2010, Journal of American Medical Association, Vol. Solomon, GM and Janssen, S., “Health effects of the Gulf oil spill,” 2010, Journal of American Medical Association, Vol. 304 (10), pages 1118-1119. 304 (10), pages 1118-1119. http://www.cdasystems.com/bp/s2.pdfhttp://www.cdasystems.com/bp/s2.pdf 22 Palinkas Palinkas, et al., “Ethnic differences in symptoms of post-traumatic stress after the , et al., “Ethnic differences in symptoms of post-traumatic stress after the Exxon-ValdezExxon-Valdez oil spill”, 2004, PDM, Vol. 19, oil spill”, 2004, PDM, Vol. 19, Pgs. 102-112. Pgs. 102-112. http://www.cdasystems.com/bp/p2.pdfhttp://www.cdasystems.com/bp/p2.pdf33 Palinkas Palinkas, et al., “Community patterns of psychiatric-disorders after the , et al., “Community patterns of psychiatric-disorders after the Exxon-ValdezExxon-Valdez oil spill”, 2003, Am. J. Psychiat., Vol. 150, oil spill”, 2003, Am. J. Psychiat., Vol. 150, Pgs. 1517-1523. Pgs. 1517-1523. http://www.cdasystems.com/bp/p1.pdfhttp://www.cdasystems.com/bp/p1.pdf

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Positive Biomarkers Resulting fromPositive Biomarkers Resulting from Exposure to Crude Petroleum HydrocarbonsExposure to Crude Petroleum Hydrocarbons

● Elevated 8-isoprostane levels in exhaled breath Elevated 8-isoprostane levels in exhaled breath condensatecondensate 1 1

● Elevated levels of vascular endothelial growth factorElevated levels of vascular endothelial growth factor 1 1

● Elevated levels of basic fibroblast growth factorElevated levels of basic fibroblast growth factor 1 1

● Structural chromosomal alterationsStructural chromosomal alterations 1,2 1,2

11 Rodriquez-Trigo, G, et al., “Health changes in fishermen two years after clean-up of the Rodriquez-Trigo, G, et al., “Health changes in fishermen two years after clean-up of the PrestigePrestige oil spill,” 2010, Annals of Internal oil spill,” 2010, Annals of Internal Medicine, Vol. 153, pages 489-498.Medicine, Vol. 153, pages 489-498. http://www.cdasystems.com/bp/r1.pdfhttp://www.cdasystems.com/bp/r1.pdf22 Zock, JP, et al., “Long-term health effects of the Zock, JP, et al., “Long-term health effects of the PrestigePrestige oil spill (Galicia, Spain),” 2009, Epidemiology, Vol. 20(6), pages 242-243. oil spill (Galicia, Spain),” 2009, Epidemiology, Vol. 20(6), pages 242-243. http://www.cdasystems.com/bp/z2.pdfhttp://www.cdasystems.com/bp/z2.pdf33 Aguilera, F, et al., “Review on the effects of exposure to spilled oils on human health,” 2010, Journal of Applied Toxicology, Vol. Aguilera, F, et al., “Review on the effects of exposure to spilled oils on human health,” 2010, Journal of Applied Toxicology, Vol. 30, pages 291-301. 30, pages 291-301. http://www.cdasystems.com/bp/a1.pdfhttp://www.cdasystems.com/bp/a1.pdf

Fair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William SawyerFair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William Sawyer

Studies by Perez-Cadahia, et al. (2006, 2007) Studies by Perez-Cadahia, et al. (2006, 2007) inin Aguilera, et al., 2010 Aguilera, et al., 2010 33 reveal that the highest exposure levels of VOCs among clean-up workers reveal that the highest exposure levels of VOCs among clean-up workers was associated with significantly elevated rates of genotoxic damage as was associated with significantly elevated rates of genotoxic damage as measured by sister chromatid exchange, MN test and comet assay. measured by sister chromatid exchange, MN test and comet assay. Additionally, alterations in hormonal status including prolactin and Additionally, alterations in hormonal status including prolactin and cortisol plasma levels were decreased (p<0.01).cortisol plasma levels were decreased (p<0.01).

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Latent Conditions Potentially Resulting fromLatent Conditions Potentially Resulting from Exposure to Crude Petroleum HydrocarbonsExposure to Crude Petroleum Hydrocarbons 1,2 1,2

11 Aguilera, F, et al., “Review on the effects of exposure to spilled oils on human health,” 2010, Journal of Applied Toxicology, Vol. 30, Aguilera, F, et al., “Review on the effects of exposure to spilled oils on human health,” 2010, Journal of Applied Toxicology, Vol. 30, pages 291-301. pages 291-301. http://www.cdasystems.com/bp/a1.pdfhttp://www.cdasystems.com/bp/a1.pdf22 ATSDR, “Toxicological profile for polycyclic aromatic hydrocarbons (PAHs),” 2010 ATSDR, “Toxicological profile for polycyclic aromatic hydrocarbons (PAHs),” 2010 inin Goldstein, BD, et al., “The Gulf Oil Spill,” 2011, Goldstein, BD, et al., “The Gulf Oil Spill,” 2011, New England Journal of Medicine, Vol. 364(14), pages 1334-1348. New England Journal of Medicine, Vol. 364(14), pages 1334-1348. http://www.cdasystems.com/bp/g1.pdfhttp://www.cdasystems.com/bp/g1.pdf

Fair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William SawyerFair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William Sawyer

●Skin and Lung CancerSkin and Lung Cancer

●Reproductive Toxic EffectsReproductive Toxic Effects

●Developmental Toxic EffectsDevelopmental Toxic Effects

Page 6: Long-term Adverse Health Effects from Exposure to … · Long-term Adverse Health Effects from Exposure to Crude Petroleum Hydrocarbons Fair-use images are representative only and

Bioaccumulation Effects ofPolycyclic Aromatic Hydrocarbons (PAHs)

●““PAHs PAHs [a component of crude oil][a component of crude oil] are are... ... persistent, persistent, can bioaccumulate and potentially cause skin can bioaccumulate and potentially cause skin and lung cancer and have reproductive and and lung cancer and have reproductive and developmental toxic effects.”developmental toxic effects.” 1 1 – – ATSDR ATSDR

●Bioaccumulation of oil compounds and Bioaccumulation of oil compounds and their transference to the food chain in oil-their transference to the food chain in oil-contaminated marine food creates a human contaminated marine food creates a human hazard in the case of chronic ingestion. hazard in the case of chronic ingestion. 22

11 ATSDR, “Toxicological profile for polycyclic aromatic hydrocarbons (PAHs),” 2010 ATSDR, “Toxicological profile for polycyclic aromatic hydrocarbons (PAHs),” 2010 inin Goldstein, BD, et al., “The Gulf Oil Spill,” 2011, Goldstein, BD, et al., “The Gulf Oil Spill,” 2011, New England Journal of Medicine, Vol. 364(14), pages 1334-1348. New England Journal of Medicine, Vol. 364(14), pages 1334-1348. http://www.cdasystems.com/bp/g1.pdfhttp://www.cdasystems.com/bp/g1.pdf22 Aguilera, F, et al., “Review on the effects of exposure to spilled oils on human health,” 2010, Journal of Applied Toxicology, Vol. 30, Aguilera, F, et al., “Review on the effects of exposure to spilled oils on human health,” 2010, Journal of Applied Toxicology, Vol. 30, pages 291-301. pages 291-301. http://www.cdasystems.com/bp/a1.pdfhttp://www.cdasystems.com/bp/a1.pdf

Fair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William SawyerFair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William Sawyer

Page 7: Long-term Adverse Health Effects from Exposure to … · Long-term Adverse Health Effects from Exposure to Crude Petroleum Hydrocarbons Fair-use images are representative only and

SummarySummary

The acute and long-term (persistent) toxicological The acute and long-term (persistent) toxicological effects of exposure to crude petroleum hydrocarbons effects of exposure to crude petroleum hydrocarbons are supported by multiple independent peer-reviewed are supported by multiple independent peer-reviewed human epidemiological studies. These studies provide human epidemiological studies. These studies provide objective symptomatic evidence, as well as disease objective symptomatic evidence, as well as disease probabilities to within a known rate of error. It should probabilities to within a known rate of error. It should be noted that adverse health effects beyond those be noted that adverse health effects beyond those reported above may exist, which have not been fully reported above may exist, which have not been fully evaluated in the current scientific literature.evaluated in the current scientific literature.

Fair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William SawyerFair-use images are representative only and do not portray individual injuries to cleanup personnel. Prepared by Toxicology Consultants and Assessment Specialists, LLC, Dr. William Sawyer