Now in your backyard: Train derailment’s toxic trail challenges unprepared communities & health care

Health Care Without Harm
5 min readFeb 15, 2023

By Ted Schettler, M.D., MPH, Health Care Without Harm science adviser

Dizziness, drowsiness, fatigue, headaches — a common list of symptoms that could have many causes. Among them is low-level exposure to vinyl chloride, a chemical used to make products we use every day. Not likely a worry on the minds of medical professionals or community members of East Palestine, Ohio, before Feb. 3. Now, exposure to this and other toxic compounds is a concern as residents return from an evacuation prompted by a train derailment carrying hazardous, flammable, colorless chemicals.

The affected area of contamination caused immediate evacuations near the train derailment in East Palestine, Ohio. (Source:

After the accident, everyone within a mile radius was ordered to evacuate immediately. A few days later, with growing concerns about an explosion, crews slowly released vinyl chloride gas from the train cars, igniting the chemical in ditches in an attempt to control its spread. Photos showed large plumes of black smoke. The day after the controlled releases and burn, EPA deemed the air quality in the town safe, and local officials told evacuated residents they could safely return home.

Vinyl chloride is primarily used to make polyvinyl chloride plastics (PVC). Exposure to this toxic chemical is associated with an increased risk of liver, lung, central nervous system, and kidney damage. Workers exposed to high levels for several years have higher rates of liver cancer. Pregnant women may have an increased risk of miscarriage and birth defects when exposed to high levels of vinyl chloride in the air.

Since the highest levels of vinyl chloride are found in the air around factories that produce vinyl products, those who don’t work in the factory or live nearby are often unaware of its dangers. But this incident reminds us of the health harms associated with products like vinyl and other plastics — and how these risks travel with these products throughout their life cycle, impacting individuals and communities near and far away from the source of production.

Burning vinyl chloride releases phosgene and hydrogen chloride, which are also highly toxic. Acute exposure to phosgene causes burning in the eyes and throat and difficulty breathing. Lung damage can be long-lasting. Hydrogen chloride is highly corrosive to the lungs, causing rapid breathing, and accumulation of fluid in the lungs. High exposure to either of these releases can be fatal.

Burning vinyl chloride and polyvinyl chloride also forms highly toxic dioxins and furans that are persistent and bioaccumulative. They are carcinogenic and can cause a range of other adverse health outcomes. They will contaminate soil, surfaces, and dust leading to inadvertent ingestion or inhalation. They will not be detected by air monitoring.

While high levels of any of these toxic compounds would not be expected in a home, this train derailment brought these health hazards to unsuspecting people’s backyards — contaminating the air they breathe and potentially their soil and water supply.

The derailment site is close to the Ohio River, which supplies drinking water to over 5 million people. One of the numerous public water utilities using the river as its source in West Virginia stated they switched to an alternate supply, according to West Virginia Gov. Jim Justice, who said chemicals of concern went into the river.

West Virginia Governor Jim Justice disclosed chemicals of concern spilled into the Ohio River when a train derailed in East Palestine, Ohio. (Source: Roman Didkivskiy | Dreamstime stock photography)

And now we wait to see if vinyl chloride, its products of combustion, or any of the other complex mixture of chemicals of concern made it into the bodies of community members showing up in local doctors’ offices and hospitals with vague, non-specific health concerns. And while this may seem like an isolated incident, more than 1,700 train derailments happen annually in the U.S. on average, according to the Bureau of Transportation.

Health care organizations serve as one of the first lines of defense when tragedies strike. But are hospitals and health professionals in your community equipped to diagnose and treat impacts of toxic exposure that aren’t common where you live?

This tragic accident illustrates the importance of proactive action needed to shift away from our reliance on highly toxic petrochemicals used in plastics and other products.

Plastic and petrochemical industries adamantly deny responsibility for these accidents and health harms while shaping legislation to protect business-as-usual rather than people. Railroad companies successfully resist calls for increased safety measures.

Moving toward an economy that uses less toxic materials is the only protection from future harm, and one of our greatest allies in the fight against toxic industries is the health care sector.

The plastics industry professes that its products save lives, but this marketing ploy has a darker side. While some plastics undoubtedly do save lives in health care settings, many also threaten the lives and well-being of others throughout their life cycle. And in some cases, there are safer products or materials that hospitals could be using today.

As the only sector with healing as its mission and representing close to 20% of the U.S. GDP, health care has an opportunity and a responsibility to leverage its ethical, economic, and political influence at this moment.

The sector can illustrate what real change looks like when you harness purchasing power, expertise, and the trusted voice of medical professionals to move the market toward environmentally safer products and technologies.

It’s hard to know what the people of East Palestine and its surrounding communities will experience as a result of this devastating accident now or if its hazardous chemicals will linger in the impacted neighborhoods posing longer-term risks.

While we can’t forecast the next time a toxic disaster arrives in an unsuspecting community, we know we are all exposed to hazardous chemicals in our hospitals and our homes — unless health professionals and other leaders demand alternatives.

Ted Schettler, M.D., MPH, is Health Care Without Harm science adviser and science director of the Science and Environmental Health Network. He practiced emergency medicine and some primary care for a number of years. He has a medical degree from Case Western Reserve University and a master’s degree in public health from Harvard University. He is the author and co-author of a number of books and articles on various environmental health topics and has served on advisory committees of the U.S. EPA and National Academy of Sciences.



Health Care Without Harm

Health Care Without Harm seeks to transform health care worldwide so the sector reduces its environmental footprint and becomes a leader in the global movement.