July 14, 2023

Up in Flames: Train Derailment in East Palestine, Ohio

Lindsay Davis, DO, MPH; Brittany Ladson, DO


On February 3, 2023, a Norfolk Southern train derailed in East Palestine, Ohio, putting this small town on the map. This train was carrying a host of hazardous chemicals that have led to an extensive cleanup and a host of environmental and health hazards of which, many are still likely unknown. The chemicals involved included substances such as vinyl chloride, ethylene glycol, and most importantly, dioxins.

The Chemicals

Dioxins (2,3,7,8-tetrachlorodibenzo para dioxin (TCDD)) are a byproduct produced when chlorine is burned. Chlorine is a common product in plastic products such as PVC piping. When the train derailed, the contents of the train caught on fire and produced dioxins as a byproduct. Dioxins are a known human carcinogen and are linked to numerous health issues including cancer, diabetes, heart disease, hormone disruption, and nervous system disorders. Dioxin exposure can also lead to fertility issues and thyroid dysfunction. The cancer risk threshold for dioxins is 3.7 ppt (parts per trillion). Regardless of legal standards of appropriate dioxin exposure, there are known medical issues of dioxin exposure at even the smallest quantities. Even short-term exposure can cause skin lesions such as chloracne and patchy darkening of the skin. Residents of the area have even complained of nausea and headache since this event occurred. 


After resisting requests for several weeks, the EPA announced that they required Norfolk Southern to do testing of the soil, water, and air. Testing was performed by Birnbaum laboratories and showed that dioxin levels were “low” according to legal standards. Soil levels showed dioxin levels of 700 ppt. The level the EPA will initiate cleanup is 1000 ppt. Currently, workers are removing dioxin contaminated soil and water. Pumps are removing contaminated water from downstream and in still water areas. The EPA stated that the area’s drinking water was not contaminated, and the air also remains safe. 


This, along with many other recent disasters, are causing significant strain on the health of communities. In addition to physical health issues, mental health issues such as anxiety are on the rise. The fear of the unknown effects of the chemicals involved in this spill can be crippling. Environmental and occupational health professionals advocate for increased funding towards environmental surveillance as well as long term collection of specimens from residents to learn more about the effects of chemicals involved with this incidence. With this, even in the tragedy of the event, more medical knowledge can be acquired. 


  1. Trucks are still taking tainted waste out of East Palestine. One spilled this week. Washington Post. Published April 12, 2023. https://www.washingtonpost.com/climate-environment/2023/04/12/east-palestine-truck-spill-soil/.
  2. Perkins T. Levels of carcinogenic chemical near Ohio derailment site far above safe limit. The Guardian. Published March 17, 2023. https://www.theguardian.com/us-news/2023/mar/17/norfolk-southern-derailment-east-palestine-ohio-carcinogenic-chemical-levels.
  3. US Environmental Protection Agency. East Palestine, Ohio Train Derailment. Published February 20. 2023.www.epa.gov.https://www.epa.gov/east-palestine-oh-train-derailment.
  4. World Health Organization. Dioxins and their effects on human health. Published October 4, 2016. https://www.who.int/news-room/fact-sheets/detail/dioxins-and-their-effects-on-human-health
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