A new report from the National Academies of Sciences, Engineering, and Medicine (NASEM) is urging clinicians to prioritize ongoing symptom evaluation and continuity of care for individuals potentially exposed to jet fuel contaminated drinking water on Oʻahu in 2021.
The report examined health risks tied to leaks of JP-5 fuel from the Red Hill Bulk Fuel Storage Facility that affected the water supply serving Joint Base Pearl Harbor-Hickam and nearby communities. As many as 93,000 people may have been exposed to the jet fuel through drinking water, inhalation of vapors or skin contact.
University of Hawaiʻi at Mānoa John A. Burns School of Medicine (JABSOM) Dean Emeritus Jerris R. Hedges, JABSOM Department of Native Hawaiian Health Chair and Professor Joseph Keaweʻaimoku Kaholokula, JABSOM graduate and clinical faculty member Marcus Kawika Iwane, and JABSOM graduate and UH West Oʻahu Professor Ricardo Custodio served on the 16-member multi-disciplinary National Academies "committee on the clinical follow-up and care for those impacted by the JP-5 releases at Red Hill," which authored this report. UH Mānoa Thompson School of Social Work and Public Health Professor of Public Health Sciences Catherine Pirkle and Water Resources Research Center Assistant Professor Aurora Kagawa-Viviani served on the multi-disciplinary peer-review team.
Key NASEM report findings
Researchers found limited evidence linking exposure to short-term respiratory, gastrointestinal, skin and mental health symptoms. However, data remains insufficient to determine specific long-term health effects, and no validated medical tests exist to confirm past exposure or the extent of exposure. As a result, the report recommends clinicians carefully document patient histories and symptoms while ensuring ongoing, patient-centered care.
The report also calls for expanded research and improved environmental monitoring to better understand exposure levels and potential health outcomes. Recommendations include developing biomarkers to detect jet fuel exposure, standardizing water testing methods and conducting long-term studies of exposed populations.
"This report highlights the importance of a registry to collect long-term health information to fill the gaps in truly understanding how JP-5 exposure may impact the community over time," Kaholokula said. "The more people who enroll in the Red Hill Registry , the more impactful the research and information becomes."
"Continued enrollment in the Red Hill Registry and similar programs is critical for future studies and research," Hedges said. "Such registries will provide important additional knowledge related to the exposure, especially regarding potential long-term effects on women and children."
The report further highlights the need for improved coordination among federal, state and local agencies to ensure drinking water safety and rebuild public trust following the contamination incident.
"The release of this report reminds families that even though we are removed in time from the May 2021 and November 2021 fuel spills, the voices of the individuals and families who lived through the water crisis are still being heard," said Rosana "Sanie" Weldon, director of the Red Hill Registry. "By enrolling in the Red Hill Registry, whether you had symptoms or not, you help researchers establish accurate baseline data, detect even small health differences which may present years from now, and ensure that findings truly reflect the whole community."
Importance of Red Hill Registry
The Red Hill Registry aims to track health outcomes and provide resources and education for those who experienced jet fuel in their drinking water from the Red Hill Bulk Fuel Storage Facility. Based in the Office of Strategic Health Initiatives at UH, the registry has dozens of partners supporting the registry from across the UH System with technology infrastructure, data security, questionnaire integrity, clinical guidance, water science and more.
