Technological disasters and public health emergencies: the case of oil spill on the Brazilian coast.

In late August 2019, an oil slick began to wash up on the coast of Northeast Brazil. To date, the slick, later identified as crude oil/petroleum, is assumed to have come from a spill from some tanker ship in transit along the Brazilian coast. The first oil slick was reported in the states of Pernambuco and Paraíba 1, and as of late November the spill had hit all states of the Northeast, including more than 400 locations, subsequently reaching the Southeast in the states of Espírito Santo and the northern coast of Rio de Janeiro. The disaster thus covers a huge geographic area, with serious environmental harm and an impact on subsistence conditions for countless human communities that depend on fishing and tourism. Despite the exposure of a large contingent of persons who struggled to contain or remove the oil slicks and residues from the sea and beaches and the fact that many of these people came into direct, unprotected contact with this toxic waste, there have been relatively few reports of human cases with acute clinical manifestations related to such exposure. However, these reports only refer to cases notified to the Brazilian Ministry of Health, probably failing to represent all the exposed individuals that developed symptoms. For example, the state of Pernambuco recorded some 90% of all the reports, while several other states seriously affected by the disaster failed to report any cases of acute toxicity at all 2. Data on the 149 cases notified in Pernambuco as of November 15 indicated that the exposure was mainly by the cutaneous and respiratory routes, and that the most frequent signs and symptoms were headache, nausea, dizziness, skin irritation, shortness of breath, itching, vomiting, and diarrhea 3, with no reported serious cases or deaths to date. Although the health sector’s reports do not contain this information, according to the media coverage, the main individuals exposed to the oil waste can be classified in two groups: persons that worked in the containment and removal of oil and cleaning the beaches (volunteers, NGOs, environmental agency staff and defense and civil defense personnel) and workers involved in artisanal fishing (fishers and crab fishers and their families). Another source of exposure is consumption of contaminated fish and shellfish, as well as occasional exposure of tourists and bathers, although direct contact with the oil tends to be lower in these other groups. The pollutants to which thousands of people were exposed are a complex mixture of hydrocarbons associated with highly toxic compounds like benzene, toluene, and xylene 4,5. It is thus crucial 1 Fundação Oswaldo Cruz, Brasília, Brasil. 2 Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil.