When NLM toxicologist Dr. Bert Hakkinen of NLM landed at Dulles Airport on Thursday, January 9, 2014, after a long vacation, he expected to go home and relax.

But an email from an HHS colleague changed his plans.

Just 350 miles away, something was wrong with the water.

Calling on staff at a library might seem like an unusual step, but the National Library of Medicine’s specialized toxicology databases were established to help in environmental hazards and public health.

John Koerner, branch head in the HHS Office of the Assistant Secretary for Preparedness and Response, emailed Hakkinen about a chemical spill in the Elk River, upstream from the Kanawha County municipal water intake in Charleston, West Virginia, the state’s capital and largest city.

Many of the area’s 300,000 residents were reporting a strong odor, similar to licorice, in their drinking water, and the governor had issued a “Do Not Use” order for residents relying on the municipal water system.

By the time Hakkinen got Koerner’s message, the source of the Elk River leak—a storage tank at Freedom Industries, a producer of specialty chemicals for the mining, steel and cement industries—had been identified, along with one of the chemicals involved: 4-Methylcyclohexanemethanol (MCHM), which was used to wash coal and remove impurities that contribute to pollution during combustion.

Not enough was known about the chemical’s properties, making it hard to realize the risks of exposure or the best way to clean it up. The company’s data on the chemical had not been made public, and NLM’s Hazardous Substances Data Bank (HSDB^®), containing toxicology data on over 5,000 potentially hazardous chemicals, had nothing on crude MCHM and its possible health hazards.

Shaking off jet lag, Hakkinen joined “an organized scramble” to identify and contain the hazardous spill.

The first order of business for Hakkinen, acting head of the Office of Clinical Toxicology at SIS, and his colleagues in NLM’s Specialized Information Services (SIS) Division was to find solid information on crude MCHM.

They needed to work quickly

A hole—just a little larger than a quarter—in the bottom of a stainless steel storage tank was causing the leak. It was possibly created when water froze in the tank during an unusually cold winter.

By the weekend, the volume of the spill would grow to 7,500 gallons and local officials had determined that two chemicals were leaking into the ground water that fed into the Elk River: MCHM and PPH, a proprietary mix of polyglycol ethers which, like MCHM, is used to wash coal and remove impurities.

Colleagues from Hakkinen and Koerner’s offices joined professionals from the National Institute of Environmental Health Sciences, part of NIH; the Centers for Disease Control and Prevention; and the Environmental Protection Agency to help.

Six solid days

Between January 10 and 16, the staff at SIS worked to understand the hazards, risks, and potential exposures posed by the chemical spill and to outline the cleanup needed for the Elk River site.

The first details on the toxicology of crude MCHM came on January 10 from the manufacturer, Eastman Chemical Company in Kingsport, Tennessee. Here, a bit of luck helped.

Hakkinen knew the former toxicology leader at Eastman Chemical and quickly reached out to him for contacts within the company. This led to fast-track access to the toxicology information needed for NLM’s HSDB Scientific Review Panel (SRP). Usually, it takes a few months to process a new substance into the HSDB.

“We as an SIS team—notably Shannon Jordan, George Hazard, and Florence Chang—and our HSDB contractors and SRP really pushed things, without compromising review and quality, to get the entire process done in about a week,” said Hakkinen.

Hakkinen, other SIS staff and contractors, and the review panel worked day and night to study and summarize crude MCHM’s toxicology information, as well as its chemical composition and purpose, before adding its profile to the HSDB. That profile went live for public access on January 17 and was quickly linked to the CDC’s 2014 West Virginia Chemical Release site.

Shannon Jordan, a chemist in SIS’s Biomedical Information Services Branch, manages the HSDB contract. “When I was asked if the HSDB team could put an MCHM record together quickly, I knew we had the staff, tools, and process in place to do it,” she recalled. “My challenge was to work with the HSDB team to accelerate the process, since we had such an urgent public health need. By coincidence, our team had an SRP peer review meeting scheduled to begin January 16, so we worked to get all the available data entered in the HSDB record by the start of the meeting. We’d done expedited records before, but not this fast!”

Jordan and her team finalized the MCHM record after review and comments up until late Friday evening, January 17. “Once I gave the green light that the record was complete, it was released publicly. The HSDB team and I felt a little pressure, but were excited to work on a record for such an important matter. Going forward, we’ve learned the process we have in place works to serve urgent information needs, and we’re happy to work with other agencies when needed.”

Scary situation and the aftermath

Understandably, the chemical leak scared local residents.

The information from Eastman Chemical about MCHM was troubling. Precautions for safe handling stated: “Avoid contact with eyes, skin, and clothing. Do not taste or swallow. Use only with adequate ventilation. Wash thoroughly after handling.” Certainly not a substance one would want in drinking water.

Within two weeks nearly 600 people had visited emergency rooms claiming symptoms caused by using the contaminated water, and 13 people were hospitalized. Schools and businesses closed.

According to a preliminary study by the Marshall University Center for Business Research, the spill cost Charleston-area businesses more than $61 million in the first month alone.

The long-term aftermath of the spill was wide reaching. West Virginia passed a bill in response to the disaster regulating above-ground storage tanks. Freedom Industries, the company whose tanks leaked the chemical, filed for Chapter 11 bankruptcy in January 2015. Four executives from the company were indicted and pleaded not guilty to negligence and criminal violation of the Clean Water Act. “It’s hard to overstate the disruption that results when 300,000 people suddenly lose clean water,” US Attorney Booth Goodwin said at the time.

And for the good news: test results in March of 2015 showed MCHM was no longer detectable in the Charleston water supply. Clean-up and other efforts are continuing in West Virginia, and “state-of the-science” toxicity and related studies of MCHM and other related chemicals by NIEHS and others are ongoing. Key results are being added to the HSDB as they become available.

Expanding the base of knowledge

The Elk River chemical spill, unfortunate and dangerous as it was, presented an opportunity for SIS staff to apply their expertise and leverage their connections with other government agencies, and for NLM to marshal its specialized toxicology resources in the service of disaster response and public health.

SIS continually seeks to improve its toxicology databases and disaster management tools at NLM used by professionals and the public:

• WISER^®, the Wireless Information System for Emergency Responders, helps with the management of chemical, radiological, and biological emergencies.
• The Household Products Database identifies the chemicals in over 14,000 consumer products and provides access to potential health effects information for each chemical.
• LactMed offers information to nursing mothers on chemicals and drugs that may reside in breast milk and could adversely impact their babies.
• Tox Town explores typical toxic chemicals and environmental health issues by location.

Michael Kosnett, MD, MPH, adjunct associate professor in the Department of Environmental and Occupational Health in the Colorado School of Public Health, said, “There are a number of very important databases that NLM maintains, like TOXNET, that you can’t find anywhere else in the world.”

SIS Acting Director Gale Dutcher summed up the SIS efforts this way: “Working in teams is a part of our culture. We not only continue to maintain our basic resources but also respond to public health incidents.” Looking back at the Elk River spill, she said, “This was a phenomenal effort.”

By Tom Conuel, with assistance from Mary Ann Leonard, Melanie Modlin, and Kathryn McKay