Researchers have found that cases of depression, post-traumatic stress disorder (PTSD) and lack of trust in public officials are rising roughly two-and-a-half years after a Norfolk Southern train derailed and spilled toxic chemicals in East Palestine, Ohio.
Why It Matters
On February 3, 2023, a freight train carrying toxic chemicals—including vinyl chloride, butyl acrylate, ethylhexyl acrylate and ethylene glycol monobutyl—derailed in East Palestine about a quarter mile west of the Ohio-Pennsylvania state line and spilled toxins in a waterway feeding into the Ohio River.
National attention was paid to the incident due to nefarious effects on locals and the broader environment. Then-President Joe Biden and his administration were ridiculed for their response, accused of not publicly releasing concerning health information while not providing Americans with sufficient information. President Donald Trump, in the infancy of his third presidential campaign, traveled to East Palestine shortly after the derailment to show support for the community and touted the impact of his visit shortly thereafter on social media.
What To Know
Researchers who co-authored what they described as the most comprehensive study yet on the aftermath of the derailment spoke with Newsweek about their findings, published Tuesday in the Journal of Traumatic Stress. The study, titled “Prevalence of PTSD and Major Depression in Ohio, Pennsylvania, and West Virginia 9 Months After the East Palestine Train Derailment,” was funded in part by the National Institutes of Health.
The study correlates upticks in mental disorders among potentially exposed residents of Ohio, Pennsylvania and West Virginia roughly nine months post-derailment. The cross-sectional study, consisting of a nonprobability sample of 1,000 adults living within 65 miles of the derailment site and who completed a self-administered clinical survey interview, assessed PTSD and major depression, physical health symptoms, negative derailment-related beliefs and experiences, and preexisting psychiatric risk factors.
The peer-reviewed study’s most notable findings show upticks, including:
- Approximately 15 percent of respondents met criteria for presumptive PTSD symptoms, more than twice the national average.
- Approximately 13 percent met criteria for major depression, about 60 percent greater than the national average.
- About half of respondents within proximity of the disaster have reported new or worsening physical symptoms including coughing, fatigue and eye irritation. Those living closer to the scene of the accident reported higher incidents.
- More than half of residents said they had little to no confidence in public officials during and after the incident, expressing a distrust of public officials and uncertainty about chemical exposure.
Effects of Disasters On Mental Health
“What we noticed was in that aftermath of the derailment, in addition to these concerns around exposure that were being reported by a lot of news sources at the time—there was a lot of initial data to suggest that these people were reporting physical and mental health problems as well,” study co-author Dr. Cameron Pugach of the Medical University of South Carolina told Newsweek.
“So, we were really motivated in this study to provide the first kind of comprehensive investigation and in a large-scale mental health survey to kind of quantify the extent to which people were reporting these mental health problems and these physical health problems, and the extent to which people were actually reporting these levels of concerns specifically associated with with toxic substance exposure,” Pugach continued.
Along with the mental health consequences, he noted how nearly three-quarters (73.9 percent) of respondents were concerned about potential toxic exposure, while another 92.1 percent were wary about associated health problems.
Also, about half the respondents reported at least one physical health problem following the derailment—with respiratory and gastrointestinal problems being the most common.
“When you look at like national level data, for example on PTSD, the rates that are being reported in the sample in and around East Palestine are over twice the prevalence of the national estimates of PTSD in the U.S., so they’re quite elevated,” Pugach said. “I think it’s pretty comparable to what you’d see in other kinds of disasters like this.”
Aaron Reuben, study co-author and an assistant professor of neuropsychology at the University of Virginia, said these types of mental health surveys became more customary following major disasters and cultural events, like the September 11 attacks or Flint water crisis—the latter of which also resulted in long-lasting psychiatric problems, including increases in reported PTSD and depression.
“There’s an interesting phenomenon with this event, which is that it was very dramatic. It was highly publicized,” Reuben told Newsweek via phone. “And if you lived in the area, because they burned so many tanks worth of chemicals, you know they were worried about explosion. The sky was filled with these extremely dramatic plumes, what we know to be toxic material…things that you would absolutely not want to be exposed to.”
He said evacuation efforts made within a mile of the site, coupled with burning tanks and broader efforts to mitigate the impacts that some studies ascertained reached some 14 percent of the United States, led to a lot of concerns.
“We had a lot of dispersion, which means it could be a lot of people exposed to very little or some people exposed to very lot—and we just had no idea,” Reuben said. “What we are seeing in our survey today is that uncertainty is leading to a lot of concern, a lot of feeling like you’re having physical health symptoms that are the kind you would experience if you had been exposed.
“Then, a lot of mental health problems that actually are significant and numerous and severe enough that if you were to walk into a clinic, we would diagnose you with a condition that needs to be treated. What we’re seeing is a really unique event.”
Reuben said the extent to which he and fellow researchers think people will recover is going to vary person to person, adding that he wouldn’t be confident that “anything would have changed” if they conducted a similar survey a year from now.
Pugach said that long-term longitudinal research that samples PTSD, from a general standpoint, shows that once developed, PTSD is a fairly chronic condition among people who develop it, and it tends to kind of stick around unless people are actively seeking trauma-focused treatment.
One prong of the research is finding how to help the people who have already experienced the trend in and around East Palestine. The second is how researchers can use this data to inform and improve responses to disasters when they happen in the future in other communities, he said.
“Improving kind of the credibility and the quality of information people are receiving in the short-term aftermath of disasters like this is going to help, I think, address people’s uncertainty around like exposure itself,” Pugach said. “And we know that those factors are associated with the extent to which people are reporting things like PTSD and depression.
“I think receiving that quality information from trusted officials is really going to help people in kind of managing their symptoms in the aftermath of these kinds of events.”
What People Are Saying
Study co-author Dean Kilpatrick, of the Department of Psychiatry and Behavioral Sciences, at the Medical University of South Carolina, in a statement: “In the future we may need to attend more in advance to limit psychological uncertainty after these events. Providing communities with timely and credible information about the likelihood of exposures should be considered front-line responses.”
What Happens Next
A July 2025 update from the Environmental Protection Agency (EPA) stated that as restoration nears completion, the cleanup area of the derailment site is shrinking and crews are assessing waterways for remaining oily sheens and to determine what additional cleanup may be needed.
The National Institute of Environmental Health Sciences (NIEHS) issued a Research Opportunity Announcement (ROA) for organizations to participate in a study to address the immediate and longer-term health concerns from exposures to chemicals released during the train derailment. The proposed settlement (lodged consent decree) between the U.S. and Norfolk Southern includes creating a community health program to provide medical monitoring and mental health services.
Groundwater, surface water and drinking water around the scene continue to be regularly sampled, per the EPA.
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