Commentary: The Ohio Train Derailment and Chemical Intolerance

Just think.

If vinyl chloride could have been gradually vented from the rail cars (in the Ohio train derailment that occurred Feb. 3, 2023), there might not have been any problem. However, “burning off“ the tons of organic (petro) chemicals aboard the train generated enormous clouds of ultrafine combustion particles (smoke). Buoyed by air currents and carried for miles, these ultrafine particles (which are odorous even at very low concentrations) are “adsorbed” onto the surfaces of every leaf, vehicle, and structure outdoors, and “absorbed” by every porous surface—from bricks, boards and concrete to wallboard, carpeting, and fabrics indoors, to clothing, fur, hair, and skin.

When a major exposure event like this one occurs, it can sensitize our immune systems’ “first responders”— specialized white blood cells called “mast cells” that are born in our bone marrow and migrate to the interface between all of our tissues and the external environment — our airways, skin and GI tract.

Sensitization of these cells by a foreign substance (xenobiotic) initiates “toxicant-induced loss of tolerance (TILT).” In the second stage of TILT referred to as “triggering,” these sensitized mast cells will “degranulate,” releasing timed cascades of pre-formed and newly formed molecules including histamine and other mediators which inflame the exposed tissue and can migrate to other tissues. When sensitized mast cells in the olfactory-limbic tract, the so-called “nose-to-brain” pathway, degranulate, there is no blood-brain barrier to protect vital portions of our brain’s limbic system.

The limbic system is where mood (amygdala) and attention/memory (hippocampus) reside. “Brain fog” is a common complaint of “TILTed” patients. Once mast cells have been sensitized and TILT has developed, everyday exposures including common, previously well-tolerated inhalants, foods, and drugs can trigger degranulation of sensitized mast cells.

“Triggering” is the second stage of TILT. Common triggers include inhalants like tobacco smoke and fragrances, also ingestants such as alcoholic beverages, caffeine, particular foods and food additives including former favorites such as chocolate, red wine and beer, and formerly well-tolerated medications. Patients’ symptoms wax and wane—seemingly unpredictably—in response to these triggers. Severely affected individuals may no longer tolerate exposures at home, work, school, or places or worship.

What these Ohio residents will experience is apt to resemble the “medically unexplained symptoms and syndromes” experienced by individuals exposed to oil well fires during the Gulf War (1990-1991), soldiers exposed to burn pits (up to 2015), workers and civilians exposed to the World Trade Center disaster (2001), workers and coastal residents exposed the Deepwater Horizon Gulf Oil spill and dispersants (2010), and Lebanese citizens exposed to massive explosions at the Port of Beirut (2020).

TILT is predictable.

Why must U.S. workers and Ohio citizens be subjected to these same exposures in 2023?

It is because doctors and public health practitioners have not yet learned about TILT.

TILT is initiated by two principal classes of toxicants:

  1. biogenic toxicants including particles and VOCs from toxic molds, algal blooms, etc., and
  2. fossil fuel-derived toxicants from coal, oil, natural gas, their combustion products, and synthetic chemical derivatives.

The latter include all “POPs” (persistent organic pollutants), endocrine disruptors, pesticides, plasticizers, breast and other implants, and VOCs in the air of “sick buildings,” etc.

Synthetic organic chemicals are new to the planet and all species since World War II; that is, within the past 100 years—a few generations ago. In contrast, mast cells evolved more than 500 million years ago in early vertebrate fish. Our exposures to fossil fuel combustion products began during the Industrial Revolution (1750-1840), less than 300 years ago.

Fossil fuels are threatening every species on this planet “from without” via climate change, and “from within” by mast cell/immune system disruption.

Cleanup from these environmental disasters is extraordinarily difficult, costly to all concerned, and exposes workers and communities to additional hazards. Exposures first must be prevented. Civilians evacuated. Then airline or powered air purifying respirators with HEPA and activated charcoal filtration must be provided to workers.

Author: Dr. Claudia Miller, allergist/immunologist, professor emeritus, and leader of the Hoffman TILT Program at UT Health San Antonio

Editor’s Note: Photos via EPA