A new report released by the state Department of Health provides an assessment of the health effects people may have faced after being exposed to jet fuel, the cleaning product Simple Green, high levels of chlorine and an anti-icing agent in their drinking water after a pipeline burst at the Navy’s Red Hill fuel facility on Nov. 20 2021.

While it was quickly clear that the Navy’s nearby drinking water system had been contaminated in the days after the fuel leak, tests of the drinking water by the Navy did not provide a helpful analysis of exactly what was in the water that people were drinking and bathing in, and at what levels. Out of urgency, the Navy was primarily testing the water for total organic carbon (TOC), a rough screening tool used to gauge the presence of contamination, rather than total petroleum hydrocarbons and volatile organic compounds, which would have helped assess health risks, according to DOH’s report.

That rough screening tool also proved unreliable, giving residents false assurances that their water was safe.

“Residents in areas where elevated TOC was not reported were told that they could continue to use the water up to at least December 9, 2021,” according to DOH’s report. “Residents still using the water at least as late as December 9th were subsequently sickened, with symptoms ranging from rashes, nausea, burning stomachs and lungs, diarrhea, headaches, convulsions and in at least one case temporary, partial paralysis.”

The Navy’s guidance was in contrast to a DOH warning on Nov. 29, 2021, that all users of the Navy’s water system, which totaled about 93,000 people, should avoid using the water for drinking, cooking and oral hygiene.

Red Hill families who are suing the Navy over the water contamination have been eagerly awaiting the report. Many of them have claimed ongoing health problems as a result of being exposed to the contamination.

Army Maj. Amanda Feindt, whose family is part of the lawsuit, said the report is a helpful counterweight to Navy assertions made throughout the crisis that water test results for contaminants were below DOH “action levels,” or the level that would prompt an environmental or health response.

While the DOH report doesn’t provide new findings as to what was in the water, it does provide a more comprehensive assessment of the health risks faced by residents living in and around Joint Base Pearl Harbor- Hickam at the time of the the water crisis.

Residents began experiencing burning rashes from showering as early as Nov. 25, 2021, five days after the pipeline rupture, according to DOH’s report. By Nov. 27, reports of fuel odors, sheens, emulsions and foam in the tap water became widespread.

Some people also reported flammable vapors coming from their taps, which DOH’s report says could have been from the jet fuel or an icing inhibitor that the military had added to its fuel to prevent the formation of ice crystals., called diethy­lene glycol monomethyl ether (DiEGME).

“The compound DiEGME is of particular concern for potential health risks both because of its relatively higher concentration in the fuel in comparison to other additives and its predicted miscibility in water,” according to DOH’s report.

The health effects of being exposed to high concentrations of hydrocarbons from the jet fuel include eye and skin irritation, headaches, dizziness, gagging, vomiting, diarrhea and depressed respiration, according to the report. Acute exposure to DiEGME can cause headaches, dizziness, tiredness, nausea, vomiting and eye irritation.

Water users may also have been exposed to Simple Green and high levels of chlorine in the water, which the Navy added out of concerns about a potential buildup of bacteria in the system. Excessive chlorine can cause eye and nose irritation and stomach discomfort.

How all of this might have mixed in the drinking water system, and the potential health implications, remains unclear.

“Additive and synergistic effects related to simultaneous exposure to hydrocarbons and DiEGME as well as disinfection products and surfactants in the water complicate a full understanding of exposure conditions and related health effects,” according to the report.

DOH concluded that some residents may have been exposed to the contamination for as long as two weeks.

The report also notes concerns among Red Hill families that their water may have been contaminated as early as May 2021, when there was another fuel spill at Red Hill. DOH concluded that water sample data from the Red Hill shaft that leads to the Navy’s water system did not indicate jet fuel contamination in the months following this spill. However, contaminants were detected in the groundwater and Red Hill shaft throughout the summer. DOH’s report hypothesizes that the contaminants may have been from chemicals used to clean the tunnel following the May spill, older petroleum products that were flushed from bedrock beneath the tanks during the cleanup, algae or contaminants from an unknown or unreported spill at the facility.

DOH said additional research into the conta­minants was ongoing and beyond the scope of the report.